inefficiency of the constabulary in suppressing public disorder,
cited by Blount.
On page 403 of his book he says, speaking of Governor Taft and disorder
in the province of Albay which arose in 1902-1903:--
"He did not want to order out the military again if he could
help it, and this relegated him to his native municipal police
and constabulary, experimental outfits of doubtful loyalty,
and, at best, wholly inadequate, as it afterwards turned out,
for the maintenance of public order and for affording to
the peaceably inclined people that sort of security for life
and property, and that protection against semi-political as
well as unmitigated brigandage, which would comport with the
dignity of this nation."
The facts as to these disorders are briefly as follows:--
In 1902 an outlaw in Tayabas Province who made his living by
organizing political conspiracies and collecting contributions in
the name of patriotism, who was known as José Roldan when operating
in adjoining provinces, but had an alias in Tayabas, found his life
made so uncomfortable by the constabulary of that province that he
transferred his operations to Albay. There he affiliated himself
with a few ex-Insurgent officers who had turned outlaws instead
of surrendering, and with oath violators, and began the same kind
of political operations which he had carried out in Tayabas, the
principal feature of his work being the collection of "contributions."
The troubles in Albay were encouraged by wealthy Filipinos who saw in
them a probable opportunity to acquire valuable hemp lands at bottom
prices, for people dependent on their hemp fields, if prevented from
working them, might in the end be forced to sell them. Roldan soon
lost standing with his new organization because it was found that he
was using for his personal benefit the money which he collected.
About this time one Simeon Ola joined his organization. Ola was
a native of Albay, where he had been an Insurgent major under the
command of the Tagálog general, Belarmino. His temporary rank had
gone to his head, and he is reported to have shown considerable
severity and hauteur in his treatment of his former neighbours
in Guinobatan, to which place he had returned at the close of the
insurrection. Meanwhile, a wealthy Chinese _mestizo_ named Don Circilio
Jaucian, on whom Ola, during his brief career as an Insurgent officer,
had laid a heavy hand, had become _presidente_ of the town.
Smarting under the indignities which he had suffered, Jaucian made it
very uncomfortable for the former major, and in ways well understood
in Malay countries brought it home to the latter that their positions
had been reversed. Ola's house was mysteriously burned, and his life
in Guinobatan was made so unbearable that he took to the hills.
Ola had held higher military rank than had any of his outlaw
associates, and he became their dominating spirit. He had no grievance
against the Americans, but took every opportunity to avenge himself
on the _caciques_ of Guinobatan, his native town.
Three assistant chiefs of constabulary, Garwood, Baker and Bandholtz,
were successively sent to Albay to deal with this situation. Baker
and Bandholtz were regular army officers. The latter ended the
disturbances, employing first and last some twelve companies of
Philippine scouts, armed, officered, paid, equipped and disciplined
as are the regular soldiers of the United States army, and a similar
number of constabulary soldiers. Eleven stations in the restricted
field of operations of this outlaw were occupied by scouts. There were
few armed conflicts in force between Ola's men and these troops. In
fact, it was only with the greatest difficulty that this band, which
from time to time dissolved into the population only to reappear
again, could be located even by the native soldiers. It would have
been impracticable successfully to use American troops for such work.
Referring to the statement made by Blount [492] that Vice-Governor
Wright made a visit to Albay in 1903 in the interest "of the
peace-at-any-price policy that the Manila Government was bent on,"
and the implication that he went there to conduct peace negotiations,
General Bandholtz, who suppressed outlawry in Albay, has said that
Vice-Governor Wright and Commissioner Pardo de Tavera came there
at his request to look into conditions with reference to certain
allegations which had been made.
Colonel Bandholtz and the then chief of constabulary, General Allen,
were supported by the civil governor and the commission in their
recommendations that no terms should be made with the outlaws. The
following statement occurs in a letter from General Bandholtz dated
September 21, 1903:--
"No one is more anxious to terminate this business than I am,
nevertheless I think it would be a mistake to offer any such
inducements, and that more lasting benefits would result by
hammering away as we have been doing."
And General Allen said in an indorsement to the Philippine
Commission:--
"... in my opinion the judgment of Colonel Bandholtz in
matters connected with the pacification of Albay should
receive favourable consideration. Halfway measures are always
misinterpreted and used to the detriment of the Government
among the ignorant followers of the outlaws."
These views prevailed.
Blount has claimed that the death rate in the Albay jail at this
time was very excessive, and cites it as an instance of the result
of American maladministration.
Assuming that his tabulation [493] of the dead who died in the Albay
jail between May 30 and September, 1903, amounting to 120, is correct,
the following statements should be made:--
Only recently has it been demonstrated that beri-beri is due to the
use of polished rice, which was up to the time of this discovery
regarded as far superior to unpolished rice as an article of food,
and is still much better liked by the Filipinos than is the unpolished
article. Many of these deaths were from beri-beri, and were due to
a misguided effort to give the prisoners the best possible food.
Cholera was raging in the province of Albay throughout the period
in question, and the people outside of the jail suffered no less
than did those within it. The same is true of malarial infection. In
other words, conditions inside the jail were quite similar to those
then prevailing outside, except that the prisoners got polished rice
which was given them with the best intentions in the world, and was
by them considered a superior article of food.
With the present knowledge of the methods of dissemination of
Asiatic cholera gained as a result of the American occupation of
the Philippines, we should probably be able to exclude it from a
jail under such circumstances, as the part played by "germ carriers"
who show no outward manifestations of infection is now understood,
but it was not then dreamed of. One of the greatest reforms effected
by Americans in the Philippines is the sanitation of the jails and
penitentiaries, and we cannot be fairly blamed for not knowing in
1903 what nobody then knew.
The troubles in Albay ended with the surrender of Ola on September
25, 1903. Blount gives the impression that he had a knowledge of them
which was gained by personal observation. He arrived in the province
in the middle of November, seven weeks after normal conditions had
been reëstablished.
On October 5, 1903, General Bandholtz telegraphed with reference to
the final surrender of Ola's band:--
"The towns are splitting themselves wide open celebrating
pacification and Ramon Santos (later elected governor) is
going to give a record-breaking fiesta at Ligao. Everybody
invited. Scouts and Constabulary have done superb work."
Blount makes much of disorders in Samar and Leyte. Let us consider
the facts.
In all countries feuds between highlanders and lowlanders have been
common. Although the inhabitants of the hills and those of the lowlands
in the two islands under discussion are probably of identical blood
and origin, they long since became separated in thought and feeling,
and grew to be mutually antagonistic. The ignorant people of the
interior have always been oppressed by their supposedly more highly
civilized brethren living on or near the coast.
The killing of Otoy by the constabulary in 1911 marked the passing
of the last of a series of mountain chiefs who had exercised a very
powerful influence over the hill people and had claimed for themselves
supernatural powers.
Manila hemp is the principal product upon which these mountaineers
depend in bartering for cloth and other supplies. The cleaning of
hemp involves very severe exertion, and when it is cleaned it must
usually, in Samar, be carried to the seashore on the backs of the
men who raise it. Under the most favourable circumstances, it may be
transported thither in small _bancas_ [494] down the streams.
The lowland people of Samar and Leyte had long been holding up the
hill people when they brought in their hemp for sale in precisely the
way that Filipinos in other islands are accustomed to hold up members
of the non-Christian tribes. They played the part of middlemen,
purchasing the hemp of the ignorant hill people at low prices and
often reselling it, without giving it even a day's storage, at a very
much higher figure. This system was carried so far that conditions
became unbearable and finally resulted in so-called _pulájanism_
which began in the year 1904.
The term _pulájan_ is derived from a native word meaning "red" and
was given to the mountain people because in their attacks upon the
lowlanders they wore, as a distinguishing mark, red trousers or a
dash of red colour elsewhere about their sparse clothing. They raided
coast towns and did immense damage before they were finally brought
under control. It should be remembered that these conditions were
allowed to arise by a Filipino provincial governor, and by Filipino
municipal officials. It is altogether probable that a good American
governor would have prevented them, but as it was, neither their cause
nor their importance were understood at the outset. The _pulájan_
movement was directed primarily against Filipinos.
The first outbreak occurred on July 10, 1904, in the Gandara River
valley where a settlement of the lowlanders was burned and some of its
inhabitants were killed. Eventually disorder spread to many places on
the coast, and one scout garrison of a single company was surprised
and overwhelmed by superior numbers. Officers and men were massacred
and their rifles taken.
In point of area Samar is the third island in the Philippines. In
its interior are many rugged peaks and heavily forested mountains. It
was here that a detachment of United States marines under the command
of Major Waller, while attempting to cross the island, were lost for
nearly two weeks, going without food for days and enduring terrible
hardships.
At the time in question there were not five miles of road on the
island passable for a vehicle, nor were there trails through the
mountains over which horses could be ridden. The only interior lines
of communication were a few footpaths over which the natives were
accustomed to make their way from the mountains to the coast.
Troops have perhaps never attempted a campaign in a country more
difficult than the interior of Samar. The traditional needle in the
haystack would be easy to find compared with an outlaw, or band of
outlaws, in such a rugged wilderness.
Upon the outbreak of trouble troops were hurried to Samar, and by
December, 1904, according to Blount himself, there were some 1800
native soldiers on the island who were left free for active operations
in the field by the garrisoning of various coast towns with sixteen
companies of United States infantry.
If the nature of the feuds between the Samar lowlanders and highlanders
had then been better understood, the ensuing troubles, which were
more or less continuous for nearly two years, might perhaps have
been avoided. As soon as it became evident that the situation was
such as to demand the use of the army it was employed to supplement
the operations of the constabulary.
About the time that trouble ended in Samar it began in Leyte. There
was no real connection between the disorders in the two islands. No
leader on either island is known to have communicated with any leader
on the other; no fanatical follower ever left Samar for Leyte or
Leyte for Samar so far as we are informed.
For convenience of administration the two islands were grouped in a
single command after the army was requested to take over the handling
of the disturbances there, in coöperation with the constabulary. The
trouble ended in 1907 and both islands have remained quiet ever
since. The same causes would again produce the same results now or
at any time in the future, and they would be then, as in the past,
the outcome of the oppression of the weak by the strong and without
other political significance. Under a good government they should
never recur.
Many circumstances which did not exist in 1902 and 1904 made it
feasible to use the army in Samar and Leyte during 1905 and 1906. The
high officers who had exercised such sweeping powers during the
insurrection had meanwhile given way to other commanders. Indeed,
a practically new Philippine army had come into existence. The
policy of the insular government as to the treatment of individual
Filipinos had been recognized and indorsed by Americans generally,
but many of the objections to the use of the troops, including the
heavy expense involved, still existed and I affirm without fear of
successful contradiction that had it been possible to place in Samar
and Leyte a number of constabulary soldiers equal to that of the
scouts and American troops actually employed, disorder would have
been terminated much more quickly and at very greatly less cost.
With the final breaking up of organized brigandage in 1905 law and
order may be said to have been established throughout the islands. It
has since been the business of the constabulary to maintain it. The
value of the coöperation of the law-abiding portion of the population
has been fully recognized. The newly appointed constabulary officer
has impressed upon him the necessity of manifesting an interest in the
people with whom he comes in contact; of cultivating the acquaintance
of Filipinos of all social grades, and of assisting to settle their
disagreements and harmonize their differences whenever possible. He
is taught a native dialect.
The constabulary have to a high degree merited and secured
the confidence and good-will of the people, whose rights they
respect. There is a complete absence of the old arbitrary procedure
followed by the _guardia civil_ and as a result there are frequent
requests from Filipino officials for additional detachments, while
the removal of a company from a given community is almost invariably
followed by vigorous protests. The power of human sympathy is very
great, and as the attitude of constabulary officers and men is usually
one of sympathy, conciliation and affection, that body has earned
and deserved popularity.
