War and epidemics

The Filipino-American War was still raging in 1902, when American colonial authorities precipitously declared it over. There was a cholera epidemic which, according to eminent historians like Dr. Reynaldo Ileto, was the direct result of the devastation caused by the Filipino-American War. Cholera was used to justify the unconscionable “hamletting” of Filipino communities. No wonder Corporal Richard Johnson of the 48th Volunteers reported: “We are more scared of cholera than anything coming from the insurrectos. With them we could defend ourselves with rifle and bullets, but cholera was an enemy whose presence we were unaware of until this fatal stroke…”

American soldiers were ordered by their health officers to burn nipa huts because these native dwellings were considered sources of infection. Major L. Mervin Maus, MD (later health commissioner) described the Northern Luzon towns occupied by his troops: “The sanitation of the towns were extremely bad… The habitations of the natives as a rule were surrounded by filth of all kinds — slops, garbage, fecal accumulations. Weeds and rank vegetation were allowed to grow along the fences and in the streets…” However, Major Maus perceived that the Filipinos believed the extreme measures taken to impose sanitation were for “purposes of revenge” because we were fighting against them.

There were strict orders to forcibly take suspected cholera cases to hospitals, even if they had to be forcibly yanked out of their homes. Such measures were extremely harsh for Filipinos who felt duty-bound to give sick family members not only medical assistance but also emotional and spiritual support. As cholera spread unabated, there was a hunt for dead bodies and strict orders to bury these in 7-feet deep pits,or cremated. In the past, burning the dead was anathema to Catholics, so those who could not afford burial preferred to throw cadavers in the Pasig River. Manila was placed under strict quarantine and the American cavalry patrolled the Marikina River 24/7, as it was the city’s main water source. There were rumors that the dreaded disease came from Hong Kong, so an American quarantine officer immediately banned all green vegetables from Southern China.

Be that as it may, the spread of “cólera morbo asiâtico” was eventually arrested, thanks to concerted efforts of Filipino scientists, which included the Colegio de Médicos y Farmaceúticos de Filipinas. One of their members, Dr. Manuel Guerrero, was researching on “Prophylaxis de Cólera Morbo Asiático,” a detailed explanation of how the disease was contracted and precautionary measures which every Filipino should take. The good doctor also made a compilation of prescriptions, many of them his own. Interestingly, one was by Dr. Ariston Bautista y Lin, friend of Jose Rizal and Juan Luna, who sheltered in his residence in Quiapo, Julio Nakpil and wife, Gregoria de Jesus, Bonifacio’s widow.

With the characteristic modesty of a true scientist, Dr. Manuel Guerrero made no claims that his work was an original contribution to medical science as it was a synthesis of everything he had researched, read, and, studied about the killer disease. However, in the prologue Dr. M. Guerrero alluded to the brashly expedient manner with which the Americans were trying to quell the epidemic. He made oblique references to the Filipino-American War.

Dr. Guerrero felt he had to explain the nature of the disease to the public; they had to know about the source of the “microscopic beings,” how these spread and are contracted by humans. “People have to be taught all that so they will stop relating any accident in their lives – like the incidence of cholera – to Destiny or Fate.” He made reference to how the public was “reacting with incredulity and skepticism” to the sanitation measures imposed by the Americans. Dr. Guerrero was of the opinion that “… only when they fully understand the nature of the epidemic will they help detect and destroy the disease, diligently and with their own initiative; only then will they stop evading the sanitation measures they find so mortifying … Prophylaxis is after all a matter of education and habit.”

The entry of the cholera bug into the digestive tract had to be prevented, but should that be too late, one had to immediately report it; the disease was spreading rapidly because “of that habit of hiding things at all cost,” the wise doctor observed. He focused on two simple prophylactic methods (1) drink only sterilized water and (2) do not eat raw food. He dedicated 10 pages to water alone in order to underscore its substantial and crucial role in the transmittal and prevention of cholera. He warned against doing one’s laundry in rivers and streams with (dead bodies!) and sewage leakages. He indicated that for safe drinking water, boiling for at least ten minutes is the simplest and most effective method of purification.

In those days, Filipinos abhorred the taste of boiled water and believed it caused flatulence due to the evaporation of minerals and salts. Dr. Guerrero belied those prejudices and gave many tips on how to retain the natural flavor of water, for instance, by covering the receptacle properly while boiling (especially when using wood fire) and by letting the water cool before drinking it. His instructions were meticulous: The container for storing clean water had to be covered at all times to protect it from dust and flies; it also had to be washed daily with boiled water. Emphatically, the doctor ordered, “Avoid the repugnant and pernicious habit of sticking unclean fingers in a glass to draw water from the container, or to drink directly from it.” A special “tabo” had to be used for water distribution.

Do not eat raw food, Dr. Guerrero warned. Avoid salads, tomatoes, onions, radishes, and fruits, because in farms and orchards, these are showered copiously with unclean water. “How can we be sure that the hands that touched these raw vegetables and fruits are not unwashed and contaminated; are we certain that the baskets and ‘bilaos’ where these are transported do not have cholera germs?”

In war and peace, Dr. Manuel Guerrero’s preventive measures are relevant because they speak of basic hygiene and cleanliness. If he were alive today, he would surely have something to say about dengue and Dengvaxia.


(Source:Guerrero, Manuel S, “Profilaxia del cólera morbo asiático” Imprenta de M. Paterno y Cia, Manila,1902)