Part 13 (1/2)
The local market used to be a community dwelling for all the vendors, who lived there, reveling in their filth. Their children were born there, also their dogs, pigs, cats, and chickens. It was so vile smelling that no American dared go into it. Never being cleaned, it was the center from which disease was spread to the city.
These markets were the first places to be cleaned by the Americans. The first step was always to burn up the entire shed, and then build an iron and concrete structure, which could be washed down every night with a hose. Only the night watchman was allowed to live there.
This is only typical of changes made in every department, from market to school, from custom house to palace. To tell a long story very shortly, gaps have been opened in the city walls to let in the air, the moat has been filled in with soil dredged from the bay to make a field for sports, nearby marshes have been reclaimed and old wells filled up, while a sewerage system and a method of collecting refuse have of course been established. The new water system has cut the death rate from water-borne diseases in half. To stop an epidemic whole districts of huts which could not be fumigated were burned and others were sprayed with strong disinfectants by fire engines. Slowly the people are being taught the rules of hygiene. The new and up-to-date medical school is turning out very good doctors, and the school of nursing, most excellent nurses, who are gentle, cheerful and dainty.
The modern hospitals were at first regarded with suspicion by the natives, who went with the greatest reluctance for treatment. But to-day the difficulty is to keep them out. A toothache is excuse enough for a week's sojourn with free board. The native doctor often is a skilful grafter, and has to be watched, otherwise he may pa.s.s in all his poor relations, more to give them food and rest than for illness. A friend was much annoyed while sick in a Manila hospital by some Filipina girls in pink and lilac hospital gowns who were romping through the corridors.
Her nurse explained that they were pa.s.sed in by the native doctor. One of these physicians had every bed in his ward filled with patients who were not ill but just enjoying themselves. Some of these doctors abuse their authority in other ways. One of them, it was discovered, used to go to San Lazaro, the hospital for contagious diseases, and take friends who were detained there with leprosy to ride in public vehicles.
But aside from occasional abuses by natives, the work which has been done for the public health in Manila is an example of what has been accomplished elsewhere. In many of the provincial towns the introduction of artesian wells has brought the death rate tumbling down to half its former size. The work was carried on under disadvantages at first, for it was the b.u.t.t of much ridicule and abuse--the former from abroad, the latter from the native press. Medical authorities in other parts of the Far East laughed at our efforts to create better conditions for the Filipinos, and told us that Orientals were incapable of sanitary reforms. Before long, these same men were seeking to learn by what magic we had accomplished what they had hardly dared even attempt, and were sending delegates to Manila to study our methods.[17]
When Americans went there they found the Filipinos a race of semi-invalids. Those who had managed to survive the various scourges which were constantly sweeping the Islands were often infected with hookworm or similar parasites which sapped their vitality. Many of them were tubercular, and most of them were under-fed. The laziness which made several Filipino workmen equal to one American was much of it due to actual physical weakness. As a people, they are showing a marked improvement in energy and activity. It was from changes of this sort that the would-be benevolent anti-imperialists laboured to save them.
Of course, a great deal remains for us to do. Half the babies still die before they are a year old. Only a beginning has been made in stamping out tuberculosis. The people have not yet been educated out of that fatalism which makes them prefer acceptance of evil to fighting it. But as fast as they learn English they come under our educative influence more and more.
Dr. Richard P. Strong, whom we knew when we were in the Islands and who is now at the Harvard Medical School lecturing on tropical diseases, has done many notable things in various parts of the world. We all know about his wonderful work in the northern part of China, when the pneumonic plague[18] was raging there a few years ago, and still later his heroism among the typhus-stricken soldiers of Serbia. But we do not all know that, among other things, he has discovered a cure for a dreadful skin disease called yaws, which has been prevalent in the Philippines. A doctor in Bontoc cured a case with a single injection of salvarsan. The ”case” was so delighted that he escaped from the hospital before a second injection could be given him, rushed home to his native village, and returned a day or so later with a dozen or more of his neighbours who were suffering from the same trouble.
We were fortunate in traveling through the Islands with Dr. Heiser, who had entire control of the health conditions there for many years--in fact, until the Democratic administration. To him is largely due the practical disappearance of smallpox from the Philippines. When the Americans took over the country there were sometimes over fifty thousand deaths a year from this one disease. The change is the direct result of the ten million vaccinations which were performed by American officials.
An effort was made to entrust the vaccinating to Filipino officials, but epidemics kept breaking out, and it was discovered that their work was being done chiefly on paper.
In a recent letter a friend writes, ”The other day one of our servants, Crispin, was ill. I tried to get him to go to the hospital, but he insisted he was not sick. I did not enjoy having him wait on the table, for I thought he had measles. So I took him to the hospital myself and told him to do what the doctor said. When I returned home a telephone call summoned us to the hospital to be vaccinated at once, for Crispin had the smallpox! They sent him to San Lazaro, where he had a good time, and came home smiling, while we spent a miserable ten days waiting to see what was going to happen to us. The native _saindados_ came promptly to disinfect, but all they did was to put a bucket of something in the center of the room. I soon saw that they were not going to be thorough, so after ten minutes, just as they were going away, I called them back and telephoned to the board of health, asking if no American sanitary officer was coming. They said no, that Filipinos had been put in all the white men's places. So I went to work myself, burning bedding, clothes and hangings, and opening every trunk and closet. It was a revelation to those two little natives, who thought they had done enough before.”