The success of the constabulary in apprehending criminals has been
both praiseworthy and noteworthy. The courage and efficiency which
have often been displayed by its officers and men in hard-fought
engagements with Moro outlaws or with organized bands of thieves
and brigands have been beyond praise. Many of its officers have
rendered invaluable service in bringing the people of the more
unruly non-Christian tribes under governmental control, not only
bravely and efficiently performing their duty as police officers,
but assisting in trail construction or discharging, in effect, the
duties of lieutenant-governors in very remote places which could be
visited by the actual lieutenant-governors only infrequently. I later
take occasion to mention the valuable work done by Lieutenant Case
in the early days of Ifugao, and to dwell at length on the splendid
service rendered there by Lieutenant Jeff D. Gallman, who was for
many years lieutenant-governor of the subprovince while continuing
to serve as a constabulary officer. Lieutenant Maimban at Quiangan,
and Lieutenant Dosser at Mayoyao, have been and are most useful,
though they do not hold official positions under the Mountain Province
or receive any additional compensation for the special services which
they render. Captain Guy O. Fort served most acceptably as governor of
the province of Agusan during the interim between the resignation of
Governor Lewis and the appointment of Governor Bryant and Lieutenants
Atkins and Zapanta have also rendered valuable service as assistants to
the provincial governor. Lieutenant Turnbull is now assistant to the
governor of Nueva Vizcaya for work among the Ilongots on the Pacific
coast of northern Luzón. Other constabulary officers, who have not
been called upon for special service of this kind, have performed
their ordinary duties in such a way as to demonstrate that they were
actuated by the spirit of coöperation and have been of great help.
But the work of the constabulary has not been confined to police
duty. They have been of the greatest assistance to the Director of
Health in effectively maintaining quarantine, and making possible the
isolation of victims of dangerous communicable diseases like cholera
and smallpox, when inefficient municipal policemen have utterly failed
to do their duty. They have given similar assistance to the Director
of Agriculture in the maintenance of quarantine in connection with
efforts to combat diseases of domestic animals. In great emergencies
such as those presented by the recent eruption of Taal volcano, and
the devastation caused by great typhoons, they have been quick to
respond to the call of duty and have rendered efficient and heroic
service. They assist internal revenue officers. Except in a few of
the largest cities they are the firemen of the islands and by their
effective work have repeatedly checked conflagrations, which are of
frequent occurrence and tend to be very destructive in this country,
where most of the houses are built of bamboo and nipa palm, and
where roofs become dry as tinder during the long period when there
is little or no rain. They have aided in combating pests of locusts,
and, in short, have been ready to meet almost any kind of an emergency
which has arisen.
The importance of having such a body of alert, industrious,
disciplined, efficient men inspired by a high sense of duty, and
physically so well developed that they can continue to perform
that duty in the face of long-continued privations and hardships,
is beyond dispute. The results which have been obtained by the
Philippine constabulary have abundantly justified the policy which
led to its organization.
Its task has been no sinecure. Eleven officers and one hundred
ninety-seven enlisted men have been killed in action. Forty-eight
officers and nine hundred ninety-one men have died of
disease. Forty-six officers have been wounded in action. Seven hundred
sixty-eight men have been discharged for disability. Seven thousand
four hundred twenty-four firearms and 45,018 rounds of ammunition have
been captured by, or surrendered to, the constabulary. Four thousand
eight hundred sixty-two outlaws have been killed and 11,977 taken
prisoners. Twelve thousand two hundred sixty-two stolen animals have
been recovered.
There are many things which are not brought home to the reader
by such statistics. The weary days and nights on tropical trails;
the weakness and pain of dysentery; the freezing and the burning of
pernicious malaria; the heavy weight of responsibility when one must
act, in matters of life and death, with no superior to consult; the
disappointment when carefully laid plans go wrong; the discouragement
caused by indifference; the danger of infection with loathsome
diseases; ingratitude; deadly peril; aching wounds; sudden death,
and, worse yet, death after suffering long drawn out, when one meets
one's end knowing that it is coming and that one's family will be
left without means or resources,--these are some of the things that
the officers and men of this gallant corps have faced unflinchingly.
The work of the constabulary and of the Philippine scouts has
conclusively demonstrated the courage and efficiency of the Filipino
as a soldier when well disciplined and well led.
The establishment and maintenance of order in the Philippines have
afforded opportunity for some of the bravest deeds in the annals of
any race, and the opportunity has been nobly met. The head-hunters
of the Mountain Province, the Mohammedan Moros of Mindanao, Joló
and Palawan, the bloody _pulájanes_ of Samar and Leyte, the wily
_tulisanes_ of Luzón, all unrestrained by any regard for the rules
of civilized warfare, have for twelve years matched their fanatical
bravery against the gallantry of the khaki-clad Filipino soldiers. Time
and again a single officer and a handful of men have taken chances
that in almost any other land would have won them the Victoria cross,
the legion of honor, or some similar decoration. Here their only
reward has been the sense of duty well done.
The force known as the Philippine constabulary was organized for the
purpose of establishing and maintaining order. It has established
and is maintaining a condition of order never before equalled or
approached in the history of the islands. The policy which led to
its organization has been a thousand times justified.
CHAPTER XV
The Administration of Justice
In no branch of the public administration have there been more
numerous or more beneficial reforms than in the administration of
justice. They have resulted in simplifying organization, in decreasing
the possibility of corruption and partiality, and in diminishing the
cost of litigation and the time which it requires.
For the benefit of those especially interested I give in the appendix
the past and present organization of the courts. [495] The subject
is too technical to interest the average layman.
The slender salaries paid to judges, the fact that in the majority
of cases their appointment and promotion were due to influence and
suggestion, their liability to be transferred from one court to another
or from the Philippines to the Antilles, as frequently happened, and
the further fact that the subordinate personnel of the courts was not
a salaried one, caused the administration of justice in the Philippine
Islands to be looked upon askance. There was a general belief, well
founded in many instances, that lawsuits were won through influence
or bribery. Clerks and the subordinate personnel of the courts were
readily bribed. Indeed, they frequently demanded bribes from litigants,
or from defendants in criminal cases, under promise to expedite the
trials if paid to do so, or under threat to commit some injustice
if payment was not forthcoming. For many years after the American
occupation justices of the peace received no salaries and had to look
to fees for their compensation. This system worked wretchedly. The
positions were only too often filled by very incompetent and unworthy
men, who stimulated litigation in order to make more money. Now all
justices of the peace receive reasonable salaries.
The paying of regular salaries and the furnishing of necessary
offices and supplies have done much to improve the work of justice
of the peace courts, which are now presided over by men who average
far better than even their immediate predecessors.
Until they were put on a salary basis the work of the Filipino
justices of the peace left much more to be desired than is lacking
at present. In many instances they allowed gross brutalities,
perpetrated by the rich on the poor, or by the strong on the weak,
to go unpunished. The following case furnished me by an American
teacher is typical of what has occurred only too often:--
"On another occasion, I met the brother of my house _muchacha_,
[496] a boy about eight. He had a sort of protuberance on
one side caused by broken ribs which had not been set. I
questioned my _muchacha_. She said her step-father had kicked
the child across the room some weeks before and broken his
ribs. The next day, I took the child together with Señora
Bayot, the wife of the Governor's secretary, before the local
Justice of the Peace. Señora Bayot translated and the child
told the same story as had his sister. The Justice of the
Peace issued an order for the step-father to report to him
on the next day. That night my _muchacha_ told me that her
step-father had threatened to kill the child if he did not
tell the Justice that he got the hurt by falling out of an
orange tree. The child did as ordered, and the step-father was
dismissed. When I questioned the Justice of the Peace as to
why he credited the second tale, he said the child was under
oath then, and was not under oath in the first statements."
It was not deemed wise at the outset to appoint a Filipino judge for
the city of Manila, as it was feared that there would be a lack of
confidence in a Filipino who had occasion to decide cases involving
large sums of money in which Americans or foreigners on the one hand
and Filipinos on the other were interested; but a few years after
the establishment of the new judicial system Filipino judges had won
such a reputation for justice and fairness as to gain the confidence
of Americans and foreigners and the appointment of a Filipino judge
for the court of the city of Manila did not arouse any opposition.
Filipino judges of courts of first instance seem usually to have
been actuated by a desire to do full justice. The instances in which
complaints have been made against them because of partiality to party
or to race are few. Some of them have been justly criticised for
tardiness in cleaning up their dockets, and it is undoubtedly true
that their capacity for turning out work is on the average below that
of their Americans associates.
The fact must not be forgotten that Americans are in the majority
in the Supreme Court, which reviews the decisions of courts of first
instance, and this undoubtedly exercises a restraining influence. It
is not possible accurately to judge what would be the actions of a
body of men now subject to such control if it did not exist. It is
furthermore true that the Filipinos are more inclined to be suspicious
of their own countrymen than of Americans, and there have been from
time to time specific requests from them that judges in certain
provinces be Americans.
Under the Spanish régime the fees paid by litigants were excessive
and the use of stamped paper was compulsory. Its value ranged from
twenty-five centavos to two pesos for a folio of two sheets according
to the amount involved in the suit. Now there are fixed fees of $8
in civil suits, except in probate matters, where the fee is $12.
It was in the power of an unscrupulous litigant to make a lawsuit
almost eternal. In matters involving an amount exceeding $250 it was
lawful to institute proceedings in the action whereby the decision of
the main issue was suspended pending decision of the proceedings, and
as a decision was appealable to the _audiencia_, this was often done
by attorneys who had an interest in delaying the suit. By instituting
one proceeding after another a suit could be indefinitely prolonged.
Another method of securing delay was to object to the judge. In
case the judge denied the ground of the objection, a proceeding was
instituted against him and the trial of the main issue was turned over
to another judge; although the proceeding arising out of the objection
did not suspend the trial of the main issue, when the time came to
decide the latter the decision was withheld until the proceeding
arising out of the objection was settled, and as this latter was one
in connection with which other proceedings could be instituted which
might delay the decision and consequently the decision of the main
issue, there was no end to the matter.
To-day all this has been stopped by the procedure in court. The
challenging of judges is not allowed, although they must refrain
from the trial of any matter when they are disqualified in any way
as regards it. Proceedings which suspend the trial of the main issue
cannot be instituted. The procedure itself is more expeditious,
the time allowances and formalities have been reduced, and all the
long Spanish civil procedure regarding the presentation of evidence
has been shortened. Suits are settled with a speediness previously
unknown. In order to avoid delay on the part of judges in rendering
decisions, an act has been passed prohibiting the payment of their
salaries without a certificate that they have no matter which has
been awaiting decision for more than three months.
Owing to the inquisitorial procedure which obtained under Spanish
rule, the disposition of criminal cases was even slower than that
of civil cases. The cause would be commenced, either _de officio_,
by the judge who had a knowledge of the crime, or by the prosecuting
attorney, or by virtue of private accusation on the part of the person
aggrieved. The case once started, the investigations made during the
period known as the _sumario_ were conducted in the absence of the
accused. The latter had no hand in the case, as it was thought that
the reserve and secrecy of the procedure ought not to be violated
to the end that the accused might not frustrate the evidence of
the prosecution by preparing his defence. Owing many times to the
inactivity of the judge or of the prosecuting attorney, to the great
amount of work which weighed down the courts--for actions were begun
when there was knowledge of the commission of the crime, although the
perpetrators were not known--and by the manipulations at other times
of the private accuser to whose interest it was to harm the accused
by delaying the _sumario_, this period was often made to extend over
years and years. Meanwhile the defendant was confined in prison,
as no bail was allowed in any case in which the penalty was that of
_presidio correccional_ (from six months and one day to six years'
imprisonment) or greater. In addition to this the circumstance that all
criminal causes in the islands had to be sent for review to the proper
_audiencia_, caused a large accumulation of old cases in these higher
courts, and this alone made their disposition a matter of some years.
