Public Health in the Philippines: A History from Spanish Era to Modern Systems

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HISTORYjOFjPUBLICjHEALTHjINjTHEjPHILIPPINES


PublicjHealth

• Ecologicaljinjperspective,jmulti-jsectoraljinjscopejandjcollaborativejinjstrategy
• Itjaimsjtojimprovejthejhealthjofjcommunityjthroughjanjorganizedj communityjeffort

HistoryjofjPublicjHealthjinjthejPhilippinesjbasedjonjsocio-politicaljperiods

1. Pre-AmericanjOccupationj(upjtoj1898)
2. AmericanjMilitaryjGovernmentj(1898-1907)
3. PhilippinejAssemblyj(1907-1916)
4. ThejJonesjLawj(1916-1936)
5. Thej Commonwealth(1936-1941)
6. Japanesej Occupationj (1941-1945)
7. PostjWorldjWarjIIj(1945-1972)
8. MartialjLawjYearsj(1972-1986)
9. PostjEDSAjRevolutionj(1986jtojpresent)

I. jPRE-AMERICANjOCCUPATION

• PublicjhealthjworksjbeganjatjthejoldjFranciscanjConventjinjIntramurosjwherejFr.jJua
njClementejputjupjajdispensaryjinj1577jforjtreatingjindigentsjinjManila.jThisjeventual
lyjbecamejthejSanjJuanjdejDiosjHospital
• DuringjSpanishjtime:
1. CreationjofjBoardjofjVaccinatorsjtojpreventjsmallpox
2. CreationjofjBoardjofjHealth
3. ConstructionjofjCarriedojWaterworks
4. FirstjMedicaljSchooljinjthejPhilippinesj–jUST
5. SchooljofjMidwifery
6. PublicjHealthjLaboratory
7. ForensicjMedicine
• HospitalsjbeforejthejAmericansjcamejtojPhilippines:
1. GeneraljHospitals
a. SanjJuanjdejDiosjHospital
b. ChinesejGeneraljHospital
c. HospiciojdejSanjJosejinjCavite
d. CasajdelajCaridadjinjCebu
e. EnfermeriajdejSantajCruzjinjLaguna
2. ContagiousjHospitals
a. SanjLazarojHospital
b. HospitaljdejPalestinajinjCamarinesjSur
c. HospitaljdelosjLeprososjinjCebu
d. HospitaljdejArgencinajinjManilajforjsmallpoxjandjcholera
3. MilitaryjHospitals
a. HospitaljMilitarjdejManila
b. HospitaljMilitarjdejZamboanga




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4. NavaljHospitals
a. HospitaljdelajMariejinjCebu
b. HospitaljdejBasilan
5. Otherjhospitals/Asylums
a. HospiciojdejSanjPascualjBaylonjinjManila
b. AsylumjofjSt.jVincentjdejPauljinjManilajforjpoorjgirls
c. HospitaljofjSanjJosejforjorphanedjchildrenjandjmentallyjill

II. jAMERICANjMILITARYjGOVERNMENT

• Controljofjepidemicsjsuchjasjcholera,jsmallpoxjandjplague
• Fightj againstjcommunicablejdiseasesjsuchjasjleprosy,jdiarrhea,jmalaria,jbe
ri-beri
• Projectsjandjactivities:
1. Establishedjajgarbagejcrematory
2. Approvedjthejfirstjsanitaryjordinancejandjratjcontrol
3. Amoebicjdysenteryj–
jcausedjbyjcontaminatedjwaterjandjuncleanjvegetables,jandjmalariaj–
jAnophelesjminismusjflavirotrisjwasjpointedjoutjasjvector
4. Cholerajvaccinejwasjfirstjtried
5. Confirmedjthatjplaguejinjmanjcomesjfromjinfectedjrat
6. OpenedjajleperjcolonyjinjCulion
7. FoundedjthejManilajMedicaljSocietyjandjPhilippinejIslandjMedicaljAs
sociation
8. OpenedjthejUPjCollegejofjMedicine
9. EstablishedjBureaujofjScience

