Carlos IV, Manila, and smallpox

Plaza Mayor, the most important public square in Spanish Manila, was that bounded by the Manila Cathedral, the Audiencia, and the Palacio del Gobernador. In it were held fiestas, processions, bullfights, and even military parades that led to it being referred to by some as Plaza de Armas.

When the United States acquired the Philippines from Spain in 1899, it renamed Plaza de Armas “Plaza McKinley,” to honor the US president who justified annexation because Filipinos had to be “civilized” and “christianized” through his “Benevolent Assimilation” policy. In 1961, to commemorate the elevation of Rufino J. Santos to the College of Cardinals, Plaza McKinley was renamed “Plaza Roma,” resulting in Rome renaming one of its squares “Piazzale Manila.”

On the surface, those bits of information may seem like useless trivia, but they underscore the importance of naming streets, plazas, buildings and monuments as markers of place and memory. In the center of Plaza Rome you will find a statue of Spanish King Carlos IV, which has stood on this spot since 1824. It is not well-known that in the nationalistic 1960s, the statue of Carlos IV was replaced by Solomon Saprid’s depiction of Gomburza. Thanks to the Intramuros Administration, Carlos IV was returned to his original place in 1981 and Gomburza was relocated outside the walls fronting the National Museum. Not many know that the statue of Carlos IV was erected by the People and City of Manila in 1824, with a fountain added in 1886 to thank the king for the gift of smallpox vaccine and the accompanying technology transfer that saved many lives.

On Sept. 3, 1803, Carlos IV decreed that smallpox vaccine be sent beyond Spain to its American colonies, and this extended all the way to the Philippines. Court physician Dr. Francisco Xavier de Balmis solved the problem of transporting the vaccine without refrigeration during the long sea voyages by using human carriers. Twenty children between 8 and 10 years old, who had not had smallpox or any vaccination, were chosen from an orphanage to be live carriers of the vaccine. Balmis transmitted the vaccine in sequence, from child to child, arm to arm along the way from Spain in November 1803 in what was then called the Royal Philanthropic Expedition of Vaccination that made calls at the Canary Islands, Puerto Rico, and Venezuela. Then, Balmis’ assistant, José Salvany, delivered the vaccine the same way to Colombia, Ecuador, Peru, Bolivia and Chilean Patagonia, while Balmis himself proceeded to Cuba, Mexico and the Philippines.

The expedition to the Philippines sailed from Acapulco on Feb. 8, 1805, with 26 Mexican boys chosen from an orphanage who carried the vaccine in a miserable voyage of two months and nine days in a filthy, rat-infested ship, the Magallanes. The passage was rough in parts, causing the accidental vaccination of some of the boys. They arrived in Manila on April 15, 1805, and were met by Governor-General Rafael Maria Aguilar, who had his own children vaccinated to encourage others to follow suit. Despite the suspicion and fear of many, including the archbishop of Manila, regarding vaccination, over 20,000 received the smallpox vaccine.

On May 16, Balmis proposed the creation of a vaccination center in Manila that would produce, conserve and distribute the vaccine to all who needed it. Young carabaos proved useful in transporting the vaccine that was distributed to the provinces “in glycerine protected by glass slides sealed in paraffin in capillary tubes or in small bottles.”

Unfortunately, Balmis was plagued with diarrhea or some other disease upon arriving in Manila, which made him irritable. First he complained about the exorbitant price charged by the owner of the Magallanes that ferried them from Acapulco to Manila. He reported this to Governor-General Aguilar, and was disappointed when his complaint was passed on to an underling in the navy department. Later Balmis complained about Governor-General Aguilar himself, saying that the only request the latter had swiftly acted upon was the issuance of a passport for his departure for China via Macao. Good riddance to an eccentric doctor whose enemies called him “Quijote.”

Without the support of the governor-general and the archbishop, Balmis was unable to get children from the orphanages, as he did in Spain and Mexico. Filipino parents were not willing to entrust their sons to a strange foreigner, so thanks to the parish priest of Santa Cruz, Balmis was able to find three boys who left with him in September on a 14-day voyage to Macao. From there Balmis traveled to Canton and not only provided vaccine but also taught people how to produce, conserve, distribute and apply it.

A historical marker of the Balmis expedition is installed in the Research Institute for Tropical Medicine in Alabang that, alas, does not record the names of the 25 Mexican orphans who carried the vaccine to the Philippines. It’s a pity that history does not record the names of the three Filipino boys who brought the vaccine from Manila to Macao either. Come to think of it, Balmis is not a household word even in the countries today that benefited from his and Carlos IV’s vision of a smallpox-free world.

Over two centuries since the Balmis expedition, it’s not too late to remember the “Quijote” and the king who began the global battle against smallpox.

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