To-day the procedure is rapid. Information having been brought against
the defendant, the trial is had in the same term or at most during
the next term of court. Sometimes the trial is suspended owing to the
non-appearance of witnesses, but it can be said that cases are rare
where causes are pending in the docket of the court for a longer period
than two terms. Causes appealed to the Supreme Court are disposed of
promptly, and as a general rule it does not take over six months to
get a decision.
Defendants in criminal cases have now been granted by the Philippine
Bill certain fundamentally important rights which they did not formerly
enjoy; namely, to appear and defend in person or by counsel at every
stage of the proceedings; to be informed of the nature and cause of the
accusation; to testify as witnesses in their own behalf; to be exempt
from testifying against themselves; to be confronted at the trial by,
and to cross-examine, the witnesses against them; to have compulsory
process issue for obtaining witnesses in their own favour; to have
speedy and public trials; to be admitted to bail with sufficient
sureties in all cases, except for capital offences. None of these
rights were enjoyed under the procedure in effect during the Spanish
régime. A man was prosecuted without being notified of the charges
against him, and he was only made aware of the case against him after
the _sumario_. When all of the evidence of the prosecution had been
taken the accused was heard in his own defence. He was compelled
to testify, and was subjected to a very inquisitorial examination,
including questions which incriminated him. Although he had the right
to compel witnesses for the prosecution to ratify over their signatures
the evidence against him given during the _sumario_, as the defence of
the majority of the accused was in the hands of attorneys _de officio_
they nearly always renounced this privilege of the defendant, and,
as has already been said, bail was not admitted in any grave offence
during the trial.
No sentence of acquittal in a criminal case can now be appealed from
by the government. Under the Spanish system sentences of acquittal of
courts of first instance had to be referred for review to the proper
_audiencia_ and the fiscal of the latter could appeal from a sentence
of acquittal by it.
The Philippine Bill grants to the inhabitants of the islands other
important individual rights which they did not formerly possess.
The Spanish constitution was not in force here, and although the
Penal Code contained provisions for punishing, in a way, officials who
violated certain rights granted by the Spanish constitution, citizens
had no expeditious method of securing their punishment. Now the Code of
Civil Procedure grants them certain special remedies by which their
rights can be made good. To illustrate: Under the Spanish régime
the only remedy for a man illegally detained was to bring a criminal
action against the person illegally detaining him. He did not have
the remedy of the writ of habeas corpus nor the writ of prohibition
against an official who attempted to make him the victim of some
unlawful act. His only remedy was to bring a criminal action against
such official, or to sue him for damages. He could not compel public
officials to perform their ministerial duties by mandamus proceedings.
The individual rights conferred by the Philippine Bill, and the
special remedies granted by the Code of Civil Procedure, assure to the
inhabitants of the islands liberties and privileges entirely unknown
to them during the days of Spanish sovereignty, and these liberties
and privileges are adequately safeguarded.
Two things still greatly complicate the administration of justice in
the Philippines.
The first is the dense ignorance of the people of the working class
who for the most part have failed to learn of their new rights,
and even if they know them are afraid to attempt to assert them in
opposition to the will of the _caciques_, whose power for evil they
know only too well.
The other is the unreliability of many witnesses and their
shocking readiness to perjure themselves. It is always possible to
manufacture testimony at small expense. While the criminal libel
suit brought against certain members of the staff of the newspaper
_El Renacimiento_, which libelled me, was in progress the judge
showed me the opinion of the two Filipino assessors [497] in one
of the cases and told me that it was written by an attorney for the
defence. I could not believe this, but a few days later an assessor
in another of the cases called at my house, bringing a draft of the
opinion of himself and his associate which he sought to submit to
me for criticism or modification, saying that I knew much more about
the case than they did! He was nonplussed at my refusal to read the
document, and left saying "_acqui tiene V. nuevo servidor_." [498]
Had I redrafted the opinion, as I might have done, my "new servant"
would have called later for a _quid pro quo_.
Some of the Filipino judges of first instance have proved weak in
matters affecting the integrity of public domain and the protection
of the public forests, but on the whole these officers have done
rather surprisingly well. It must be remembered that the best men
in the islands have now been appointed, and that another generation
must come on before there will be available any considerable number
of new candidates who are up to the standard of the present appointees.
CHAPTER XVI
Health Conditions
I had abundant opportunity to observe health conditions in the
Philippines during the Spanish régime and they were shocking in the
extreme. There were no provisions for the sanitary disposal of human
waste even in Manila. If one had occasion to be out on foot at night,
it was wise to keep in the middle of the street and still wiser to
carry a raised umbrella.
Immediately after the American occupation some five hundred barrels
of caked excrement were taken from a single tower in one of the old
Manila monasteries. The moat around the city wall, and the _esteros_,
or tidal creeks, reeked with filth, and the smells which assailed
one's nostrils, especially, at night, were disgusting.
Distilled water was not to be had for drinking purposes. The
city water supply came from the Mariquina River, and some fifteen
thousand Filipinos lived on or near the banks of that stream above the
intake. The water was often so thick with sediment that one could not
see through a glass of it, and it was out of the question to attempt
to get it boiled unless one had facilities of one's own.
Conditions in the provinces were proportionately worse. As a rule,
there was no evidence of any effort to put provincial towns into
decent sanitary conditions. I must, however, note one striking
exception. Brigadier General Juan Arolas, long the governor of Joló,
had a thorough knowledge of modern sanitary methods and a keen
appreciation of the benefits derivable from their application. When
he was sent to Joló, practically in banishment, the town was a plague
spot to which were assigned Spaniards whose early demise would have
been looked upon with favour by those in power. He converted it into
a healthy place the death rate of which compared favourably with that
of European cities, thereby demonstrating conclusively what could
be done even under very unfavourable conditions. No troops in the
islands were kept in anything like such physical condition as were
the regiments assigned to him, and he bore a lasting grudge against
any one inconsiderate enough to die in Joló.
Everywhere I saw people dying of curable ailments. Malaria was
prevalent in many regions in which it was impossible to secure good
quinine. The stuff on sale usually consisted largely of cornstarch,
or plaster of Paris. Fortunately we had brought with us from the
United States a great quantity of quinine and we made friends with
the Filipinos in many a town by giving this drug gratis to their sick.
Smallpox was generally regarded as a necessary ailment of childhood. It
was a common thing to see children covered with the eruption of
this disease watching, or joining in, the play of groups of healthy
little ones.
The clothing of people who had died of smallpox was handed on to other
members of the family, sometimes without even being washed. The victims
of the disease often immersed themselves in cold water when their fever
was high, and paid the penalty for their ignorance with their lives.
The average Spaniard was a firm believer in the noxiousness of night
air, which he said produced _paludismo_. [499] Most Filipinos were
afraid of an imaginary spirit, devil or mythical creature known as
_asuáng_, and closed their windows and doors after dark as a protection
against it. Thus it came about that in a country where fresh air is
especially necessary at night no one got it.
Tuberculosis was dreadfully common, and its victims were conveying
it to others without let or hindrance.
A distressingly large percentage of native-born infants died before
reaching one year of age on account of infection at birth, insufficient
clothing, or improper food. I have many times seen a native mother
thrust boiled rice into the mouth of a child only a few days old,
and I have seen babies taught to smoke tobacco before they could walk.
Before our party left the islands in 1888, cholera had broken out
at a remote and isolated place. A little later it spread over a
considerable part of the archipelago. On my return in 1890 I heard
the most shocking stories of what had occurred. Victims of this
disease were regarded with such fear and horror by their friends
that they were not infrequently carried out while in a state of
coma, and buried alive. It became necessary to issue orders to have
shelters prepared in cemeteries under which bodies were required to
be deposited and left for a certain number of hours before burial,
in order to prevent this result.
In Siquijor an unfortunate, carried to the cemetery after he had
lost consciousness, came to himself, crawled out from under a mass
of corpses which had been piled on top of him, got up and walked
home. When he entered his house, his assembled friends and relatives
vacated it through the windows, believing him to be his own ghost. They
did not return until morning, when they found him dead on the floor.
I heard a well-authenticated story of a case in which all the members
of a family died except a creeping infant who subsisted for some time
by sucking a breeding sow which was being kept in the kitchen.
During the great cholera epidemic in 1882 it is said that the
approaches to the Manila cemeteries were blocked with vehicles of
every description loaded with corpses, and that the stench from
unburied bodies in the San Lazaro district was so dreadful that one
could hardly go through it.
Beri-beri was common among the occupants of jails, lighthouses and
other government institutions, as well as in certain garrisoned towns
like Balabac.
In 1892 I found the wife of a very dear Spanish friend dying from
an ailment which in the United States could have been promptly and
certainly remedied by a surgical operation. I begged him to take her
to Manila, telling him of the ease with which any fairly good surgeon
would relieve her, and promising to interest myself in her case on
my arrival there. To my utter amazement I found that there was not a
surgeon in the Philippine Islands who would venture to open the human
abdomen. The one man who had sometimes done this in Spain stated that
it would be impossible for him to undertake it in Manila, on account
of the lack of a suitable operating room, of instruments and of the
necessary anaesthetist and other professional assistants. In fact, at
the time of the American occupation there was not a modern operating
room, much less a modern hospital, in the Philippines. Thousands upon
thousands of people were perishing needlessly every year for the lack
of surgical intervention. A common procedure in dealing with wounds
was to cover them with poultices of chewed tobacco, ashes, and leaves.
In many provinces the people were without medical assistance of
any sort, and fell into the hands of native quacks who were little,
if at all, better than witch doctors.
The most fantastic views were entertained relative to the causation
of disease. In some towns it was vigorously asserted that after a
peculiar looking black dog ran down the street cholera appeared. In
other places cholera was generally ascribed to the poisoning of wells
by Spaniards or foreigners.
Cemeteries were not infrequently situated in the very midst of towns,
or near the local supplies of drinking water. Conditions within
their walls were often shocking from an aesthetic view point. As the
area available for burials was limited, and the graves were usually
unmarked, parts of decomposed bodies were constantly being dug up. It
was the custom to throw such remains about the foot of the cross at
the centre of the cemetery.
Military sanitation was also very bad. I was at Zamboanga when
the wreck of General Weyler's expedition to Lake Lanoa began to
return. There had been no adequate provision for the medical care of
the force in the field, and the condition of many of the soldiers was
pitiable in the extreme. Disabled men were brought in by the shipload,
and the hospitals at Zamboanga, Isabela de Basilan and Joló were soon
filled to overflowing.
The lack of adequate sanitary measures was equally in evidence in
dealing with cattle disease. Rinderpest, a highly contagious and
very destructive disease of horned cattle, was introduced in 1888 and
spread like fire in prairie grass. No real effort was made to check
it prior to the American occupation, and it caused enormous losses,
both directly by killing large numbers of beef cattle and indirectly
by depriving farmers of draft animals.
When I first visited the islands every member of our party fell
ill within a few weeks. All of us suffered intensely from tropical
ulcers. Two had malaria; one had dysentery; one, acute inflammation
of the liver, possibly of amoebic origin; and so on to the end of
the chapter. I myself got so loaded up with malaria in Mindoro that
it took me fifteen years to get rid of it.
Fortunately the American army of occupation brought with it numerous
competent physicians and surgeons, and abundant hospital equipment
and supplies, for the soldiers promptly contracted about all the
different ailments to be acquired in the islands.
When I arrived in Manila on the 5th of March, 1899, I found that a
great army hospital, called the "First Reserve," had been established
in the old rice market. There was another sizable one on the Bagumbayan
drive. A third occupied a large building belonging to French sisters
of charity which was ordinarily used for school purposes.
In immediate connection with the First Reserve Hospital was a tent
hospital where sick and wounded Insurgents were being given the best
of care.
Field hospitals were promptly established as the troops moved out
from Manila, and in connection with many of these Filipinos were given
much needed medical and surgical help. The recipients of such kindly
treatment were, however, prohibited by Insurgent officers from telling
others of their experiences lest the hatred of Americans diminish as
a result.
