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Show Health Service In The Philippines SBlUUoa 1b the Philippine! mar be divided Into two epochs, fighting and constructive, says J. H. Linton In the Philippine Review. The fighting epoch began with the landing of the first contingent of American troops gjg) at Manilla; the Conitructlre tame time later. There It on sharp line of demarcation between the two; In fact the flrts epoch la not yet ended. The first epoch Is characterised by' the campaigns waged against epidemics epi-demics of Infectious diseases and tho measures employed to meet emergencies emergen-cies as they arose. The second epoch l "Is concerned with tht more varied v problems ot public health and pre- ' ventlve medicine proper. The Sani tary Commissions are the outgrowth of the Conitructlre epoch of sanitation. sanita-tion. The first sanitary commission went to. work In July, 1915, In the town of Paslg, Rlsal. The task set for the sanitary commissions com-missions la to search out and elimln- ate the causes rather than to be con tent with fighting diseases already existing, and to raise the standard of living o fthe eople by pointing out ' ways and means whereby they may J Improve their economic, social and a physical state. The plan of work of the commissions Is essentially con structive rather than reparative In nature. - ' ' ' . Upon entering a town one ot the first acts ot the commission Is to op- en a free dispensary. This dispen sary Is a valuable asset In the work j S ot the commission. Its usefulness Is " not confined to treating the sick but it serves as an invaluable source of Information concerning the. preval- ence ot the disease and as a sort of lyceum for Instructing the people In ' hygiene, sanitation and dietetics. The dispensary work helps to secure the cooperation ot the people, who, alii al-ii i though somewhat slow to avail them-'' them-'' ,jmL selves of the opportunity of securing tratutlous medical and surgical, re; I lleK eventually grasp Its significance 'i when they observe a number of their j neighbors relieved ot the infirmities I when they throng ,the dispensary In 1 incresaslng crowds. By the time the commission has finished Its survey? 1 and announce its intention to depart $ ' It Is often overwhelmed with requests ( to remain and continue the, dispen- ($ . anry. Here the medical officer gets at J JL first hand, a vast amount of valuable ijj information regarding the prevalence and distribution of disease. The in- 9 formation thus secured is carefully compared with the morbidity and ; - mortality statistics of previous years. I tA the same time the study of local M conditions, dralnage.water supply, fl waste disposal, personal habits, pop- H ular customs and economic develop- H ment Is carried forward by the other H raembers.ofthe commission. H A very popular accessory of the dispensary Is the diet kitchen. Here the dietitian Instructs the women, es-H es-H peclally the mothers, in the prepara- ti'on of balanced diets for themselves S and families from the materials lo-B lo-B cally available. In order to encour-H encour-H age and aid the people to supplement their ordinary diet of rice and fish VM with vegetables, the Health Service M has planned a model garden of veg- '9 etables carefully selected for their value in furnishing the substances W needed to balance the ordinary Flll- ; plno diet. Because ot the generally V poor nutrition ot the Filipino people H and the scarcity ot food the world .H over, this feature ot the work Is par- H tlcularly Important at the present H time. V The mothers are taught how to HI V care for themselves and Infants dur- H ing pregnancy and the puerperlura H by the public health nurse. She at- H so Instructs them In the care ot the J sick and the sanitation of the home. B Since the last official census of the .H Philippine Islands was taken In 1903 J It is jiecessary, in order to ascertain J lty and mortality, as well as to obtain 'HJ the preselnt population ,tho morbid- Hi adequate information concerning the SBBSS BBBSl iggV B . . conditions under which the people are living, to take a new census. This census Is not a mere enumeration of the people but Includes valuable Information In-formation concerning the general health and the sanitary environment ot each Individual. Special attention Is directed to the study ot the caus es ot Infant mortality with a view to their removal. It is a well known -tact that certain cer-tain ot the respiratory diseases, notably not-ably tuberculosis, are favored In their spread by overcrowding and lack of ventilation in the home. Bearing this fact In mind the question ot housing Is carefully studied in each of the towns surveyed with a view to remedying existing conditions. In order to remedy present housing con dltlons the Health Service has, after two years of experimenting, designed a house constructed with a wooden frame, root and sides ot thin slabs of concrete reenforced with bamboo. This Is strong, durable, sanitary and cheap. A number have been built and seem to bo well adapted to the needs of the Filipino ncople. An Important feature of the work of the commissions Is the Investtga tlon of the water supplies ot the towns surveyed. Ever