Cholera, COVID-19, and ‘philippinitis’

What a way to start the day, catching a TV interview with Metro Manila’s chief of police, birthday boy Debold Sinas, explaining the government’s latest anti-COVID-19 operations in Navotas, which has been placed on total lockdown. In the background were armored personnel carriers that had been brought in, prompting a newscaster to ask, with a noticeable tinge of sarcasm, “Sino ang kalaban? Bayrus?” (Who’s the enemy? A virus?)

Earlier, the government announced there would be house-to-house searches for COVID-19 patients. Home quarantine has apparently been banned, and patients—heaven knows how they will be detected simply by house searches—will be sent to barangay quarantine centers.

From the very beginning of the lockdown, I’ve worried about how we’ve been using police/military models to control COVID-19, a bad way to start the quarantine. But, instead of learning from the futility of these measures, we’re now intensifying them.

We should be learning from the experiences of Americans, who first introduced this police model of public health during their colonial occupation of the Philippines. Here, I draw rich materials from Warwick Anderson’s book “Colonial Pathologies.” Anderson is a physician and a historian who worked on the Americans’ public health policies as his doctoral dissertation.

The Americans occupied the Philippines in 1898, plunging straight into the Philippine-American War as Filipino guerrillas resisted the new colonial power. Early on, the Americans realized they had to face another “insurrection,” that of disease.

Try to imagine how the Americans felt with the new, unfamiliar, and uncharted territory before them. They saw dangers everywhere. The guerrillas were foremost, but there was more. One American official wrote that “even the dogs seemed trained to bark peculiarly at an American.”

Danger came from everywhere, even the tropical weather. In sum, “air, water, soil, the whole earth and its sundry encumbrances (living and dead) were reeking it seems in germs.”

Remember, the germ theory of disease had just been accepted late in the 19th century, displacing early theories about miasmas or vapors of the earth as the main causes of disease.

The most feared enemy then, as it is today, was invisible.

A cholera epidemic that broke out in Manila in 1902 became a nightmare with its rapid spread. The Americans responded by going house to house, rounding up suspected patients and putting them in detention camps. The nipa houses of the poor were then burned down. Wooden houses of the middle- and upper classes were deemed “less dangerous” and simply sprayed with disinfectants.

The result? People fled from Manila, and the epidemic quickly spread out to the rest of the country. The Board of Health (the equivalent of our health department today) had to fan out to the rest of the country. By then, the American colonial government had learned from their mistakes and were allowing home quarantine instead of using detention centers, and had stopped burning houses down.

But people had lost trust in both the Americans and the Filipinos in the Board of Health. They continued to flee from their homes, or would hide infected relatives and bury their dead secretly.

The Board of Health blamed Filipinos for the spread, calling them superstitious and ignorant. Health inspectors armed themselves with rifles. “Pasaway” had not been coined yet at that time, but if it had been, I can imagine the Americans would have learned it right away, albeit with the pronunciation “pe-se-way.”

Dr. Trinidad Pardo de Tavera, one of only two Filipinos in the Philippine Commission administering the country, called out the Americans for their atrocities and said Filipinos “fear the Board of Health more than they fear the epidemic.”

The Americans had to become more conciliatory in their tactics. The epidemic came under control after more than a year. More than 100,000 people perished in that epidemic out of a population of 8 million. Manila, where it all started, had 5,000 deaths.

Similar fiascos happened a few years later, for example in the way the Americans tried to handle malaria, a problem that never really went away.

Meanwhile, a mental health problem called “philippinitis,” first reported in 1898 and that seemed to affect only Americans, administrators in particular, began to spread. Even the American head of the Philippine General Hospital came down with philippinitis and had to be sent to recover in Baguio, which was built, in part, to handle this new affliction.

mtan@inquirer.com.ph