Smallpox had broken out among the Spanish soldiers in the walled
city and was spreading badly when my friend, Major Frank S. Bourns
of the army medical corps, was given the task of eradicating it,
which he promptly accomplished. A little later the use of the Santa
Ana church as a smallpox hospital was authorized, and sick Filipinos
were carefully tended there.
The army promptly set about cleaning up Manila and waging war
upon the more serious ailments which threatened the health of the
soldiers and that of the public. The work was at the outset put under
the direction of Major Edie, a very capable and efficient medical
officer. Subsequently it was turned over to Major Bourns, who, on
account of his intimate knowledge of Spanish, and his wide acquaintance
with the Filipinos, was able to carry out many much-needed reforms,
and in doing so aroused a minimum of public antagonism.
Upon the establishment of civil government Governor Taft was very
desirous of retaining Major Bourns's services, but this did not prove
practicable, as he desired to give up government work and engage in
private business.
There was promptly created an efficient board of health made up of men
of recognized ability and large practical experience. Its chairman was
Major Louis M. Maus, commissioner of public health. The other members
were Mr. H. D. Osgood, sanitary engineer; Dr. Franklin H. Meacham,
chief sanitary inspector; Dr. Paul C. Freer, superintendent of
government laboratories; and Dr. Manuel Gomez, secretary.
This board was promptly put upon its mettle. It had inherited from
the army an incipient epidemic of bubonic plague in Manila, and
the disease soon spread to Cavite and also to Cebú, then the second
port of the Philippines in commercial importance. It also appeared in
several provincial towns near Cavite. An effective campaign against it,
inaugurated at this time, was never abandoned until it was completely
eradicated in 1906,--a noteworthy result to achieve in a country like
the Philippines.
On March 21, 1902, I was advised that two patients at San Juan de
Dios hospital were developing symptoms of Asiatic cholera, and on the
following day a positive laboratory diagnosis was made. Other cases
followed in quick succession, and we soon found ourselves facing a
virulent epidemic of this highly dangerous disease. At the outset
the mortality was practically 100 per cent. Unfortunately, there was
no one connected with the medical service of the islands who had had
practical experience in dealing with cholera, and we had to get this
as we went along.
At the time of the outbreak, Governor Taft was in the United States,
Acting Governor Wright was in Leyte, the secretary of finance and
justice was in Japan, and there were present in Manila only the
secretary of public instruction and the secretary of the interior. As
the executive head of the government was absent, and there was no
quorum of the legislative body, I of necessity arrogated to myself
powers which I did not lawfully possess, appointing employees and
incurring expenses without the usual formalities.
On the morning of March 22 I informed General Chaffee that four cases
of cholera had occurred in Manila, and requested that an adequate
military force be despatched to the valley of the Mariquina River to
protect the city water supply from possible contamination.
This request was promptly acceded to, and the guard thereafter
maintained proved adequate to prevent infection of the city water,
although there are three towns on the river above the intake, and it
was the custom of their people to bathe and wash their clothing in
this stream. Many of the filthy surface wells of the city were filled
as rapidly as possible, and those that could not be filled were closed.
The people, entirely unaccustomed as they were to any sanitary
restrictions, believing that the disease was not cholera, and firm in
their conviction that they had a right to do whatever they liked so
long as they kept on their own premises, bitterly resented the burning
or disinfection of their houses and effects, and the restriction of
their liberty to go and come as they pleased, and in spite of the
fact that the number of cases was kept down in a manner never before
dreamed of at Manila, there arose an increasingly bitter feeling of
hostility toward the work of the board of health. In fact, the very
success of the campaign proved an obstacle, and we were assured that
the disease could not be cholera, as, if it were, there would be a
thousand deaths a day!
An educational campaign was immediately begun, and simple
directions for avoiding infection were published and scattered
broadcast. Distilled water was furnished gratis to all who would drink
it, stations for its distribution being established through the city
and supplemented by large water wagons driven through the streets. The
sale of foods likely to convey the disease was prohibited. Large
numbers of emergency sanitary inspectors were immediately appointed,
and every effort was made to detect all cases as soon as possible. A
land quarantine was established around the city, to protect the
provinces.
In anticipation of a possible extensive outbreak of contagious disease
a detention camp capable of accommodating some twenty-five hundred
people had been established previously on the San Lazaro grounds, and
to this place were taken the cholera "contacts." A cholera hospital
was opened near this camp, and the stricken were removed to it from
their homes as speedily as possible, the buildings which they had
occupied being thoroughly disinfected, or burned if disinfection
was impracticable.
The bodies of the dead were at the outset either buried in hermetically
sealed coffins or cremated. When the detention camp and hospital at
San Lazaro threatened to become crowded, a second camp and hospital
were established at Santa Mesa. At this latter place both "contacts"
and the sick were obliged to live in tents.
The Spanish residents were allowed to establish a private cholera
hospital in a large and well-ventilated _convento_ on Calle Herran. As
the number of sick Spaniards was nothing like sufficient to fill this
building, they were asked to turn over the unoccupied space in it to
the board of health, which they most generously did.
In response to popular clamour a hospital under strictly Filipino
management was opened in a nipa building in Tondo. Interest in it
soon flagged, and the government found itself with this institution
on its hands.
The epidemic came soon after the close of a long-continued war,
and there were at that time in Manila not a few evil-intentioned
persons, both foreign and native, who welcomed every opportunity
to make trouble. The difficulties arising from the claim advanced
by a number of reputable but ignorant medical men that the disease
was not cholera at all were sufficiently great. They were enormously
increased by false and malicious stories to the effect that "contacts"
were killed at the detention camp; that patients on arrival at the
cholera hospital were given a drink of poisoned _vino_ [500] and
instantly dropped dead; that the distilled water distributed free of
charge was poisoned, and that the Americans were poisoning the wells.
The necessary use of strychnine as a heart stimulant at the cholera
hospital was made the basis for a story that the sick were being
poisoned with this drug.
These silly tales were widely circulated and quite generally believed,
and as a result of the fear thus engendered, and of the desire on
the part of relatives and neighbours of stricken persons to escape
disinfection and quarantine, strong efforts were often made to conceal
the sick and the dead, and when this was not possible the "contacts"
usually ran away. There were not wanting instances of the driving of
cholera victims into the streets.
In spite of the generally hostile attitude of the public and some
grave mistakes in policy, the measures adopted sufficed at the outset
to hold the disease in check to an extent which surprised even the
health officers themselves.
On May 15 there began a rapid and quite steady decline in the number
of cases.
In June, however, it increased. During July it grew steadily larger,
and on the 25th of that month there were ninety-one cases, the
largest number which has ever occurred in Manila on any day since
the American occupation.
Throughout the early months of the epidemic Major Maus had laboured
unceasingly to check it, displaying an energy and an indifference to
fatigue and personal discomfort which were highly commendable. The
long-continued strain ultimately began to tell on him severely. On
May 17 orders were received from the Adjutant-General's Office
providing for his relief on or about July 30, and stating that Major
E. C. Carter, of the United States Army Medical Corps, would be
available for detail as commissioner of public health on that date,
if his services were desired. Arrangements were accordingly made to
have Major Carter proceed to the Philippines. Major Maus's resignation
was accepted, effective July 31. Dr. Frank S. Bourns was urged to
take temporary charge of the situation, and consented to do so.
On the 8th of August Major Carter arrived and announced his readiness
to assume his duties, but it was suggested to him that he ought first
to have some time to familiarize himself with them, and Dr. Bourns
was left free to carry out the special work for which he had been
appointed.
This he did with promptness and despatch, the number of cases for
August being but seven hundred twenty as against thirteen hundred
sixty-eight for the previous month. On the 8th of September, having
brought the disease under control at Manila, he insisted on resigning
in order to attend to his private affairs, which were suffering from
neglect, and his resignation was reluctantly accepted.
Dr. Bourns's remarkable success in dealing with a very difficult
situation was largely due to his ability to devise measures which,
while thoroughly effective, were less irritating to the public than
were those which had been previously employed.
The policy which he had inaugurated was followed by his successor
with the result that the cases fell to two hundred seventy-five
in September and eighty-eight in October. In November there was
a slight recrudescence, but the disease did not again threaten to
escape control and in February practically disappeared, there being
but two cases during the entire month.
The return of hot, damp weather again produced a slight recrudescence,
and scattering cases continued to occur until March, when the epidemic
of 1902-1904 ended in Manila.
In view of the conditions which then prevailed and of the extreme
risk of a general infection of the city water supply, which, had it
occurred, would doubtless have resulted in the death of a third of
the population, this is a record of which the Bureau of Health may
well be proud.
The effort to prevent the spread of infection by maintaining a land
quarantine around Manila proved entirely ineffective. The disease
promptly appeared in the provinces where the campaign against it
was from the outset in charge of newly appointed Filipino presidents
of provincial boards of health, aided, when practicable, by medical
inspectors from Manila.
Before it was finally checked in Manila there were 5581 cases with
4386 deaths; while in the provinces, in many of which it necessarily
long ran its course practically unhindered, there were 160,671 cases,
with 105,075 deaths.
On the 27th of April, 1904, the Board of Health passed the following
resolutions:--
"Whereas cases of Asiatic cholera have occurred in but three
provincial towns of the Philippine Islands since February 8,
1904; and
"Whereas only one case of Asiatic cholera has been reported as
occurring any place in the Philippine Islands since March 8,
1904; and
"Whereas the city of Manila was declared on March 23 to be
free from the infection of Asiatic cholera; On motion
"_Resolved_, That the islands composing the Philippine
Archipelago are, and are hereby declared to be, free from
the infection of Asiatic cholera; and
"_Be it further resolved_, That the Commissioner of Public
Health be directed to send a copy of these resolutions to the
honourable the Secretary of the Interior, the Municipal Board,
the United States Marine-Hospital Service, and the Collector
of Customs."
As a matter of fact, however, it later proved that cholera was endemic
in certain swampy regions near Manila, and in 1905 we found ourselves
with a new epidemic on our hands.
At the end of the second week, beginning August 23, there had been one
hundred thirty-seven cases, as compared with one hundred twenty-five
for the same period during the epidemic of 1902-1904.
However, the conditions for combating cholera were now far more
favourable than in 1902. Major E. C. Carter had at his own request been
relieved from duty as commissioner of public health, and Dr. Victor
G. Heiser, passed assistant surgeon of the United States public
health and marine hospital service, had been appointed to succeed
him on April 5, 1905. Dr. Heiser was a highly trained officer of one
of the most efficient services which has ever been organized for the
combating of contagious and infectious diseases.
He had under him in the city of Manila a small but thoroughly trained
body of twenty-four medical inspectors, of whom nineteen were Americans
and five Filipinos. Profiting by his previous experience and that of
his predecessors in the Philippine service, he inaugurated a campaign
which practically terminated the epidemic in Manila on February 21,
1906, [501] with a total of two hundred eighty-three cases and two
hundred forty-three deaths.
This brief and decisive campaign reflects the greatest credit on all
concerned with it.
The board of health had one great advantage in the fact that the San
Lazaro contagious disease hospital had been completed. This building,
with its cool wards and attractive surroundings, made it possible to
give cholera victims the best of care.
There was at the outset little or no fear of this hospital, but
apparently this condition of things was not satisfactory to that
small but dangerous element of the Manila public which from the time
of the American occupation has never let pass any opportunity to make
trouble. As usual, the medium of attack was the local press. _Soberanía
Nacional_ published a most extraordinary article painting in vivid
colours the alleged horrors of the San Lazaro Hospital, and stating
among other things that the naked bodies of the dead, tagged and with
their feet tied together, lay about the entrance of that institution. A
more false statement was never published.
Within twenty-four hours after its appearance terror reigned among
the lower classes, and living and dead cholera victims were being
smuggled out of the city to neighbouring towns.
