As we have seen, the people of Manila were formerly supplied with impure drinking water from the Mariquina River, and were therefore in constant danger of infection with cholera and other deadly diseases. At a cost of some $1,500,000 we have given the city a modern water system, the intake of which is far up in the hills above the last village. The annual deaths from ordinary water-borne diseases exclusive of cholera have fallen from 3558—the average number at the time the new system was introduced—to 1195. Recently a leak in the dam, which necessitated temporary resumption of the use of the Mariquina River water, was immediately followed by a marked increase in the number of deaths from such diseases, thus conclusively demonstrating the fact that we were right in ascribing the previous reduction in deaths to a better water supply.
This annual saving of lives is an important result, but more important yet is the fact that when Asiatic cholera reappears in the Mariquina valley, as it inevitably will sooner or later, we shall not live in constant fear of a general infection of the Manila water supply, which, judging from the experience of other cities where modern sanitary methods have been introduced, might result in the death of a third of the population. In every country a very considerable part of the population always fails to boil its drinking water, no matter how great the resulting danger may be.
Manila lacked any facilities for the proper disposal of human waste, and the conditions which resulted were unspeakable, especially in the little barrios, or groups of houses, placed close together, helter-skelter, on wet, swampy ground and reached by means of runways not worthy even of the name of alleys, as one often had to crouch to pass along them.
A modern sewer system costing $2,000,000, supplemented by a pail system, has very effectively solved this problem, while thousands of homes closely crowded on disease-infected, mosquito-breeding ground have been removed to high, dry, sanitary sites. The regions thus vacated have in many instances been drained, filled, provided with city water and good streets, and made fit for human occupancy.
The old moat around the city walls was a veritable incubator of disease. It has been converted into an athletic field where crowds of people take healthful exercise. The esteros, or tidal creeks, reeked with filth. More than twenty miles of such creeks have been cleaned out, although much still remains to be done to put them in really satisfactory condition.
There were no regulations covering the construction of buildings, and it was not unusual to find six or eight persons sleeping in a closed and unventilated room 10 × 8 × 8 feet. Manila now has an excellent sanitary code, and such conditions have been made unlawful.
The previous woeful lack of hospital facilities has been effectively remedied. At a cost of approximately a million and quarter pesos we have built and equipped the great Philippine General Hospital, one of the most modern institutions of its kind in the world, and by far the best in the Far East. In it we have very satisfactorily solved the question of getting sufficient light and air in the tropics without getting excessive heat. Its buildings are certainly among the very coolest in the city of Manila, and “the hospital smell” is everywhere conspicuously absent.
It is called a three-hundred-bed institution, but as a matter of fact the ventilation is so admirable that nearly two hundred additional beds can safely be put in as an emergency measure.
Two hundred and twenty of its beds are free. In them a very large number of persons are annually given the best of medical and surgical care. At its free clinic some eighty thousand patients find relief in the course of a year.
The increase in private hospital facilities has also been noteworthy. Among the new institutions doing admirable work should be mentioned the University Hospital, an Episcopal institution; the Mary J. Johnston Hospital, a Methodist institution; and St. Paul’s Hospital, a Catholic institution. Patients are admitted to all of them without regard to their religious belief, a policy the liberality of which must commend itself to all broadminded persons.