Apparently the natives had the same aversion to the preventive method of vaccination that some of our own countryfolk have, for Dr. Heiser writes of the early work in the field: ”Formerly ... the lives of the vaccinators were seriously threatened by persons who refused to be vaccinated. However, after much persuasion, a considerable number of the inhabitants were vaccinated. Shortly afterwards smallpox was introduced and the death rate among the unvaccinated became alarming; the people themselves then noted that in spite of the fact that the vaccinated persons frequently came in constant contact with the disease they did not contract it, while the unvaccinated died in large numbers. This led to urgent request being made for vaccination and the vaccinators who previously found their lives in constant danger were welcomed.”
But perhaps Dr. Heiser's greatest work has been done in freeing the Islands of the worst-feared disease of all times and nations--leprosy. I was walking along the street with him one day when he noticed the swollen ear lobes of a man near by. It was one of the first symptoms of leprosy. He stopped and spoke to the man and walked with him to the hospital. The disease is not really so much to be feared as people think, for it is seldom inherited and is not easily contagious.
We had planned to go to Culion, the beautiful island where thousands of lepers have been taken to live or to die, and where they have every care and comfort that science and unselfish devotion can give them.
Unfortunately for us, the Secretary of War was obliged to cut the trip short, owing to official business in Manila, so we did not go there. We heard so much about the place that this was a real disappointment.
The island is a day's sail from Manila. It is well forested, and has hills and fertile valleys and a fine harbour. The more important buildings of the town which the authorities knew would be needed by the thousands of lepers then at large, were built from the foundations entirely of concrete, for sanitary reasons and economy. Besides hundreds of houses, one finds there to-day a theater, a town hall, a school, dining halls, hospitals, stores, docks and warehouses. Water, lighting and sewerage systems were also constructed, and a separate settlement was built for the non-leprous employees.
Culion is really a leper's heaven. The people have perfect freedom, and live normal lives, farming or fis.h.i.+ng when they are able, carrying on their own government, having their own police force, playing in the band if they are musical, giving theatrical performances. They have social distinctions, too--those better born take the place denied them in the outer world because of their affliction. Here they are again Somebody.
When Americans took possession of the Islands there were six thousand lepers at large. Two things evidently had to be done--first, prevent a further spread of the disease; and second, cure those who already had it, if this were possible.
Segregation of all known cases, as fast as accommodations could be provided for them, was the immediate necessity. The colony at Culion was opened in 1906 with five hundred patients. These went reluctantly to their new abode, but once settled there, found it so much to their liking that they wrote home enthusiastically, and after that the authorities had no difficulty in persuading others to go. Indeed, the plight of these poor outcasts had been pitiful enough. They were so neglected that in one of the larger cities they had been known to go into the markets and handle the produce, as a protest against their treatment.
More than eight thousand have been transferred to Culion in all, and to-day every known leper in the Philippines is there. New cases are still occasionally found, but even the worst provinces are now practically free from the historic scourge. It was that remarkable man, Dr. Heiser, who not only organized and carried out this great undertaking, but who himself saw to the smallest details. Many times he is known to have carried the loathsome patients in his own arms.
The second problem, that of finding a cure, was not so easily solved.
But it has been found, and our nation had the credit of finding it--”the first definite cure ever established,” Dr. Heiser says. Two methods were tried out very carefully, both with some success. The first was the x-ray, which brought a marked improvement in most of the cases where it was used, and an apparent cure in one case. The other method was the use of chaulmoogra oil. This remedy had been known and used in the Far East for some time, but it could rarely be given long enough to produce much effect, because it was so unpleasant to swallow. Our doctors, however, devised ways of injecting it, after mixing it with resorcin and camphorated oil, so that there were no ill effects. Already several cures have resulted.
Ten years ago there were forty thousand users of opium in the Islands.
In five years that number was reduced ninety-five per cent, and most of those still addicted to the drug are Chinese. In the last few years, moreover, cholera and bubonic plague have been practically wiped out, but, of course, a few other tropical diseases still exist.
The Philippine a.s.sembly recently conceived the brilliant idea of cutting down expenses by halving the health appropriation. Dr. Heiser got permission to speak before them, but instead of talking a few minutes, as they expected, he spoke for three days. He told them that if they did not give him the money he needed for the work, he would be forced to economize by setting free the criminally insane, who, he promised, should be given tags stating that they had been set free by order of the a.s.sembly. Also, he said, he would have to send back many of the lepers to their friends. It proved to be the way to deal with the child-like legislators, who in the end gave him what he wanted. Since that, however, he has resigned, and his loss will be sadly felt. Indeed, there has already been an outbreak of cholera since he left.
Regenerative work among the Filipinos has by no means been confined to their bodies, however, for besides the educational advance that has been made in their schools, which I have mentioned elsewhere, their prisons have become sources of light instead of darkness. It is true that penology in the Philippines has gone ahead with great strides.