Feeling that the vicious attitude of a certain section of the press
had cost lives enough, I sent the editor of this paper a courteous
invitation to call at my office. He made no response. I then wrote
him, demanding a retraction, and sending him a correct statement to
publish. [502]
He was at first disposed to argue the matter, but finding that I
meant business published the article which I sent to him and made
the following retraction:--
"We are exceedingly glad to affirm in the honour of truth and
justice, that the news given by us on the seventh instant under
the title 'Painful Scenes,' and 'Naked Dead,' is absolutely
absurd, false and unreasonable.
"We have investigated the truth of the said notice, and can
affirm to our readers that it is entirely inaccurate, as in
the courtyard of the said hospital the naked dead that we
have spoken of are not now exposed, nor have they ever been
so exposed.
"The truth is above all things, and to rectify a baseless
piece of news should not be a doubtful action on the part
of the person who gave the news, but rather something in his
favour that the public should appreciate it at its full value.
"To conclude, we must record our gratitude to the Secretary
of the Interior, the Hon. Dean C. Worcester, for the
investigations made in the premises with the purpose of
ascertaining the truth of the alleged facts, and for the
courteous way in which he received us this morning when
interviewed by one of our reporters."
In the provinces the results of the campaign against cholera were
far less satisfactory than in Manila as was to be anticipated, owing
to lack of adequate personnel, but the cases, which numbered 34,238
and deaths which numbered 22,938, were far fewer than during the
previous epidemic.
I shall not attempt here to trace the course of the subsequent
epidemics which have occurred from time to time, but shall content
myself with giving the deaths by years. In 1908, they numbered 18,811;
in 1909, 7306; in 1910, 6940; in 1911, 203. In 1912, there were none,
and thus far in 1913 there have been none. [503]
The superstitious practices which were formerly employed by the
Filipinos to combat this scourge have given way to simple and
inexpensive hygienic measures, and we can safely count on sufficient
coöperation from the people to make an effective campaign possible
when it next appears.
Never shall I forget the strain of the early days of the first
epidemic. Two of my best men, Dr. Meacham and Mr. Mudge, literally
worked themselves to death, remaining on duty when they knew that
they were in imminent danger, and in the end laying down their lives
willingly for an alien and hostile people. Such things make one proud
of being an American.
At times the situation was not devoid of amusing features. I had
occasion to visit one of the northern provinces, where the epidemic was
especially severe, in an effort to calm the panic-stricken populace. I
stayed with the governor, a very intelligent Filipino. For obvious
reasons I investigated his domestic arrangements, finding that he
was boiling drinking water, thoroughly cooking all food, and taking
all usual and necessary precautions to prevent infection.
On returning to his house the first evening, after a short absence, I
found the grounds decorated with lighted Japanese lanterns. Supposing
that the proverbial Filipino hospitality had risen above even such
untoward circumstances as those which then existed, I asked the
governor what the entertainment was to be. In evident perplexity he
replied that he had not planned to have any entertainment, and on
my inquiring what the lanterns were for, said he had heard that they
were good to keep away cholera germs!
I have referred to the fact that the civil government inherited a
fairly well developed epidemic of bubonic plague. In 1901 this disease
caused four hundred twenty-seven deaths, in 1902 it caused ten only,
but the demands made on the sanitary force by the cholera epidemic
which began in that year rendered it impossible to give to plague
the attention which it otherwise would have had, with the result
that in 1903 we had one hundred seventy-four deaths. In 1904 there
were seventy-eight; in 1905, forty-three; in 1906, seven; in 1907,
none; and from 1907 until 1912, none. In the latter year the disease
was reintroduced.
Rats become infected with it, and fleas transmit it from them to human
beings. It was probably brought in by pestiferous rodents hidden
inside packages of vegetables, as it appeared in a district where
crates of vegetables are opened in large numbers, and did not appear
in the vicinity of the piers, although shore rats are abundant there,
and if diseased rodents had landed from shipping, would promptly have
become infected,--a thing which did not occur.
At about the same time plague also appeared at Iloilo, where it was
eradicated with a total of nine deaths. At Manila there have been
up to the present time [504] fifty-nine deaths, and scattering cases
continue to occur at considerable intervals.
Had plague not been promptly and effectively combated, it would
unquestionably have spread rapidly, causing untold misery and heavy
property losses.
As I have previously stated, at the time of the American occupation
smallpox was by many people regarded as an almost inevitable ailment
of childhood. It proved necessary to secure the passage of legislation
forbidding the inoculation of human beings with it to prevent misguided
Filipinos from deliberately communicating it to their children, not
because they did not dearly love them, but because they regarded
infection with it as a calamity sure to come sooner or later, and
desired to have it over with once for all.
We have performed more than ten million vaccinations, with the result
that the annual deaths from this disease have decreased from forty
thousand at the outset to seven hundred for the year just ended. There
is now less smallpox in Manila than in Washington.
In the six provinces nearest Manila it was killing, on the average,
six thousand persons annually. For a year after we finished vaccinating
the inhabitants of these provinces it did not cause a death among them;
nor has it since caused such a death except among new-born children
or newly arrived unvaccinated persons.
These extraordinary results have been achieved without the loss of
a life or a limb so far as we know. The vaccine used was prepared by
our own Bureau of Science with extraordinary care, and has proved to
be remarkably pure and active.
We at first endeavoured to have vaccinations performed by local
Filipino health officers, but, after spending large sums without
obtaining satisfactory results, gave up this plan and substituted
therefor a method of procedure by which the work was carried on under
the very immediate supervision of the director of health. We then made
substantial progress. However, under the law as it at present stands,
succeeding annual vaccination, intended to insure the immunization
of children soon after they are born and of unvaccinated persons who
may come into a given territory, are intrusted to the local Filipino
authorities, with the result that in very many cases they are not
attended to. We get elaborate returns showing the number of persons
vaccinated. Then comes an outbreak of smallpox, and on investigation
we learn that the vaccinations so fully reported were made on paper
only! In other words, the continuance of this work, of such vital
importance to the Filipino people, is still directly dependent upon
continued control by American health officers.
Another great problem now in a fair way to final solution is the
eradication of leprosy. At the outset we were told by the church
authorities that there were thirty thousand lepers in the islands. In
1905 we began to isolate and care for all supposed victims of this
disease, only to find that many outcasts believed to be suffering
from it were really afflicted with curable ailments. We were able to
restore a very large number of them to society, to their great joy
and that of their friends.
A few hundreds of true lepers were being humanely cared for in
Manila and elsewhere. Many others had been driven out of the towns
into forests or waste places on the larger islands, where they were
perishing miserably from fever and other diseases. Still others had
been isolated on sand quays, where they were in danger of dying from
thirst during the dry season. Not a few wandered through the towns
at will, spreading the disease broadcast.
All known lepers are now cared for at Culion, a healthful, sanitary
town with good streets, excellent water and sewer systems, many modern
concrete buildings and a first-class hospital.
They are not confined to the limits of the town, but wander at will,
except that they are excluded from the immediate vicinity of the
houses of the officers and employees of the colony.
They may have their little farms, and raise pigs, chickens, vegetables,
etc., if they wish. They may, and do, float about over the waters of
the neighbouring bay in boats or on rafts, and fish to their hearts'
content. They are well fed and well cared for, and their physical
condition improves to a marked degree promptly after their arrival at
the colony. The only hardship which they suffer is that necessarily
involved in separation from their relatives and friends, and this is
mitigated by occasional visits which the latter may make them.
Since we began to isolate lepers, their number has decreased to
approximately three thousand, and with a continuance of the present
policy the disease should soon disappear from the Philippines.
During the period immediately subsequent to the American occupation,
amoebic dysentery wrought sad havoc both among our soldiers and among
civil government officers and employees. Four of my own family of five
had it, and one had it twice, in spite of the fact that we took all
known precautions; and the experience of my family was by no means
exceptional. This disease then annually cost the lives of a large
number of American men and women, and a considerable additional
number went home invalids for life as a result of infection with
it. We seemed to hear almost daily of some new case.
Careful scientific investigation carried on at the bureau of science
taught us the best methods of combating this type of dysentery,
and the proper disposal of human feces, the regulation of methods
used in fertilizing vegetables, improvement in supplies of drinking
water, and other simple, hygienic measures have reduced the deaths
from it among Americans to an almost negligible minimum. Such cases
as occur are almost without exception detected early, and readily
yield to treatment.
The belief that Filipinos do not suffer from this disease has proved
to be without foundation. It kills thousands of them every year. Those
who are willing to adopt the simple precautions which experience has
shown to be necessary may enjoy the large degree of immunity from it
which Americans now have.
The chief cause of amoebic dysentery in the Philippines has undoubtedly
been infected drinking water. From time immemorial the people have
been obtaining their water for drinking purposes from flowing streams,
open springs or shallow surface wells.
The wells were especially dangerous, as it was the common custom
to wash clothing around them so that water containing disease germs
frequently seeped into wells used by whole villages. The results of
such conditions during a cholera epidemic can readily be imagined.
The drinking supplies of many provincial towns have now been radically
improved by the sinking of 853 successful artesian wells.
In many places there has been a resulting reduction of more than
fifty per cent in the annual death rate. Large sums are spent yearly
by the government in drilling additional wells,--a policy which is
warmly approved by the common people. The recent appropriations for
this purpose have been $255,000 for the fiscal year 1912, $60,000
for 1913 and $200,000 for 1914.
When we came to the islands, malaria was killing as many persons
as was smallpox. The mortality caused by it is now being greatly
reduced by giving away annually millions of doses of quinine, and by
draining or spraying with petroleum places where mosquitoes breed,
as well as by teaching the people the importance of sleeping under
mosquito nets and the necessity of keeping patients suffering from
active attacks of malaria where mosquitoes cannot get at them. Only
quinine of established quality is allowed in the market.
The results obtained in combating malaria are often very
striking. Calapan, the capital of Mindoro, was in Spanish days known as
"the white man's grave" on account of the prevalence of "pernicious
fever" there. To-day it is an exceptionally healthy provincial town.
At Iwahig, in Palawan, the Spaniards attempted to conduct a
penal colony. They were compelled to abandon it on account of
pernicious malaria, which caused continued serious mortality when
the American government attempted to establish a similar institution
there. Application of the usual sanitary measures has made it a
healthful place.
Old jails throughout the islands have been rendered sanitary,
or replaced by new ones. The loathsome skin diseases from which
prisoners formerly suffered have in consequence disappeared. The
practical results obtained in Bilibid, the insular penitentiary, are
worthy of special note. The annual death rate at this institution was
78.25 per thousand for the calendar year 1904. It increased steadily
each month from January, 1904, to September, 1905, when it reached
its maximum, deaths occurring at the rate of 241.15 per thousand per
year. At this time the director of health was given charge of the
sanitation of this prison.
By remedying overcrowding, improving drainage, installing sewers and
regulating diet along scientific lines, the rate was reduced in six
months to 70 per 1000, and there it stuck.
A systematic examination of the stools of prisoners was then
made. Eighty-four per cent were found to be afflicted with at least
one intestinal parasite. Fifty per cent had two or more, and twenty
per cent had three or more. Fifty-two per cent of the total had
hookworm. Active treatment for the elimination of these parasites was
begun in one barrack, and after the work was completed it was noted
that there was much less disease there than in the remainder. All
of the thirty-five hundred prisoners were ultimately examined,
and intestinal parasites eradicated if present. The death rate then
dropped to thirteen to the thousand, and has remained at or near this
figure up to the present time.
I have already referred to the discovery of the cause of beri-beri,
and to the effect of the governor-general's order forbidding the
use of polished rice in government institutions or by government
organizations.
I subsequently made a strong effort to secure legislation imposing
a heavy internal revenue tax on polished rice, thus penalizing its
use. I failed, but such effort will be renewed by some one, let us
hope with ultimate success.