III. jPHILIPPINEjASSEMBLY

• NewjwaterworksjinjManilajwasjinauguratedjtojcontroljcholera
• NursingjstudentsjatjPhilippinejNormaljSchool
• HygienejandjPhysiologyjwerejincludedjinjcurriculumjofjpublicjelementaryjschool
• Anti-TBjcampaignjwasjstarted
• PhilippinejTuberculosisjSocietyjwasjorganized
• Pasteurjprophylaxisjtreatmentjagainstjrabiesjwasjoffered
• OpeningjofjthejPhilippinejGeneraljHospitalj(PGH)
• Usejofjanti-typhoidjvaccinejwasjinitiated
• HypochloritejofjlimejwasjfirstjusedjforjtreatingjthejwaterjsupplyjofjManila
• EtiologyjofjAmoebicjdysenteryjwasjmadejclear
• Dryjvaccinejagainstjsmallpoxjwasjfirstjused

IV. jJONESjLAWjYEARS

• Retrogressionjratherjthanjprogressionjinjsojfarjasjthejhealthjwasjconcern
1. IncreasejCDR
2. IncreasejIMR
3. IncreasejMorbidity
• Increasedjdeathsjfromjsmallpox,jcholera,jtyphoid,jmalaria,jberiberijandjTB
• Re-organizationjhappenedj(re-
organizedjthejhealthjservicejandjencouragedjeffectivejsupervision




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1. Studyjthejcausejandjprevalencejofjtyphoidjfever
2. Thej composition,j valuej andj vitaminj distributionj ofj manyj Philippinej foodsjwer
ejstudied
3. Schickjtestjwasjusedjtojdeterminejthejcasesjofjdiphtheria
4. CampaignjagainstjHookwormjwasjlaunched
5. Anti-dysenteryjvaccinejwasjfirstjtried
6. Thejrolesjofjseafoodjinjtransmissionjofjcholerajandjthejpollutionjofjfishingj secto
rjtojtyphoidjwerejstudied
7. Firstjtrainingjcoursejforjsanitaryjinspectorjwasjgiven
8. Womenjandjchildjlaborjlawjwasjpassed
9. ThejmechanismjofjtransmissionjofjdenguejfeverjthroughjAedesjaegyptijwasjstu
died
10. ConstructionjofjNovalichesjdam
11. EstablishmentjofjschooljofjHygienejandjPublicjHealth
12. NationaljResearchjCounciljofjthejPhilippinesjwasjorganized
13. BSjinjEducationjmajorjinjHealthjEducationjwasjopenedjinjUP
14. PhilippinejPublicjHealthjAssociationj(PPHA)jwasjorganized

V. jTHEjCOMMONWEALTHjPERIOD

• Processjofjgainingjandjmaintainingjaltitudej(becausejthejlaterjyearsjunderjJonesjLa
wjwasjsuccessful)
• Thej epidemiologyj ofj lifej threateningj diseasesjwasj studiedj –
j diphtheria,j yaws,jdengue
• Researchjinjthejfieldjofjhealthjwasjpromoted
• UPjSchooljofjPublicjHealthjwasjestablishedjtojtrainjpublicjhealthjleaders
• Constructionjofjadditionaljleprosariajandjprovincialjhospitals
• ConstructionjofjQuezonjInstitutej forjPTBjpatients
• ResearchjandjcontroljofjTB,jmalaria,jleprosyjandjyaws
• DevelopmentjofjMaternaljandjChildjHealthj(MCH)
• 1939,jcreationjofjDepartmentjofjPublicjHealthjandjWelfarej–
jDr.jJosejFabellajasjthejfirstjsecretary
• 1940,jBureaujofjCensusjandjStatisticsjwasjcreatedjtojgatherjvitaljstatistics
• Injspitejofjdevelopmentj:
1. Inequitablejdistributionjofjhealthjservicesjremainedjajproblem
2. 80%jofjthosejwhojdiedjwerejneverjgivenjmedicaljattention

