Directed to Take Charge of Plague Suppressive Measures.—Upon my arrival in Manila from the United States, on October 23, 1912, I received orders from the Director of Health to take charge of all plague suppressive measures in Manila and I remained in charge of this work continuously until July 11, 1914.
Plague Fighting Organization.—The plague fighting organization was composed of three American Sanitary Inspectors and from ten to fifteen native Assistant Sanitary Inspectors of the Bureau of Health, rat catchers and laborers of the Bureau and laborers of the City of Manila supplied by the Department of Sanitation and Transportation. The combined force varied in numerical strength from 100 to 150 men and was usually divided into three parties, distributed in various parts of the city according to the local indications and needs from time to time.
After the invasion of Tondo by rat plague we made special effort to rat-proof the light material houses of that section, in the course of our cleaning operations, by the closure of the open ends of bamboo timbers with cement and with tin cans, in the manner shown in photographs herewith. In addition to this, special attention was given to the repair of broken cement work, and hundreds of Bureau of Health orders, verbal and written, were issued to owners, at my request, in the rat plague districts.
The number of houses in which bamboo timbers were closed by cement or tin exceeded a thousand.
In addition to these means, the very important matter of depopulating the insanitary basements of the light material houses in squares where plague has occurred was given attention, with the result that hundreds of families were moved from these insanitary and dangerous ground-floor rooms to quarters well above ground and measurably removed from the rats, which roam over the ground from house to house, foraging for food under kitchens and in ground-floor storerooms, tiendas and eating places. The fish packing factories afford them abundant food and a number of cases of plague have occurred adjacent to these fish-drying establishments.
Rat-proofing and Rat Destruction.—While it is frankly admitted that rats may not be completely exterminated by poisoning and trapping, the statement, so frequently repeated of late, that destructive measures really increase their number, is unwarranted and unsustained by facts, at least in Manila. It seems to be the common practice for disbelievers in trapping and poisoning to array the methods of rat-proofing and rat destruction as alternative policies, whereas everyone practically familiar with the work in such cities as Manila—or even in the United States—knows that there is often no choice permitted. Rat-proofing is highly desirable, permanent in its results, and in every respect the "method of election." On the other hand, it is entirely inapplicable at certain times and in certain localities where poverty, lack of interest of property owners, and ofttimes lack of interest and of money on the part of municipalities, absolutely preclude its immediate application. It is therefore unfortunate that the statement, that rat poisoning and trapping are ineffective, either in controlling plague or in reducing the numbers of rats, is circulated. It may be shown easily, by the daily records, that within a few weeks after extensive rat poisoning and trapping (with the breaking up of nests) is pursued in a given locality, the rat catch drops in the most decided manner.
Individual premises may be practically cleared of rats by continued intelligent rat catching and poisoning, and while the normal rat birth-rate may keep pace with the normal rat death-rate it will not keep pace with the normal death-rate plus the poisoning and trapping death-rate in any given locality, provided that the poisoning and trapping, with the destruction of nests, be intelligently and continuously carried out.
Rat-proofing and rat destruction, then, should not be contrasted as alternative procedures or policies. Both are valuable and each has a proper place. In communities non-infected with plague and unexposed to infection it will probably be found that rat-proofing, carried out in connection with the repairs of old buildings and the erection of new ones, will meet the requirements. On the other hand, in cities exposed to plague infection or already infected, rat destruction is bound to be necessary for years to come.
In emergency, the removal of people from intimate relationship with rats (so far as is possible), as practised recently in Tondo district, Manila, will often have to take the place of rat-proofing; and rat destruction and expulsion will be found, in the last analysis, to be the methods upon which success or failure in fighting plague during epidemic time will depend.
In this connection I quote correspondence which passed between the Director of Health and myself in 1913.