In Spanish days cholera, leprosy, smallpox and other dangerous
communicable diseases were constantly reintroduced from without. This
is no longer the case. The United States public health and marine
hospital service has stretched an effective defensive line around the
archipelago and has sent its outposts to Hongkong, Shanghai and Amoy,
to prevent, so far as possible, the embarkation for Manila of persons
suffering from such ailments. We now have the most effective quarantine
system in the tropics, and one of the best in the world. At Mariveles
there is a very large and complete disinfecting plant, and vessels
may also be satisfactorily disinfected at Cebú and Iloilo.
This quarantine service kept the Philippines free from bubonic plague
for seven years, and has repeatedly prevented the entry of pneumonic
plague, that most deadly of all known diseases.
A peculiar and shockingly disfiguring disease known as yaws occurs
somewhat infrequently in the Philippine lowlands and is very prevalent
in a number of places in the highlands. In many ways it resembles
syphilis, and indeed at one time was considered to be syphilitic
in its origin. Doctor Richard P. Strong, of the Bureau of Science,
made the very important discovery that salvarsan is an absolute
specific for it. The effect of an injection of this remedy closely
approaches a miracle in medicine. In five or six days the condition
of the patient begins to improve rapidly. By the end of the second
week his horrible sores have healed.
It was with this remedy that we began our health work among some of
the wilder head-hunters of northern Luzón. Think of the advantage of
being absolutely certain of curing such an ailment in every case, and
think of the gratitude of poor wretches, undergoing untold suffering,
when they were almost immediately relieved!
Soon after this use for salvarsan was discovered, I caused a liberal
supply of it to be sent to the Bontoc Hospital. For some time we
were unable to persuade any victims of yaws to undergo treatment,
but finally we found one at Barlig who was guilty of a minor criminal
offence, arrested him, and took him to Bontoc. Instead of putting
him in jail there, we sent him to the hospital for treatment.
At first he complained bitterly that we were putting no medicine
on his sores. Then the remedy began to work and he decided it was
"strong medicine." By the tenth day he was running around town
joyfully exhibiting his rapidly healing body to every one who would
look at it. On the fourteenth day he suddenly disappeared, to the
deep regret of the medical men, who had hoped that they might keep
him as an example of what could be done, and thus persuade others
to undergo treatment. A few days later, however, he reappeared with
thirteen victims of yaws from his home town, having meanwhile twice
covered on foot the great distance which separates Barlig from Bontoc,
and assembled and brought in his fellow-sufferers.
As we have seen, the people of Manila were formerly supplied with
impure drinking water from the Mariquina River, and were therefore in
constant danger of infection with cholera and other deadly diseases. At
a cost of some $1,500,000 we have given the city a modern water system,
the intake of which is far up in the hills above the last village. The
annual deaths from ordinary water-borne diseases exclusive of cholera
have fallen from 3558--the average number at the time the new system
was introduced--to 1195. Recently a leak in the dam, which necessitated
temporary resumption of the use of the Mariquina River water, was
immediately followed by a marked increase in the number of deaths
from such diseases, thus conclusively demonstrating the fact that we
were right in ascribing the previous reduction in deaths to a better
water supply.
This annual saving of lives is an important result, but more important
yet is the fact that when Asiatic cholera reappears in the Mariquina
valley, as it inevitably will sooner or later, we shall not live in
constant fear of a general infection of the Manila water supply,
which, judging from the experience of other cities where modern
sanitary methods have been introduced, might result in the death of
a third of the population. In every country a very considerable part
of the population always fails to boil its drinking water, no matter
how great the resulting danger may be.
Manila lacked any facilities for the proper disposal of human waste,
and the conditions which resulted were unspeakable, especially in
the little _barrios_, or groups of houses, placed close together,
helter-skelter, on wet, swampy ground and reached by means of runways
not worthy even of the name of alleys, as one often had to crouch to
pass along them.
A modern sewer system costing $2,000,000, supplemented by a pail
system, has very effectively solved this problem, while thousands of
homes closely crowded on disease-infected, mosquito-breeding ground
have been removed to high, dry, sanitary sites. The regions thus
vacated have in many instances been drained, filled, provided with
city water and good streets, and made fit for human occupancy.
The old moat around the city walls was a veritable incubator of
disease. It has been converted into an athletic field where crowds
of people take healthful exercise. The _esteros_, or tidal creeks,
reeked with filth. More than twenty miles of such creeks have been
cleaned out, although much still remains to be done to put them in
really satisfactory condition.
There were no regulations covering the construction of buildings, and
it was not unusual to find six or eight persons sleeping in a closed
and unventilated room 10 × 8 × 8 feet. Manila now has an excellent
sanitary code, and such conditions have been made unlawful.
The previous woeful lack of hospital facilities has been effectively
remedied. At a cost of approximately a million and quarter pesos we
have built and equipped the great Philippine General Hospital, one of
the most modern institutions of its kind in the world, and by far the
best in the Far East. In it we have very satisfactorily solved the
question of getting sufficient light and air in the tropics without
getting excessive heat. Its buildings are certainly among the very
coolest in the city of Manila, and "the hospital smell" is everywhere
conspicuously absent.
It is called a three-hundred-bed institution, but as a matter of fact
the ventilation is so admirable that nearly two hundred additional
beds can safely be put in as an emergency measure.
Two hundred and twenty of its beds are free. In them a very large
number of persons are annually given the best of medical and surgical
care. At its free clinic some eighty thousand patients find relief
in the course of a year.
The increase in private hospital facilities has also been
noteworthy. Among the new institutions doing admirable work should be
mentioned the University Hospital, an Episcopal institution; the Mary
J. Johnston Hospital, a Methodist institution; and St. Paul's Hospital,
a Catholic institution. Patients are admitted to all of them without
regard to their religious belief, a policy the liberality of which
must commend itself to all broadminded persons.
In enumerating the hospitals of Manila, the old Spanish institution,
San Juan de Dios, should not be forgotten, for it has been improved
and modernized until it offers good facilities for the treatment of
the sick and the injured.
All of the above mentioned institutions are in effect acute-case
hospitals designed for the treatment of curable ailments. Cases
of dangerous communicable disease are excluded from them, but are
adequately provided for at San Lazaro where the insular government
has established modern and adequate hospitals for plague, smallpox,
cholera, diphtheria, scarlet fever, measles, etc., as well as a
detention hospital for lepers, pending their departure for Culion.
An insane hospital capable of comfortably accommodating 300 inmates
has also been provided. A few years since the insane were commonly
chained to floors, or tied to stakes under houses or in yards,
and were not infrequently burned alive during conflagrations. Such
conditions no longer exist, but the government is not yet able to
provide for nearly all of the insane who need institutional care.
The several institutions above mentioned have a very important
function apart from the relief of human suffering, in that they afford
unexcelled opportunities for giving practical instruction in nursing
and in the practice of medicine and surgery.
A few years ago there was not such a thing as a Filipina trained
nurse in the islands. I was firmly convinced that the Filipinas of
this country could learn to be good nurses, and made earnest efforts
to have included among the first students sent at government expense
to the United States several young women of good family who should
attend nurses' training schools and then return to assist in our
hospital work.
I failed to secure the adoption of this plan, but later the training
of nurses was inaugurated in connection with hospital work at the
old Civil Hospital, St. Paul's, the University Hospital, the Mary
J. Johnston Hospital and the Philippine General Hospital. At the latter
institution there is now conducted an admirable school where more than
two hundred young men and women are being trained. Three classes have
already graduated from it, and Filipina nurses have long since proved
themselves to be exceptionally efficient, capable and faithful. It
will be some time before we can educate as many as are needed in the
government hospitals, and after that has been accomplished a vast
field opens before others in the provincial towns, where the need of
trained assistants in caring for the sick is very great.
We found exceedingly few competent Filipino physicians or surgeons
in the islands. This condition was due not to natural incompetence
on the part of the Filipinos but to the previous lack of adequate
educational facilities. The government has established a thoroughly
modern college of medicine and surgery, well housed, and provided
with all necessary laboratory facilities. It furnishes the best of
theoretical instruction, while its students have every opportunity
for practical work at the bedsides of patients in the government
hospitals, all patients in free beds being admitted subject to the
condition that they will allow their cases to be studied.
While there is still an evident tendency on the part of graduates of
this school to feel that they know enough, and to desire to get to
making money without delay, we are nevertheless managing to attract an
increasingly large number of the more competent to the intern service
of the Philippine General Hospital, where as the result of additional
years of practical experience they become exceptionally proficient.
This institution, with its great free clinic, offers very exceptional
facilities for practical instruction, and we have already trained
some extremely competent Filipino physicians and surgeons.
As funds permit, hospital work is being extended to the provinces. At
Cebú a thoroughly up-to-date sixty-bed institution is now open. A
smaller one was established years ago at Baguio, where surgical work
may be performed with great advantage on account of the rapidity with
which convalescence occurs in the cool, pure mountain air, which also
expedites the recovery of persons recuperating from wasting diseases.
A little more than a year ago a hospital was opened at Bontoc, the
demand for accommodations being so great from the start that we did
not even await the arrival of beds. Sick Igorots were only too glad
to lie on the floor if their needs could be ministered to.
It had previously been the custom of the wild men to kill chickens,
pigs or carabaos in case of illness, in order to propitiate evil
spirits, the kind and number of animals killed being of course
determined by the wealth of the patients. They have now satisfied
themselves that quinine for malaria, salvarsan for yaws, and other
effective remedies for common ailments are more useful and more
readily obtained than was the helpful intervention of the _anítos,_
or spirits of the dead, while the methods and results of modern
surgery are a source of unending amazement and satisfaction to them.
The first surgeon to anesthetize a Kalinga became promptly and widely
known as "the man who kills people and brings them to life again,"
and the individual on whom he operated successfully, who chanced to
be the most influential chief of the tribe, became his friend for
life. Indeed, the results of medical and surgical work for the wild
men have been an important factor in bringing about and maintaining
friendly relations with them.
Their gratitude is at times very touching. At Atok, in Benguet, there
lives an Igorot chief named Palasi. When he was already old a son was
born to him. This boy, who was the delight of his declining years,
became deathly ill with confluent smallpox, and the Igorots considered
him as good as dead. At this time Sanitary Inspector Baron appeared
on the scene. He promptly turned every one else out of the house and
himself nursed the boy, saving his life. Palasi wished to pay him
for his services, but was informed by Mr. Baron that the government
paid him, and he could not accept additional compensation. Palasi
promptly made the long journey to Baguio to ascertain whether Baron
had told him the truth, and was informed by Governor Pack that this
was the case. The old man retired to Atok, quite disgusted with the
strange ways of Americans.
Six months later he again appeared at Baguio to ask the governor about
a _fiesta_ which he had just heard it was customary to celebrate
on the 25th of December. He had been told that Americans were in
the habit of giving presents to each other at this time, and asked
if this was the ease. Governor Pack said yes. Palasi then inquired
if the feast was a _good_ feast, and the custom a _good_ custom,
and was assured that both of these things were true. He next asked
if it would be a good feast for Igorots as well as for Americans,
and receiving an affirmative reply from the unsuspecting governor,
triumphantly declared that he was going to give Baron his best
horse. Under the circumstances the governor allowed him to do so.
In connection with the Bontoc Hospital we use two men, one of whom
travels from settlement to settlement, relieving minor ailments on
the spot and sending to the hospital only those patients who need
to go there, while the other stays at home and receives them. From
time to time these two doctors "change works." Pages from their daily
journals, written in the field, often read like romance.
Were I a young man, and possessed of adequate knowledge of medicine
and surgery, I would ask nothing better than to minister to the wants
of these people. One might not, and indeed would not, acquire great
wealth, but he would be rich in friends. Here lies a great field for
practical missionary work.
In connection with the health work there have been many occurrences
which were both amusing and sad. At one time there was great excitement
over a sacred spring which had appeared in Manila Bay off the district
of Tondo. It was duly blessed by Aglipay, the head of the so-called
Aglipayano church. Coincidently with its discovery there was a sharp
little outbreak of Asiatic cholera. Investigation revealed the fact
that the "spring" had its origin in a broken sewer pipe. We were
obliged to prevent the faithful from further partaking of its waters,
and thus insuring themselves a speedy trip to the better world.
