Death and disease during the US occupation

When enemy troops arrived from the US in 1898, they found the port cities of Manila and Cavite “filthy in the extreme.” What followed in the decade following US occupation was a vigorous campaign against disease, and the “pacification” of Filipino aspirations for independence.

When textbook history highlights education and health as legacies of the US colonial period, it obscures a darker side. Hamletting, for example, the clearing of a rebel-infested area by the military during the Philippine-

American War, was veiled as quarantine. When Filipinos were forced from farmlands into camps in town, their fields and huts burned for sanitation, it also served to starve “insurgents” of supplies and support.

In 1908, William Washburn, civil service director, addressed the Philippine Islands Medical Association with remarks relevant to us in the COVID-19 pandemic 112 years later:

“The health conditions of any locality or country are only relative at best, and not absolute. The opposite state to that of health is disease, the principal causative factors of which are microorganisms, myriads of which surround us as unseen friends or foes… It is now realized that the observance of the laws of personal, domestic, and public hygiene is the best protection against the invasion of the agencies of disease.”

Washburn reported on public health improvements: sanitation, sewage, construction of hospitals, isolation of lepers to Culion, and the healing properties of Baguio. I was struck by his observation about US army personnel in the Philippines that more soldiers were killed or incapacitated by disease than injuries from warfare. “For every man killed by bullets” during the US Civil War, he said, “there were two who died, and probably five whose health was permanently destroyed, by camp diseases which are now known to be preventable.”

Data on US soldiers serving in the Philippines from 1898 to 1906 showed a marked decrease in typhoid fever, undetermined fevers, malarial fevers, tuberculosis, diarrheal disease, insanity, and venereal disease. “Colored” soldiers were less prone to disease than whites, and native soldiers were more sturdy against diarrhea. Tainted food and water were blamed for diarrhea, and Washburn made it clear that natives were not immune from cholera or intestinal parasites. Malaria afflicted both US and native troops.

Per the 1907 US Surgeon General’s Report: “Of the 1,364 men discharged for disability in the US, over 64 percent were for disabilities not incurred in the line of duty, and of these, 51 percent were contracted before enlistment. The principal causes of discharge, with the number for each cause, were: tuberculosis 149; venereal diseases 165; defective vision 141; defective hearing 90; and organic disease of the heart 71.”

Washburn said that of the 181 discharges from the Philippines in 1906, 38 were for causes existing previous to service in the islands, 22 for causes not originating in the line of duty, 33 were injured in line of duty, three injured not in line of duty, and 85 from disease incurred because of service in the line of duty. Fourteen deaths from drowning were reported in 1906, the same figure for 1907. One in seven deaths in Manila was due to tuberculosis.

Venereal disease was of particular concern, but: “Even by the strictest isolation of infected soldiers it will be difficult for the military authorities to reduce venereal disease so long as infected women near military posts are not isolated. The responsibility for their isolation rests with the civil not the military authorities.”

Compared to soldiers, the American teachers, one-third of whom were women, fared better, with an average six days’ illness a year from 1902 to 1907. Sixty-two deaths were recorded: 16 from injuries or violence, 46 from disease (smallpox 11, cholera 9, dysentery 7, typhoid 3, tuberculosis 3, nephritis 3; and one each for encephalitis, cerebral hemorrhage, cerebral meningitis, pneumonia, diphtheria, abortion, heart disease, and hepatic abscess. Two cases were undetermined.). No teacher deaths from malaria were reported. This proved that whites could adapt to life in the tropics.

Reading all this made me wonder why nobody remembers previous epidemics of the bubonic plague, cholera, smallpox, malaria, dysentery, typhoid, and beri-beri. These may be a distant memory now, but the experience of previous generations has a lot to teach us on how to live with a pandemic.

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