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The National Geographic Magazine 



sanitation according to modern methods. 

 In the city of Manila and in the other 

 large towns of the islands the American 

 military medical authorities, who were 

 the first to assume responsibility for the 

 health of the islands, found the same 

 utter disregard of the proper rules for 

 the disposition of house sewage that was 

 found in Habana. Thousands, yes, tens 

 of thousands, of Filipinos were carried 

 off year after year by a peculiarly viru- 

 lent type of smallpox. 



In Manila, in Cebu, and in Nueva 

 Caceres, respectively, were leper hospit- 

 als, but in each the management was 

 inefficient and the care of the inmates 

 poor. More than this, no supervision 

 was exercised to isolate lepers not in 

 hospitals. Sometimes the poor creatures 

 were driven out of villages by popular 

 riots and herded together with no proper 

 food and no shelter. The contact of 

 lepers with the people of course only in- 

 creased the number of cases of the dread 

 disease. 



In 1885 or 1886 the islands were visited 

 by an epidemic of cholera, and the pros- 

 tration of the people of Manila and the 

 Philippines, due to the rapid spread of 

 the scourge, beggared description. In 

 Manila the deaths were 1,000 or more a 

 day from that cause alone for a number 

 of weeks. The trade proximity of Ma- 

 nila, Iloilo, and Cebu to China, India, 

 Java, Burma, and the Straits Settlements 

 makes the danger of transmitting tropical 

 and other infectious diseases very much 

 greater. 



Quarantine in Spanish times was lax. 

 The American Army medical authorities 

 took hold of the matter of sanitation in 

 their usual vigorous way and made much 

 progress in the matter of quarantine and 

 in correcting the glaringly unsanitary 

 conditions in Manila. But it remained 

 for the civil government to effect a thor- 

 ough organization of a health department 

 which could do permanent good. 



The introduction of sanitary methods 

 by law among the people has given rise 

 to more dissatisfaction and greater criti- 

 cism of the government than any other 



one cause. The truth is that the people 

 have to be educated in the effectiveness of 

 such methods before they can become 

 reconciled to them, and the work of the 

 health department since the beginning 

 of the civil government, in 1901, has been 

 obstructed, first, by the inertia and indif- 

 ference of the people in respect to the 

 matter, and, second, by their active re- 

 sistance to affirmative restraints upon 

 them necessary to prevent disease. 



SMALLPOX AND ASIATIC CHOLERA STAMPED 

 OUT 



The fight against smallpox has been so 

 successful that in the past year not a 

 single death from it occurred in Manila, 

 and in the provinces of Cavite, Batangas, 

 Cebu, Rizal, Bataan, La Laguna, and La 

 Union, where heretofore there have been 

 approximately 6,000 deaths per year, not 

 one was reported. In the few places in 

 other provinces where smallpox appeared 

 it made little headway. More than 

 2,000,000 vaccinations against smallpox 

 were performed last year, and vaccination 

 is being carried on so that it will reach 

 every inhabitant of the islands. 



In 1902 Asiatic cholera appeared. The 

 loss the first year by reason of the meth- 

 ods introduced was much less than it had 

 been fifteen or sixteen years before, but 

 great difficulty was encountered in put- 

 ting into force the health regulations, and 

 a futile attempt was made to establish 

 quarantine between localities in the 

 islands. Since that time a better system 

 of isolation and stamping out the dis- 

 ease in the locality where it appeared has 

 been followed, and it is gratifying to 

 note that, although the dread disease ap- 

 peared each year, it was finally brought 

 to an end on November 2J, 1906, and the 

 authorities now feel that the people have 

 been so thoroughly roused to the best 

 methods of treating the disease that any 

 local reappearance of it can be readily 

 suopressed. 



In 1902 or 1903 the bubonic plague 

 appeared in the islands. This has been 

 suDDressed by the isolation of all persons 

 suffering from the disease and the de- 



