SANITARY CONDITIONS AND NEEDS IN PROVINCIAL 

 TOWNS. 1 



By Thomas W. Jackson. 2 



The circumstance of continued residence in provincial towns, (where 

 the opportunities for observation of social and sanitary conditions surpass 

 those for studies purely medical), is the principal reason for my choice 

 of this topic. Some members of the Philippine Islands Medical Asso- 

 ciation have spent a good portion of the past ten years in these Islands, 

 others have had interrupted residence, and some have returned after 

 five years' absence or longer in America. To this last class, at least, 

 a comparison of conditions then and now is interesting. 



In Manila, at every hand, striking changes in methods and facilities 

 for transportation, communication, procuring of food, recreation, illu- 

 mination, and external conditions affecting the comfort and safety of 

 living for Americans are in evidence. Great improvement in highways, 

 buildings, sewers, hospitals, schools and churches, and bettered condi- 

 tions as to the control of epidemic diseases are notable. 



A splendid Bureau of Science and a Medical College have been estab- 

 lished. Exhaustive studies of tropic diseases have been undertaken and 

 important facts concerning their causation have been discovered. In a 

 word, great things have been wrought. 



Both in and out of Manila, American soldiers and sailors are so safe- 

 guarded that the morbidity rate for the Islands is slightly less than 

 that for the United States. Conditions are less favorable for Americans 

 outside of garrisons, but with due attention to hygienic law and the observ- 

 ance of well-known precautions against infection, reasonable health may 

 be maintained by all. The relative infrequency with which Americans 

 have suffered from epidemic plagues, such as cholera, emphasize this 

 contention. 



The Director of Health for the Islands stated in the annual report for 

 1906 that "each succeeding year of experience in health work shows that 

 the white man's chances of contracting disease in the Philippine Islands 

 are less than in the United States." He also shows statistically that for 



1 Read at the Fifth Annual Meeting of the Philippine Islands Medical Associa- 

 tion, Manila, February 29, 1908. ' 



2 First lieutenant, Medical Reserve Corps, Fort William McKinley. 



431 