VI. jJAPANESEjOCCUPATION

• Duringjthisjtime,jalljpublicjhealthjactivitiesjwerejpracticallyjparalyzedjT

HEjWORLDjWARjII
• Afterj5jyearsjofjJapanesej occupation,jpublicj healthj triedjtojpickjupjthejd
ebrisjandjrisejfromjthejruins
• Survey:j increasedj incidencej ofj TB,j VD,j malaria,j leprosyj andjmal
nutrition
• Generaljsanitationjhasjbeenjreducedjtojleveljenoughjtojconstitutejajnatio
naljhazard
• USj congressj passedj anj emergencyj measuresj toj controlj diseases:jT
B,jVD,jmalaria,jleprosy,jmalnutrition




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• Immunizationjprogram

VII. jPOSTjWORLDjWARjII

• THEjPHILIPPINEjINDEPENDENCE
1. CompletionjofjajresearchjonjDichlorodiphenyltrichlorothanelj(DDT)jsawj
dustjasjlarvicidejandjDDTjresidualjsprayingjofjhousesjinjthejcontroljofjma
laria
2. ConstructionjofjthejNationaljChestjCenterj–
jforjcontroljcasejregistryjforjTB,jmassjimmunizationjwithjBCG
3. Industrialjhygienejlaboratory
4. Introductionjofjone-infectionjmethodjforjgonorrheajwithjpenicillin
5. CreationjofjcentraljHealthjLaboratoryjinjthejPhilippines
6. CreationjofjInstitutejofjNutritionjunderjBRL,jthenjitjwasjtransferredjtojNati
onaljInstitutejofjSciencejandjTechnologyjandjwasjrenamedjasjFoodjandj
NutritionjResearchjCenter,jitjwasjagainjrenamedjasjFNRI
• ManilajwasjselectedjasjHeadquartersjforjthejWHOjWesternjPacificjOffice
• StrengtheningjHealthjandjDentaljservicesjinjruraljareas
ThisjisjthrujRHUjprogramj(perjmunicipalitiesjwithj5,000-10,000jpopulation)
1jMunicipaljHealthjOfficerj(MHO)j1j
PublicjHealthjNursej(PHN)
1jMidwife
1jSanitaryjInspector
• Re-organizationjofjDOHj–jcreationjofjseveraljoffices
1. DentaljHealthjServices
2. MalariajEducationjServices
3. DiseasejIntelligencejCenter
4. FoodjandjDrugjAdministration
5. NationaljSchistosomiasisjControljCommission
6. NationaljNutritionjProgram
• Initiationjofjprogramsjwithjmultilateraljassistance
1. WHOjandjUNICEFjassistedjTBjandjBCGjprograms
2. TBjcontroljprogramjasjbasicjservicejofjRHU
3. TBjsputumjcasejfindingjbyjmicroscopy
4. SerumjandjvaccinejproductionjinjAlabang
5. ExpandedjMCHjandjMentaljHealthjProgram
6. TrainingjprogramsjforjMidwives
7. StrengthenedjgraduatejhealthjprogramsjatjthejUP-CPH
• DevelopmentjofjFamilyjPlanningjMovement
• Launchingj ofj programsj inj cooperationj withj privatej sectorsj–
j topj providejservicesjtojperipheryj(indigents,jminorityjgroups)


• RizaljDevelopmentjProject
1. RestructuringjofjthejDOHjRuraljHealthjCarejDeliveryjSystem
2. Eachjbarriojwasjprovidedjwithjmidwife
3. Forjthejfirstjtime,jdenguejvirusjwasjisolatedjfromjtypicaljHjfeverjcases





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