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

This is a typical old-style well, with the family washing going on beside it. Under such circumstances infection of the well water invariably resulted.

There is no way in which the water from such a well can become infected. More than eight hundred fifty have been sunk, and the death rate in some towns fortunate enough to possess them has fallen off fifty per cent, as a result.

This hospital, built on a picturesque site in the midst of imposing mountain scenery, where it gets the full sweep of the cool pinescented breezes, has done wonderful work. Note the tuberculosis cottages on the crest of the ridge.

He con

looked upon with favour by those in power. verted 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.1 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.

1 Malaria.

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 spead 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,