since the Health Service inaugurated Us cam paign to improve the water supply in the islands In 1906 the number of ar-tlslan ar-tlslan wells, which are practically th'o only sources of safe water In the pro- ( vlnces, has been gradually Increasing. The commissions found 75 per cent of the population ot the towns sur-' veyed used sate water obtained from artesian wells, 0.3 per cent used rain water, 2.4 per cent used water of questionable purity obtained from springs, while the remaining 23,2 per cent used water dangerous to health, of which 14.9 per cent was obtained from surface wells and 7.3 per cent from rivers. After the commissions have collected col-lected their data they often aid the municipal councils bydraftlng laws looking to the eradication ot existing evils and malpractices in sanitation. As a result ofthelr duty of the economics econ-omics ot the town they have been able in many instances to suggest, means by which the food supply may be augmented. This has been accomplished ac-complished by Industrial and agricul tural development. Smallpox has practlcallybeen ellm-. Inated from the Philippines by means ot wholesale vaccination made possl-1 ble by a compulsory vaccination law. I The last death from smallpox of a citizen ot Manilla occurred In July, 1909. Over eight years have passed' without a death In a city where for- j merly the annual toll ot victims was counted by thousands. Among the things 'the health commissions com-missions have accomplished are the following. They have taken a census "of the, towns surveyed in which they have" obtained valuable Information regarding re-garding the nationality, age, sex, civil civ-il condition, occupation and literacy of each Individual, the diseases ha has experienced, the sources of his drinking water and the number ot rooms and 'construction material ot his dwelling. In the collection of vital statistics they have taken special pains to secure se-cure a complete record ot Infantile morbidity and mortality. They,have made bacterologlcal studies stu-dies ot the water supply of each town; of soft drinks, Ice-creaim and milk sold in the markets and of the mother's milk. They have studied the disinfection ot open wells and examined ex-amined a considerable proportion ot Ibo peonlo for Intestinal parasites. Their studies In general sanitation have included the public markets, slaughter houses, garbage and sewage sew-age disposal, housing conditions, sanitation of factories and town location lo-cation and drainage In many cases recommendations were made looking to the removal of existing evils. A3 a result ot these recommendations, laws providing tor improvements in sanitation were enacted in practl ally alt the towns surveyed. The Impulse Im-pulse given to proper sewage disposal was such that nearly 10,000 Antlpolo systems have been built as a result. With a view toward Improving tho economic conditions ot the people Irrigation Ir-rigation and the various Industries were studied and recommendations made. Medical and surgical relief was furnished .o over 10,000 persons, many of whom had never known the possibility ot relief but had suffered for years from ailments easily rem edied. In fact the dispensaries created cre-ated such a demand for medical and surgical service In the various towns visited that the local, doctors found their practices greatly Increased. In one of the towns where a solitary physician and one small botlqulnihad i 'eked out precarious livelihoods bo-fore bo-fore the survey there are now .two busy doctors and two thriving drug stores. The good work ot the public health nurses and dietitians In teaching the mothers how to care for their Infants was strikingly demonstrated In Paslg the first town surveyed, where the Infant In-fant mortality fell more than 100 during the year following the survey. The people of towns surveyed have shown their appreciation of the work .done by the nurses by hiring other nurses to succeed them after the departure de-parture ot the. commissions. The commissions have organised women's clubs to continue and extend the Infant In-fant welfare and dietetic work. ThU phase of their activity Is not confined to the towns surveyed but is spread- i lng throughout the Islands. Over one j hundred clubs hare already organ-1 Ized and are doing good work in In-1 fant welfare. The commissions have been an Important Im-portant factor In the development ot the Idea of planting home vegetable gardens advocated by the Health service. Over 30,000 people have promised pro-mised to grow gardens during the present season, the planting of which is doubly Important at the present 'time because ot the food stringency, j By a practical demonstration of what can be done In the way of sanitation san-itation in the provinces they have Inspired In-spired the local health officers with Increased enthusiasm for their work. During their sojourn ln each town they have attempted to raUe tho standard ot the people. They have taught them the essentials ot proper diet and sanitation and the benefits to be derived from medical and sur-gieal sur-gieal care. The prime resource ot a country Is the health of Its citizens. 'This is what the health commissions are endeavoring en-deavoring to promote, j |