Cholera in the Philippines

"Today, no one should die of cholera," said the Philippines' Health Secretary Francisco Q. Duque last week. But, he added, a cholera epidemic now rages in 37 of the Philippines' 55 provinces. Out of more than 10,000 Filipinos stricken, 1,228 have died. Even with urgently needed international help, there will probably be many new cases for six months more.

An unusual combination of medical complexities and political maneuvering conspired to make the Philippines so vulnerable. A disease that is completely preventable (by keeping water and food free of contamination by sewage), cholera has been spreading throughout southeast Asia from Red China since last summer. An epidemic reached the Philippines last September. Elpidio Valencia, then Health Secretary, correctly identified it as "choleriform enteritis caused by a vibrio (bacillus) called El Tor," which he less soundly defined as a "mild" form of cholera. A presidential campaign was in progress, and the regime of President Carlos P. Garcia was anxious to downplay any threat to the nation's health.

Pilgrim Stock. El Tor strains of cholera vibrios take their name from a Sinai Peninsula quarantine station where they were originally found in Mecca-bound Moslem pilgrims. The strains were long thought to be harmless, but recently they proved to be the cause of a deadly epidemic in Indonesia.

In the Philippines, El Tor spread a bit more slowly than typical cholera. Mass inoculations might have helped, but government and antigovernment forces, burning with election fever, accused each other of cornering vaccine for their partisans. The government welcomed a U.S. Navy team of veteran cholera fighters from Formosa, but failed to use vigorously the weapon that the Navymen recommended: salt water. Cholera victims are weakened and killed by a catastrophic loss of body fluids through vomiting and diarrhea (as many as 15 quarts in a day); they can nearly always be saved by prompt, aggressive treatment, in which saline solution is given intravenously, sometimes with sodium bicarbonate. The Manila government did not get enough of the solutions or the equipment to administer them.

When new President Diosdado Macapagal took over Dec. 30, he intensified the anticholera campaign. New Health Secretary Duque put an end to the doubletalk about "choleriform" disease, attacked El Tor as vigorously as if it had been old-fashioned cholera. He sent saline solution to 1,300 rural health teams, put 27 ten-man vaccinating teams in the field. But it was too late to stop El Tor.

Balky Beneficiaries. Worst hit was the Moslem community on Mindanao around Lake Lanao. Villagers refused to stop drinking water from the lake and rivers into which they defecated, arguing "Why shouldn't I drink it, when my forefathers did and lived to be 90?" They balked at vaccinations, protesting that government health workers were "trying to inject Christian blood into our veins."

The Philippines have received donations of vaccine and lifesaving solutions from the U.S., Formosa and Hong Kong. Last week UNICEF raised a $50,000 fund to pump more in. But for too many Filipinos the effort was too late. Said a foreign observer: "A terrible social and medical crime has been committed."

This file is automatically generated by a robot program, so reader's discretion is required.