On returning to his house the first evening, after a short absence, I found the grounds decorated with lighted Japanese lanterns. Supposing that the proverbial Filipino hospitality had risen above even such untoward circumstances as those which then existed, I asked the governor what the entertainment was to be. In evident perplexity he replied that he had not planned to have any entertainment, and on my inquiring what the lanterns were for, said he had heard that they were good to keep away cholera germs!
I have referred to the fact that the civil government inherited a fairly well developed epidemic of bubonic plague. In 1901 this disease caused four hundred twenty-seven deaths, in 1902 it caused ten only, but the demands made on the sanitary force by the cholera epidemic which began in that year rendered it impossible to give to plague the attention which it otherwise would have had, with the result that in 1903 we had one hundred seventy-four deaths. In 1904 there were seventy-eight; in 1905, forty-three; in 1906, seven; in 1907, none; and from 1907 until 1912, none. In the latter year the disease was reintroduced.
Rats become infected with it, and fleas transmit it from them to human beings. It was probably brought in by pestiferous rodents hidden inside packages of vegetables, as it appeared in a district where crates of vegetables are opened in large numbers, and did not appear in the vicinity of the piers, although shore rats are abundant there, and if diseased rodents had landed from shipping, would promptly have become infected,—a thing which did not occur.
At about the same time plague also appeared at Iloilo, where it was eradicated with a total of nine deaths. At Manila there have been up to the present time[6] fifty-nine deaths, and scattering cases continue to occur at considerable intervals.
Had plague not been promptly and effectively combated, it would unquestionably have spread rapidly, causing untold misery and heavy property losses.
As I have previously stated, at the time of the American occupation smallpox was by many people regarded as an almost inevitable ailment of childhood. It proved necessary to secure the passage of legislation forbidding the inoculation of human beings with it to prevent misguided Filipinos from deliberately communicating it to their children, not because they did not dearly love them, but because they regarded infection with it as a calamity sure to come sooner or later, and desired to have it over with once for all.
We have performed more than ten million vaccinations, with the result that the annual deaths from this disease have decreased from forty thousand at the outset to seven hundred for the year just ended. There is now less smallpox in Manila than in Washington.
In the six provinces nearest Manila it was killing, on the average, six thousand persons annually. For a year after we finished vaccinating the inhabitants of these provinces it did not cause a death among them; nor has it since caused such a death except among new-born children or newly arrived unvaccinated persons.
These extraordinary results have been achieved without the loss of a life or a limb so far as we know. The vaccine used was prepared by our own Bureau of Science with extraordinary care, and has proved to be remarkably pure and active.
We at first endeavoured to have vaccinations performed by local Filipino health officers, but, after spending large sums without obtaining satisfactory results, gave up this plan and substituted therefor a method of procedure by which the work was carried on under the very immediate supervision of the director of health. We then made substantial progress. However, under the law as it at present stands, succeeding annual vaccination, intended to insure the immunization of children soon after they are born and of unvaccinated persons who may come into a given territory, are intrusted to the local Filipino authorities, with the result that in very many cases they are not attended to. We get elaborate returns showing the number of persons vaccinated. Then comes an outbreak of smallpox, and on investigation we learn that the vaccinations so fully reported were made on paper only! In other words, the continuance of this work, of such vital importance to the Filipino people, is still directly dependent upon continued control by American health officers.