HEISER— SANITATION IN THE PHILIPPINES. 61 



authority of which army officers did good work and made an excel- 

 lent beginning in reducing the ravages of certain diseases which they 

 found very prevalent. This work was largely concerned with pro- 

 tecting the health of the troops and was chiefly confined to the city 

 of Tvlanila. 



When the civil regime began, in addition to deplorable sanitary 

 conditions resulting from centuries of neglect, the newly created civil 

 board of health found itself confronted with a severe outbreak of 

 plague in jManila and in a number of the provinces. To add to 

 these difficulties, the board of health had scarcely opened its offices 

 before there began one of the severest epidemics of cholera that has 

 been known in modern times. In a little more than a year it num- 

 bered over 300,000 victims, of whom 150,000 or more died. 



When the civil board of health began its work 40,000 persons 

 were dying annually from smallpox. Beriberi in jails and public 

 institutions was responsible for a large number of deaths. There 

 was no governmental provision for the insane, and more than 3,000 

 of these unfortunate individuals were without adequate care. The 

 sanitary condition of the prisons throughout the islands left much 

 to be desired. With the exception of the water system which was 

 available for a part of Manila, and possibly a few other minor in- 

 stallations, there was not a reservoir, pipe line, or artesian well for 

 the seven or eight million people of the entire archipelago, and even 

 the water for Manila was known to be grossly polluted. The burial 

 of the dead was not properly regulated. In making new interments, 

 the bones of those who had been previously buried were frequently 

 cast out to bleach in the sun or were thrown upon a bone pile. The 

 city of Alanila, with its population of over 200,000, had no sewer 

 system. Disease-carrying human discharges found their way into 

 esteros or canals or were deposited directly on the ground, causing 

 serious soil pollution. 



Sections of Alanila varying in population from 5,000 to 25,000 

 were built up with houses so closely crowded together that there was 

 no room for streets and alleys. Entrance and egress, in many in- 

 stances, had to be made by passing under the houses. As most of 

 these crowded sections were built over tidal flats, the difficulties of 

 the situation can well be imagined. 