At one time cases of cholera appeared scattered generally throughout
the Mariquina valley and without apparent connection. For some days we
were unable to make a guess as to their origin. Then we heard that a
"Queen" had arisen at the town of Taytay near the Laguna de Bay. An
investigation of the Queen and her activities resulted in rather
astonishing revelations. She was a very ordinary looking Tagálog girl
who had secured the body of an old bull-cart, stopped the cracks with
clay, partially filled it with water and decaying vegetable matter,
and at rather frequent intervals had bathed in the fermenting mass
thus concocted. In due time she announced herself a healer of all
the ills to which flesh is heir, and the sick flocked to her. Cholera
was then prevalent in some of the towns near Taytay, and there were
persons suffering from it among those seeking relief. Some of them
were directed to wash their hands in the extemporized tank, while
others bathed their bodies in it. As a result it soon contained a
cholera culture of unprecedented richness. This was given to patients
applying for treatment, and was bottled and sent to those who were
too ill to come in person. Hence numerous scattering cases of cholera
which did not bear any relationship to other known cases.
It proved quite an undertaking to put the Queen of Taytay out of
business. We first asked the local authorities to have her sent to
Manila, but the presidente and the police declined to act. We then
applied for a warrant to the Filipino judge of the court of first
instance having jurisdiction over Taytay, but that worthy official
found it convenient to be suddenly called out of the province. At
last we prevailed upon soldiers of the Philippine constabulary to
arrest the queen and bring her to Manila.
We had anticipated that she might prove insane, but she showed herself
to be a very keen-witted young woman. We employed her at the San Lazaro
Hospital to look after cholera patients. The people of Taytay were
not satisfied, and a few days later a large delegation of them came
to Manila and demanded the Queen. I was at my wits' end to know what
to do, but old Spanish law can usually be relied upon in emergencies,
and the attorney-general discovered a provision couched in very general
terms, which provided against disobedience to the authorities. It was
only necessary for an "authority" to have read to an ordinary person a
statement setting forth what that person must not do; then if the order
was violated, such person could be made to suffer pains and penalties.
I accordingly prepared a most impressive order prohibiting the Queen
of Taytay from further engaging in the practice of medicine, had her
followers drawn up in battalion formation, placed myself at the front
and centre, caused the Queen to be brought before me, and read her my
communication, at the same time charging the good people of Taytay
not to tempt her again to try her hand at healing, for the reason
that if they did she would surely get into serious trouble. They
marched away with the Queen and I have not heard of her since.
Hardly a year goes by that some similar miraculous healer does not
set up in business, and the supply of dupes seems to be unending.
While it is comparatively easy to combat disease in a place like
Manila, what of the provinces, where in many cases there is not one
physician to two hundred thousand inhabitants?
To meet this difficulty we have an organization of district and
municipal health officers. A district may include a single province
or several provinces. A district health officer is invariably a
physician who has had reasonably thorough practical training in the
work of public sanitation, usually at Manila.
He is supposed to spend his time in sanitary work rather than in
treating sick individuals, but it is, of course, impossible for him
always to refuse to treat such persons, and we encourage gratuitous
work for the poor when it can be carried on without interfering too
seriously with more important duties.
Presidents of municipal boards of health may exercise jurisdiction over
a single municipality or over several. They are supposed to maintain
good sanitary conditions in their respective towns, under the general
supervision of district health officers, and to instruct their people
in sanitary methods and their results, as well as to devote a certain
amount of their time to the relief of the suffering poor.
On the whole it must be admitted that while this system has
accomplished much, it has fallen far short of accomplishing what
it should.
Men like Dr. Arlington Pond of Cebú have wrought marvels, and have
conclusively demonstrated the fact that it is not the system that
is at fault. Of our thirteen district health officers, ten are
Filipinos. They are, with few exceptions, letter-perfect. They know
what they ought to do, but as a rule lack the initiative and the
courage to do it.
Recently after discovering exceptionally bad sanitary conditions in
several towns of the province of Misamis, I demanded an explanation
of the district health officer, an exceptionally well-educated and
intelligent Filipino physician. I found, as I had anticipated, that
the sanitary regulations of his towns left little to be desired,
but that they were absolutely ignored.
I asked him what sense there was in paying his salary if he failed
to remedy such conditions as I had discovered. He replied that if he
were really going to compel people to clean up, it would be necessary
to begin with the provincial governor, whose premises were in a bad
state. When I suggested that in my opinion the provincial governor
would be the best possible man to begin with, the doctor evidently
thought me crazy!
It is as yet impossible for the average intelligent Filipino to
understand that the rich and the poor, the powerful and the weak,
should be treated alike.
It often happens that a province asks for an American health officer,
or a Filipino demands the services of an American physician. My
invariable procedure in such cases has been to request that the
application be made in writing. For some mysterious reason the
petitioners are seldom willing to go on record.
A short time since we had a strong demand from Iloilo for an American
district health officer. I made the usual suggestion and got a written
request that there be sent to Iloilo a district health officer "after
the style of the district health officer of Cebú." If Dr. Pond's
nationality may be considered a part of his style, then this was a
request for an American, otherwise not!
With rather shocking frequency, Filipinos who must be examined for
leprosy or some other dangerous communicable disease strongly insist
that the examination be made by an American bacteriologist rather
than by one of their own countrymen.
In connection with recent election troubles two men were wrongfully
denounced as lepers. In several instances perfectly sound people
have been thrust among lepers who were being taken on board steamer
for transfer to Culion. This grievous wrong was committed by their
enemies under cover of darkness, and in the confusion which attends
the embarking of a number of people in a heavy sea. The reason why
the services of Americans are often specially requested for diagnostic
work is not far to seek!
It is a significant fact that our greatest success in establishing
satisfactory provincial sanitary conditions has been achieved in
certain of the "special government provinces," where the people are
under the very direct control of American officials.
There is not a regularly organized province in the Philippines in
which the towns are as clean as are those of Mindoro, where, until
recently, we have never had a resident district health officer.
I believe that nowhere in the tropics can there be found native
towns which are cleaner or more healthful than are those of Bukidnon,
inhabited in some instances by people who have literally been brought
down out of the tree-tops within the last two or three years. We have
never had a resident health officer in this subprovince.
I mention these facts not as an argument against health officers, but
as a proof of what can be done without them by intelligent Americans
vested with proper authority.
It has given me especial pleasure to see the fundamental change which
has come about in public sentiment relative to medical, surgical
and sanitary work. At the outset sanitary inspectors and vaccinators
carried on their work at serious risk of personal violence. Indeed,
several of them were killed. Incredible tales were believed by the
populace, with the result that cholera victims sometimes had to be
taken to the hospital by force. In later years it has been by no
means unusual for them to come in voluntarily and request treatment.
General hospitals were in the old days regarded as places where people
so unfortunate as to have no homes to die in might go to end their
days. It was almost impossible to get any other class of persons
into them.
Now we constantly turn away deserving patients from the Philippine
General Hospital because of lack of room. The common people are
flocking to it in rapidly increasing numbers. We even have "repeaters,"
and persons who drop in just to get a comfortable bed and a bath while
waiting for an examination which will inevitably show that there is
nothing wrong with them.
Our difficulties were increased at the outset by the fact that many
foreign medical men working in the Far East good-naturedly ridiculed
our efforts to better conditions, claiming that in tropical colonies it
was customary to take only such steps as would safeguard the health of
European residents, and that it was really best to let the masses live
as they would, since orientals were incapable of sanitary reform, and
the attempt to bring it about involved a waste of effort that might
be more profitably directed elsewhere. Furthermore these men were,
in their several countries, practising what they preached.
It has been very interesting to note the reaction of American methods
upon those previously in vogue in neighbouring colonies. At first
our efforts to make Asiatics clean up, and to eliminate diseases
like leprosy, cholera and plague, were viewed with mild amusement,
not unmixed with contempt; but the results which we obtained soon
aroused lively interest.
Foreign governments began to send representatives to the annual
meetings of the "Philippine Island Medical Association," [505] in
order to learn more of our methods. From these small beginnings sprang
"The Far Eastern Association of Tropical Medicine," the biennial
meetings of which bring together the most experienced, skilful and
widely known physicians and sanitarians in the East for an interchange
of views and experiences which is invaluable, and greatly facilitates
concerted action between the various governments concerned in dealing
with what may be termed "international health problems."
The first meeting of this Association was held at Manila, the second
at Hongkong. The third will take place at Saigon.
The results of a rigid enforcement of the "Pure Food and Drugs Act"
are worthy of more than passing notice. Such enforcement has been
comparatively easy as the officials concerned are not hampered
by politics. The Philippines were at one time a dumping-ground for
products that could not be sold elsewhere, but it is now possible for
Filipinos to obtain wholesome preserved foods and unadulterated drugs,
except in very remote places where none of any sort are available.
The cost of our medical and sanitary work has been comparatively
small. The per capita rate of taxation here is lower than in any
other civilized country. What we have done has been accomplished
without spending vast sums of money or resorting to military measures.
The results obtained are very largely due to the faithfulness
and efficiency of Dr. Victor G. Heiser, who was chief quarantine
officer of the Philippines when he succeeded Major E. C. Carter as
commissioner of public health on April 5, 1905, and was later made
director of health when the original board of health was abolished
as an administrative entity. He has continued to hold the office of
chief quarantine officer, and thus has been in complete executive
control of the health situation for eight years.
Through good report and ill, mostly ill, he has given unsparingly of
his time, his skill and his wisdom, always treating the government
money as if it were his own.
His tenure of office has been long enough to enable him to inaugurate
and carry out policies, and thus get results.
Seldom, if ever, have health officials been more viciously and
persistently attacked than have Dr. Heiser and myself. The assaults
on us have been the direct result of a firm stand for a new sanitary
order of things, established in the interest of the whole body of
inhabitants of these islands, civilized and uncivilized. We both
welcome the profound change in public sentiment, which has slowly
but surely come about as a result of practical accomplishment.
Many very grave health problems still confront the insular
administration. Of these the most serious are the eradication of
tuberculosis and the reduction of the very high infant mortality rate.
It is believed that about one Filipino in five suffers from
tuberculosis in some form during his life and the work we have thus
far accomplished in many fields must be considered as in a way a
clearing of the decks for action against this, the greatest enemy of
all. However, the Philippines do not differ essentially from other
civilized countries, in all of which tuberculosis is a very serious
factor in the death rate.
As regards infant mortality the situation is different. More than
fifty per cent of the babes die before completing their first year of
life. The causes which lead to this appalling result have been made
the subject of careful investigation which still continues. Popular
interest has been aroused, but it is undoubtedly true that many
years of patient work will be necessary before anything approaching
satisfactory results can be brought about.
The physical condition of the average Filipino is undoubtedly
bad. Of one hundred seventy-eight university students recently
examined sixty-nine were found to be suffering from serious
organic troubles. Unquestionably the great mass of the people are
underfed. This is largely due to the poor quality of the rice which
they consume, and to the fact that rice forms too large a part of
their diet. I am firmly convinced that much of the so-called laziness
of the Filipinos is the direct result of physical weakness due to
improper and insufficient food.
Since the American occupation a large amount of time has been
successfully devoted to the working out of a good all-around diet made
up of local products the cost of which comes within the means of the
poor. The next thing will be to get them to adopt it, and there comes
the rub. Incalculable good would result, if we could only persuade the
people of these islands to sleep with their windows open. Thousands
upon thousands of infant lives would be saved annually, if mothers
could be persuaded not to give solid food to their little ones during
the early months of their existence.
In the educational campaign which we have thus far conducted with some
considerable degree of success, two agencies have proved invaluable,
namely the Catholic Church and the public schools. Again and again I
have begged Apostolic Delegate Monsignor Agius and Archbishop Harty to
bring to bear the influence of the Church in favour of simple sanitary
regulations, the general adoption of which was imperatively necessary
in combating some epidemic of disease. They have invariably given me
invaluable assistance.
