434 JACKSON. 



ordinances are absolutely dead letters. Thej r are doubtless unknown to 

 a large part of the populace. They provide for garbage collection and 

 disposal and for a sanitary cart for the house-to-house collection of 

 excreta and other wastes. They prohibit the running at large of pigs 

 and other domestic animals and prescribe penalties for the violation of 

 these provisions. They provide for the screening of foods in market 

 places and for inspection and policing. In short, they provide for the 

 maintenance of decent conditions, which is probably as much as we can 

 reasonably expect in this country. 



This recital is not made to excite commiseration for the Americans 

 who by force of circumstances are obliged to live in these towns and 

 endure these conditions; neither is it in any sense a complaint against 

 the constituted Health Department of these Islands. If I sought to 

 excite sympathy for the Americans I would relate conditions as they 

 exist in another large town in the same province, where matters are worse 

 than I have described them. As for the Public Health Department we 

 can not overlook the tremendous work it is doing and has accomplished, 

 especially in the sanitation of Manila, the establishing of vital statistical 

 records, charity hospitals, the vaccination of the people, the control of 

 epidemics, the segregation and colonization of lepers, and best of all the 

 enactment of laws. 



It is rather on behalf of the Filipinos themselves that I have described 

 conditions as they are. The question which propounds itself is this : 

 "Are we doing less than our duty to the Filipino people in this matter ?" 

 I fear that we are. Whether we agree with the doctrine that the United 

 States is exercising a temporary control of the Islands preparatory to 

 entire withdrawal therefrom, or whether we consider the Islands as 

 colonial possessions, it must be admitted that at present the United States 

 Government is actually in possession and control. As candid medical 

 men and good Americans we recognize, as our duty, the obligation to 

 promote health conditions in these Islands to our utmost. This obliga- 

 tion is not contingent upon the wishes of the Filipinos. We hear a 

 great deal these days about altruistic government. In what way can real 

 altruism be better shown than_ by requiring the observance of hygienic 

 law? 



In the last annual report of the Bureau of Health for the Islands 

 attention is called to "the comparative freedom from disease which resi- 

 dents of the Philippine Islands who are willing to follow the few simple 

 rules recommended by the Bureau of Health enjoy". In this statement 

 lies the explanation of the situation. Residents of the Islands are "per- 

 mitted a choice" as to whether or not they will observe hygienic laws, the 

 violation of which affects not only themselves, but their fellow-men. So 

 long as this is our policy we can hope for little improvement. Surety we 

 can not hold the Health Department accountable. The Bureau must 



