CHOLERA AND THE ORIGINS OF THE AMERICAN SANITARY ORDER IN THE PHILIPPINES
Reynaldo C. Ileto
(REVIEWER)
American colonial rule was a sanitary regime which saved countless Filipino lives.
Historians T.A. Agoncillo and M.C. Guerrero, influential textbook they narrate in some detail the
Philippine-American War of (1899-1902). Highlighting the Filipino struggle to defend their
independence “through blood and tears”.
Stress that although the republican commander-in-chief Emilio Aguinaldo had been captured in
mid-1901.
Guerrilla warfare continued under the leadership of General Miguel Malvar until relentless
American campaigns forced him to surrender on 16 April 1902.
Agoncillo and Guerrero uphold their ant-colonial stance. (‘originally established as an instrument
of pacification’)
Before 1900, ravages or CHOLERA, smallpox, dysentery, malaria, tuberculosis, and other deadly
diseases plagued the people.
When the Americans came, they immediately set to work to minimize the spread of diseases and
to improve (the health of the people).
Epidemics that used to migrate to the Philippines were either prevented or minimized by the
establishment of the Quarantine Service supervised by the competent American doctors and
public health officers.
The task of educating the people in the ‘elementary principles of hygiene and sanitation’ was
difficult because the Filipinos were superstition-ridden and ignorant of the strange power of the
minute germs to cause deadly diseases, and were not easily convinced by the efficacy of medical
methods in combating the cause of death from various sickness. Thus, Americans were up
against a formidable wall of ignorance and superstition.
1899-1902 WAR OF RESISTANCE
1902-1904 CHOLERA EPIDEMIC belong to two distinct series in the Philippines historiography.
19th century forebear Jose Rizal – the ‘father’ of nationalist historiography and doctor of
medicine.
Apparent victory over the cholera in 1902-3 is thus assimilated into the universal history of medical
progress.
1st decade of American rule are authored by the very architects of the anti-cholera measures: the
SECRETARY OF THE INTERIOR, DEAN WORCESTER, and the COMMISSIONER OF PUBLIC
HEALTH, DR. VICTOR HEISER. (read pp. 126 for more details)
The fight against the cholera of 1902-4 has been represented, even by nationalist writers, in
similar fashion: as a drama whose theme is American heroism and medico-sanitary skill, where
Filipino participants – the victims from the poorer classes in particular – function as the
anonymous backdrop for the saga process.
March 14, 1902 – a vessel from Hong Kong arrived in Manila with Cholera on its bill of health.
1st cases of cholera were discovered in a barrio called Farola near the mouth of Pasig.
The spread of the epidemic which devastated the country up to November 1902, lingered on till
early February 1904, and ultimately claimed a total – conservatively estimated – of 109,461
deaths 4,386 of which were in Manila.
The cholera was certainly impossible to contain, for even American troop movements contributed
to its spread.
Nueva Caceres Pagsanjan Majayjay Laguna Camp Wallace in Manila Pasig River
Mariquina Valley Laguna De Bay (Laguna, Batangas, Tayabas)
December 10 previous year, all port had been closed as part of General J. Franklin’s all-out
effort to force Malvar’s capitulation.
April 19, three days after Malvar’s surrender, all restrictions to trade and travel in the region were
to be lifted, but the cholera forced the ports to remain closed in order to give time for the local
health boards to organize and take the required precautions.
First of May the disease attacked first the ports and thence spread the back into the country.
The coastal quarantine proved useless as infected Filipinos and ‘occasional Americans’
managed to land surreptitiously, usually at night between ports.
CHOLERA claimed its victims from all levels of society, including AMERICAN SOLDIERS AND
RESIDENTS, PROMINENT FILIUPINOS, CHINESE, AND SPANIARDS.
“The distribution of victims among the races and social classes was, however UNEQUAL,
Americans, Spaniards, and Chinese had well-equipped hospital catering especially for them.
“Overcrowding, poor sanitation, and poor diet in certain districts of Manila were the primary
causes of the malignancy of the cholera among the lower classes.”
The death toll for Batangas alone at 20,000.
War, the cholera, and famine conditions came together, at least in southwestern Luzon.
Commissioner of Public Health note: “Poverty and Malnutrition, together with poor sanitation, are
mentioned as some of the causes of the ‘malignancy’ of the epidemic among the lower classes.
The ineffectiveness and eventual lifting of the quarantine, the agricultural situation in 1902 was
HOPELESS.
‘A LOT OF PEOPLE ARE DYING MORE OF STARVATION THAN THE CHOLERA, IN VIEW OF
WHICH I BEF YOU TO GIVE US PROTECTION.’
Cholera, in fact, was the lesser problem compared to, as one veteran surgeon wrote, ‘an
IGNORANT and SUSPICIOUS people, impoverished by war, locusts and rinderpest and
embittered by conquest’, making sanitation work ‘an extremely difficult task, calling for much
patience, tact and firmness, the brunt of which fell on the Army’.
The rationale for the Army’s intervention was to cleanse the regions, to eradicate the dual
scourge of killer germ and popular stubbornness.
Developments in 19th century medicine contributed to the convergence of colonial warfare and
disease control.
Towards the end of 19th century, medical thinking that recognized the importance of a patient’s
state of mind that attributed disease to a lack of harmony between man and his environment.
By about 1905, control of water or food supplies and of insect vectors had checked typhoid,
cholera, yellow fever and malaria.
American surgeons and sanitation personnel, then, had just witnessed the glimmer of victory over
the disease in their own country when they confronted the cholera in the Philippines.
Routine treatments involved the use of benzoyl-acetyl-peroxide, guiacol carbonate, calomel,
potassium permangante, two per cent tannic acid, and dilute sulphuric acid. These treatments
were really experimental in nature, based on the assumption that some drug ought to be able to
attack and destroy the cholera vibrio within the patient.
In 1882, when Manila experienced an estimated death toll ranging from 13,000 to 34,000, bodies
remained unburied for days.
The government finally intervened with a battalion of engineers to help bury the dead en masse in
a common pit. The approaches to the Manila cemeteries 'were blocked with vehicles of every
description loaded with corpses'.
As the local elites put their towns in to line with at least the broader outlines of the colonial
sanitation scheme, the government increasingly found itself confronting the traditional 'other' of the
Hispaniswed town-centre. The new colonial order, in fact, merely reproduced the classic
Philippine pattern of principalia-dominated, sanitary, towns whose outskirts faded into a world of
'uncontrollable', 'disorderly' or 'subversive' elements.
1903 report on the religio-political movements based on these hills states that 'independence' had
become a religion among them. 'The magical condition of independencia' was their goal. In
Tagalog, the word 'independence' is kalayaan, one of whose meanings is derived from
kaginhawaan: 'relief from pain', 'a life of ease'. 'Relief from the cholera' would certainly have
registered in 1902-3.
Cholera epidemics clearly offered ideal conditions for the appearance of healers who attracted
villagers away from town-centres and to their fold.
It was common for colonial authorities in 1902 and subsequent cholera years to forcibly disperse
people gathered in places considered to be sources of infection: sacred springs, pilgrimage sites,
even churches and cockpits. At times, a proscribed healer was the centre of attention and
promptly suppressed; in other cases, the normal ritual life of the people was disrupted.
The virulence of the 1902 cholera strain had also expended itself by that time, the population
gained increasing immunity.
In terms of preventing further serious outbreaks, such measures, adapted to local conditions, were
probably effective. But in 1902 their actual role was to close a chapter of the Philippine-American
War.
