The people, entirely unaccustomed as they were to any sanitary restrictions, believing that the disease was not cholera, and firm in their conviction that they had a right to do whatever they liked so long as they kept on their own premises, bitterly resented the burning or disinfection of their houses and effects, and the restriction of their liberty to go and come as they pleased, and in spite of the fact that the number of cases was kept down in a manner never before dreamed of at Manila, there arose an increasingly bitter feeling of hostility toward the work of the board of health. In fact, the very success of the campaign proved an obstacle, and we were assured that the disease could not be cholera, as, if it were, there would be a thousand deaths a day!
An educational campaign was immediately begun, and simple directions for avoiding infection were published and scattered broadcast. Distilled water was furnished gratis to all who would drink it, stations for its distribution being established through the city and supplemented by large water wagons driven through the streets. The sale of foods likely to convey the disease was prohibited. Large numbers of emergency sanitary inspectors were immediately appointed, and every effort was made to detect all cases as soon as possible. A land quarantine was established around the city, to protect the provinces.
In anticipation of a possible extensive outbreak of contagious disease a detention camp capable of accommodating some twenty-five hundred people had been established previously on the San Lazaro grounds, and to this place were taken the cholera “contacts.” A cholera hospital was opened near this camp, and the stricken were removed to it from their homes as speedily as possible, the buildings which they had occupied being thoroughly disinfected, or burned if disinfection was impracticable.
The bodies of the dead were at the outset either buried in hermetically sealed coffins or cremated. When the detention camp and hospital at San Lazaro threatened to become crowded, a second camp and hospital were established at Santa Mesa. At this latter place both “contacts” and the sick were obliged to live in tents.
The Spanish residents were allowed to establish a private cholera hospital in a large and well-ventilated convento on Calle Herran. As the number of sick Spaniards was nothing like sufficient to fill this building, they were asked to turn over the unoccupied space in it to the board of health, which they most generously did.
In response to popular clamour a hospital under strictly Filipino management was opened in a nipa building in Tondo. Interest in it soon flagged, and the government found itself with this institution on its hands.
The epidemic came soon after the close of a long-continued war, and there were at that time in Manila not a few evil-intentioned persons, both foreign and native, who welcomed every opportunity to make trouble. The difficulties arising from the claim advanced by a number of reputable but ignorant medical men that the disease was not cholera at all were sufficiently great. They were enormously increased by false and malicious stories to the effect that “contacts” were killed at the detention camp; that patients on arrival at the cholera hospital were given a drink of poisoned vino[2] and instantly dropped dead; that the distilled water distributed free of charge was poisoned, and that the Americans were poisoning the wells.
The necessary use of strychnine as a heart stimulant at the cholera hospital was made the basis for a story that the sick were being poisoned with this drug.
These silly tales were widely circulated and quite generally believed, and as a result of the fear thus engendered, and of the desire on the part of relatives and neighbours of stricken persons to escape disinfection and quarantine, strong efforts were often made to conceal the sick and the dead, and when this was not possible the “contacts” usually ran away. There were not wanting instances of the driving of cholera victims into the streets.
In spite of the generally hostile attitude of the public and some grave mistakes in policy, the measures adopted sufficed at the outset to hold the disease in check to an extent which surprised even the health officers themselves.