HomeThe Journal of Historyvol. 48 no. 1 - 2 (2002)

Health and Sanitation During the American Period

Cristina E. Torres

Discipline: History



The American colonialist had a stereotype image of the Filipinos, an image that may have been largely fostered by Dean C. Worcester's book, The Philippine Islands and their People. Worcester, an academic from the University of Michigan, first came to the Philippines in 1887 as a member of a scientific expedition. He pictured the Filipinos then as a people who behaved like children, lazy, of low intellectual capacity and morality, and with such character that they deserved to be colonized and placed under the supervision of a more progressive Western culture. He wrote that they were very superstitious and fatalistic and accepted disease and other forms of misfortune as God's will. They were not particularly inclined to adopting measures to avoid disease or to improve their unfortunate conditions. They would accept the simple explanation that the highly contagious disease, cholera, was brought by a black dog that caused an epidemic outbreak whenever it roamed the city streets.


Like Worcester, the American media, including The Manila Times, blamed the outbreak of epidemics on the poor Filipinos for their unsanitary habits and surroundings, their lack of education, and their belief in superstitions. The newspaper had then recommended that during a cholera outbreak, Filipino servants should not stay in the same quarters as their American employers and that a massive campaign be waged urging the natives to clean their nipa shacks and dirty surroundings to save Manila and the Americans living in the city.


Victor Heiser, who belonged to the same "imperialist" school of thought as Worcester, believed that the future of public health in the Philippines depended on the territory's ability to attract a big number of American investors who would do business in the Philippines. As a doctor, he was excited by the prospect of using the Philippines as a big laboratory where they would be privileged to conduct their experiments. Obviously, he lived in an era when the informed consent of the subject population was not an ethical prerequisite in conducting experiments involving human subjects. In his autobiography, he admitted that the Americans had mixed motivations, combining their personal and noble interests in supporting the health program. He believed that as long as the "Orientals" (referring to the Filipinos) remained in poor health, the Americans in the Philippines would continue to be exposed to the threat of tropical diseases. He was of the opinion that, from an economic perspective, the health of workers should first be addressed to prevent American businesses from incurring unnecessary losses. This view represented the thinking of most American colonialists then who addressed the health and sanitation concerns in the Philippines with zeal and vigor for their own survival and preservation.


This paper analyzes the status of the Philippines in terms of health and sanitation during the American period. It discusses the involvement of American Officials in health as well as their health initiatives against infectious diseases. It is followed by a description of  the health and scientific infrastructure that the Americans established in the Philippines, including  Filipinization of the Health Professions (specifically medicine, dentistry and nursing). It also presented some Filipino reactions to American Health Initiatives, primarily how Filipinos initially resented the dictatorial means used to implement those programs. According to the study, Filipinos   complained about American lack of culture sensitivity. At the end of the paper, it is stated that at some point, Victor Heiser eventually recognized the value of making necessary adjustments to Filipino culture. He realized that "the sanitary regeneration of the Philippines had to be brought about, not in spite of the Filipino, but with his assistance. He also began to understand the strong familial ties binding the Filipino families.