SUPPRESSIOjSI of cholera in MANILA. ' 55 



DISPOSAL OF HUMAN EXCEETA. 



The new sewer sj^stem is another sanitary improvement anxiously 

 awaited. The existence in the Meisic district of thousands of tight vaults 

 and filthy closets is responsible in a great measure for the spread of 

 cholera in that district and the difficulty experienced in eradicating the 

 disease. These filthy closets and tight vaults can be replaced by modern 

 flush closets connected with the new sewer system. In the newer residence 

 districts, septic vaults and absorbing basins are used as receivers of sewage 

 from modern flush closets. It will be an improvement when all vaults, 

 however satisfactory in construction, are no longer necessary, because of 

 the installation of the new system. 



In the nipa districts, the people depend upon the sparsely scattered 

 public closets or have no closet facilities whatever. In the latter instance, 

 the fascal matter is deposited in the most convenient place ; in the long 

 grass, in pools or gutters, or under the house. The family pig takes 

 care of a considerable quantity of human excreta and garbage. There are 

 large barrios within the limits of the city of Manila where the only 

 way of entrance is a path too narrow to permit a wagon to enter. These, 

 of course, have no garbage collection or closet facilities. 



Habits of cleanliness are best secured by a campaign of popular educa- 

 tion. Excluding the water supply and the disposal of faeces, the other 

 factors in spreading infection can be nullified by the inculcation of 

 cleanly habits. It the bacilli carrier washed his hands often enough and 

 at the proper times he would not transfer infection from his dirty fingers 

 to the food or drink of others. If the kindly, native neighbors who 

 assist those sick with cholera, and who disappear before the arrival of the 

 health officers, can be taught the necessity of washing their hands before 

 eating or handling food, many more cases will be prevented. 



The Bureau of Health has printed cholera circulars in Spanish, Eng- 

 lish, and all the native dialects, telling how to preserve one's self and 

 others against the infection of cholera. This campaign is best conducted 

 in the schoolroom and from the pulpit. The Bureau of Education and 

 the Eoman Catholic Church have cooperated in an attempt to spread the 

 knowledge and advice contained in the cholera circulars among the people. 

 Efforts along this line have met with success, but it requires a long time 

 completely to change the habits of a people and it will probably require 

 another generation to complete tlie work. 



MEASURES LOOKING TO THE PREVENTION OF FUTURE EPIDEMICS. 



The writer has made, in his report to the honorable the Secretary of 

 the Interior the following recommendation, calculated to prevent the 

 recurrence of cholera in epidemic form in Manila. The difficulties which 

 attend the carrying out of these projects are recognized as well-nigh 