Through the public schools we reach more than half a million children,
and they take the information which we convey to them home to
their parents. Simple rules for the prevention of cholera have been
universally taught in the schools. When the use of English has become
generalized the difficulty now encountered in reaching the common
people will largely disappear. The truth is that they are singularly
tractable and docile when their reason can be effectively appealed
to. The readiness with which they have submitted to the rigorous
measures necessary for the elimination of leprosy is a lasting honour
to them.
Would the sanitary campaign so vitally important to the people of
the Philippines be effectively continued if American authority were
withdrawn at this time? With regret I must answer this question
emphatically in the negative. We have succeeded in training a few
good physicians and surgeons. We have thus far failed to train
really efficient sanitary officers. What is lacking is not so much
knowledge as to what should be done as initiative and courage to do
it. Until this condition changes radically for the better, Filipinos
cannot safely be intrusted with the sanitary regeneration of their
country. Under American control the population of the islands is
steadily and rapidly increasing. It is my firm conviction that if
Filipinos were at this time placed in control of the health work,
the population would steadily and rapidly decrease.
The present attitude of the Filipino press toward sanitary work is
both interesting and important. I quote the following editorial from
the March 27, 1913, issue of _El Ideal_, a paper generally believed
to be controlled by Speaker Osmeña:--
"Some persons, who, because of being ignorant of many
things, do not sympathize with the Filipino people, who are
in the habit of frequently throwing up to them the violent
opposition of our masses to strict sanitary measures in cases
of epidemics, and the lively protests which are provoked
here on some occasions by other provisions tending to end
some public calamity, thinking they see in this disposition
of mind an indication of our incapacity to govern ourselves....
"To be more expressive, we shall say that the sanitary agents
and veterinarians of the government, swollen with power and
overly zealous of their prestige, quickly become, when an
occasion like those cited by us presents itself, cunning czars,
whose sphere of influence is in direct ratio to the peaceful
character and ignorance of the people intrusted to their
care, and whose excesses and abuses recognize no limits but
the natural ones established by the greater or lesser honour
of those public servants, their greater or lesser cynicism,
and their greater or lesser degree of temerity.
"This, and nothing else, is the logical and natural explanation
of the hostility of our people toward those measures of good
government which are sincerely esteemed for what they are
worth, but for which they have veritable terror because of
the nameless abuses to which they give rise.
"These comments are of palpitating current interest at this
moment, when reports are made almost daily to the press and
the proper authorities of misbehaviour and excesses befitting
soulless people who live without the law committed by persons
who should be examples of prudence, honesty and good manners,
for it is in this concept that the people are compelled to
furnish them their daily bread."
It is deeply to be regretted that the public press of the islands
has not yet become sufficiently enlightened to join in the great
sanitary campaign which has already relieved an enormous amount of
human suffering and has greatly increased the expectancy of life of
the people of the Philippines.
The Philippine Assembly has repeatedly passed acts providing for the
creation of a sort of sanitary council of numerous members authorized
to pass on public health measures proposed by the director of health
and instructed to disapprove them if not in accordance with the
beliefs and customs of the Filipinos.
In protecting the public health in the Philippine Islands emergencies
constantly arise which must be instantly and effectively met. It would
be as logical to place a commanding general directing a battle under
the control of an advisory board as it would thus to tie the hands of
the director of health, and it is difficult to see how any competent
and self-respecting sanitarian could be willing to continue to hold
this position if so hampered.
The Philippine Commission has heretofore invariably tabled the
acts designed to accomplish this end, but that body has now been
"Filipinized" and its future attitude on this very important
question is therefore in doubt. Hardly had the legislative session
opened in October, 1913, when the assembly again passed the same
old bill. Should it become a law, there will be occasion to watch,
with especial interest, the death rate of Manila and that of the
archipelago as a whole.
CHAPTER XVII
Baguio and the Benguet Road
In June, 1892, when sitting in a native house on a hill overlooking
Naujan Lake in Mindoro, and anxiously awaiting the boats which were
to make it possible for my party to return to the coast, I saw a
small flotilla approaching.
To my surprise and regret I found that it was not coming for us, but
brought a number of Spanish officers who had heard that we had some
mysterious procedure for killing the tamarau, an extraordinarily wild
and vicious little buffalo peculiar to this island. They had come to
get us to tell them how we did it, if possible, and if not to watch
us and find out for themselves.
We described to them our method, which was easily understood. It
consisted in picking up a likely trail along some water course,
following it until the tamarau was overtaken, and then shooting
him. This looked suspiciously simple to our Spanish friends before they
had tried it, and they shook their heads. After trying it they became
convinced that more than a few days of experience would be necessary
before satisfactory results could be obtained. They profited little
by the best information we could give them, and by the services of
the expert tracker whom we loaned to them. Meanwhile I obtained from
one of them, Señor Domingo Sanchez, information destined to become
of great importance in the development of the Philippines.
Señor Sanchez, who was an employee of the Spanish forestry bureau,
told me that in the highlands of Northern Luzón at an elevation
of about five thousand feet, there was a region of pines and oaks
blessed with a perpetually temperate climate and even with occasional
frosts. I confess that I did not believe all of his statements. I
was then experienced in climbing Philippine mountains, and at five
thousand feet had invariably found a hopeless tangle of the rankest
tropical vegetation, with humidity so high that trees were draped with
ferns, orchids, and thick moss, and dripping with moisture. However,
I knew that the mere presence of pine and oak trees would mean the
occurrence of special bird species feeding upon their seeds, and so
determined to investigate.
A severe attack of typhoid fever necessitated my leaving the islands
before I could carry out this plan, but upon my return with the first
Philippine Commission in 1899 I remembered Señor Sanchez's story. In
view of the probability that American occupation would continue
for a long period, the existence or non-existence near Manila of an
extensive highland region with a temperate climate became a question
of great practical importance. I therefore caused search to be made
in the Spanish archives to see what, if any, reliable information was
available, and to my great satisfaction unearthed a detailed report
made by a committee of three distinguished and competent Spanish
officers who had spent some weeks at Baguio in the _comandancia_ of
Benguet, during which period they had made six temperature observations
daily, had tramped over the neighbouring country very thoroughly,
had located a number of springs of potable water and determined their
approximate flow, and in short had gathered a large series of very
valuable data which more than bore out the statements of Señor Sanchez.
I found, furthermore, that Spanish engineers had made a survey for
a carriage road into this country, and had prepared a profile of it
with estimates of the amount and cost of the necessary excavation
and other work.
While in Washington during the winter of 1899-1900, I brought
this matter to the attention of Secretary Root. Just as the second
Philippine Commission was filing out of his office, after receiving
its instructions, he called out to us directing that we look into
that Benguet matter, and if the facts proved to be as stated open up
the country.
Mindful of these instructions the commission delegated General Luke
E. Wright and myself to visit Benguet and familiarize ourselves with
conditions by investigation on the ground. General MacArthur was
dubious when we expressed a desire to carry out the instructions of
the secretary of war. He told us that the country was very dangerous,
doubtless confusing it with Bangued, the capital of Abra, near which
there was at that time a strong and active Insurgent force.
We insisted on going, so he said that he would send a troop of
cavalry with us, and he kept his word. During the last week of July
we finally sailed from Manila on a naval vessel for San Fernando in
the province of Union. From this place we expected to go by road as
far as Naguilian, in the same province, and thence on horseback to
Trinidad and Baguio, in Benguet.
In order to expedite investigations as much as possible we took
with us Mr. Horace L. Higgins, president of the Manila and Dagupan
Railway Company, who was an engineer of experience, to report on
the practicability of constructing a railway to Baguio. We also took
Major L. M. Maus, of the army medical corps, and Dr. Frank S. Bourns,
who then held the volunteer rank of major in the same corps, to report
on the possibilities of the place as a health resort. Two young naval
officers went along just for the trip.
Major Maus accompanied us only because requested to do so. Taking
the latitude and altitude as a basis for his calculations, he had
already determined with a lead pencil and piece of paper just what
the climate of Baguio must be, and had demonstrated to his own
complete satisfaction that the statements of the members of the
Spanish committee above referred to were necessarily false.
His first rude shock came when we were met at San Fernando by a young
aide to Colonel [506] Duval, who was in command of the local garrison
at that place. This lieutenant told us that some negro soldiers were
stationed at Trinidad and were being kept supplied by an army pack
train. I asked him how they were getting on. He said very well,
except that they could not keep warm. They had called for all the
spare blankets available, but still complained of the cold!
The trail proved to be in execrable condition. No repair work had been
done on it since 1896, and its constant use during the then-existing
rainy season by a pack train had completed its destruction. Much of
the way it was a mere V in the earth, with deep mud at the bottom.
We left Naguilian early in the morning and stopped for lunch at
a little place properly called Sablán, but unofficially known as
"The Bells." Aguinaldo had thought at one time of establishing his
headquarters in Benguet and had planned to have a gun foundry at
Sablán. His troops accordingly stole most of the church bells in
the neighbouring lowland towns, meaning to use them for gun metal,
and compelled the unfortunate Benguet Igorots to carry them up the
steep trail. Boiler pipes, which had been used in lieu of carrying
poles, had in several instances been badly bent out of shape. There
was even an old vertical boiler which had been lugged up entire for
some unknown reason.
The labour involved must have been enormous, and we were assured
that when the Igorot bearers, prostrated with fatigue, had refused
to continue their titanic task without rest, they had been driven
to it at the muzzles of Insurgent rifles, and that some of them had
been shot as a lesson to the others. At all events, the boiler and
the bells were there, and there the boiler and the larger bells have
remained ever since!
It was still steaming hot at Sablán, and the whole countryside
was buried in the densest tropical vegetation. Major Maus was
triumphant. Things were working out just as he had predicted. However,
as we were already halfway up, we thought that we might as well
continue the journey. I had expected to find pines and oaks, but
had anticipated that they would grow amidst a dense tangle of damp
tropical vegetation.
We were all literally dumfounded when within the space of a hundred
yards we suddenly left the tropics behind us and came out into a
wonderful region of pine parks. Trees stood on the rounded knolls at
comparatively wide intervals, and there were scores of places where,
in order to have a beautiful house lot, one needed only to construct
driveways and go to work with a lawn-mower. At the same moment,
a delightful cold breeze swept down from the heights above us.
Just at sunset we experienced a second surprise, coming out on the
knife-sharp crest of a ridge, and seeing spread before us the Trinidad
Valley, which is shaped like a huge wash-basin. Its floor was vividly
green with growing rice, Igorot houses were dotted here and there over
its surface, and the whole peaceful, beautiful scene was illuminated
by the rays of the setting sun. The air had been washed clean by
the heavy rain which had poured down on us throughout the afternoon,
and the sight was one never to be forgotten.
Just at dusk we reached the little settlement of Trinidad, which had
been the capital of the Spanish _comandancia_ of Benguet, finding
that its inhabitants were in part Ilocanos and in part Igorots.
Here we were hospitably entertained by the officers of the military
post. It was so cold that one's breath showed. Major Maus improved
the opportunity to indulge in a severe chill. Finding him buried
under blankets, we asked his views as to the Benguet climate. They
were radical! It is only fair to the Major to say that the report
which he ultimately made set forth the facts fully and fairly. It
did not suit General MacArthur. Years afterward, when discussing the
climate of Benguet with Surgeon-General Sternberg, I referred to this
report and found to my amazement that he had never seen it. He caused
an investigation to be made, and it was at last resurrected from a
dusty pigeonhole.
On our arrival at Trinidad we received a letter from Mr. Otto Scheerer,
the one white resident of Benguet, inviting us to make our headquarters
at his house when we visited Baguio. Bright and early the next morning
Mr. Scheerer himself appeared on the scene and guided us to his home,
where he entertained us most hospitably during our entire stay. The
trip from Trinidad, a distance of four miles, was made over a wretched
pony trail.