IX, A, 4 Cox et al. : Water Supplies in the Philippines 341 



of death of 300 babies, it is found that tap water, either with or without 

 boiling, is used as a diluent in most instances. As a majority of the 

 houses of these people are at considerable distances from the nearest 

 faucet, the water is carted by water carriers and kept in earthenware 

 jars or other vessels under the most unsanitary conditions; in many 

 instances whatever safety might be secured by boiling the water is 

 destroyed by the subsequent manipulations and care of the water and by 

 the methods employed in making the dilutions of the milk mixtures. 



WATER-BORNE DISEASES 



The average Filipino is undernourished and underdeveloped. 

 From 80 to 96 per cent ^■' of the native population suffers from 

 intestinal parasites. Just how great a role impure water has 

 played in bringing about this state of affairs has not been demon- 

 strated, but it certainly has been one of the great factors. Vital 

 statistics indicate that the death rate from intestinal diseases 

 was three times as great before the installation of the new 

 Manila water supply (1908) as at present. In periods of con- 

 tinued drought when it became necessary temporarily to use 

 water from Mariquina River to supplement the regular supply, 

 there was in each case a sudden increase in the death rate.^'' 



Contrary to experience in the United States, water-borne dis- 

 eases are more prevalent in the Philippines during the rainy 

 season " than at any other time, probably due to the washing 

 of accumulated surface debris and faecal matter into the water 

 courses. 



The three most important "water-borne" diseases are typhoid, 

 cholera, and entamcebic dysentery, although water probably is 

 not the most important medium for their transmission. 



Typhoid. — Typhoid fever is very common and widespread in 

 temperate and tropical countries. Chamberlain ^^ and Heiser ^^ 

 have written concerning the prevalence and nature of typhoid 

 in the Philippines. It appears to be distributed equally through- 

 out the year. Chamberlain reported the death rate in Manila 

 from typhoid as 36.8 per 100,000. This rate was exceeded only 

 by those of cities which were notorious for high typhoid rates. 

 Chamberlain points out that — 



The water supplies are almost universally bad, the proper disposal of 

 excreta is almost entirely neglected, the crowding in the habitations and 



"/Wd. (1909), 4, 261. 



^'Annual Rep. P. I. Bur. Hlth. (1912), 4, 46. 



" Ibid. (1911-12), 47. 



" This Journal, Sec. B (1911), 6, 299. 



'"Ibid. (1912), 7, 115. 



