HISTORY OF PUBLIC HEALTH IN THE PHILIPPINES

History of Public Health in the Philippines based on socio-political periods

1. Pre-American Occupation (up to 1898)

2. American Military Government (1898-1907)
3. Philippine Assembly (1907-1916)
4. The Jones Law (1916-1936)
5. The Commonwealth (1936-1941)
6. Japanese Occupation (1941-1945)
7. Post World War II (1945-1972)
8. Post EDSA Revolution (1986 to present)

I. PRE-AMERICAN OCCUPATION

 Public health works began at the old Franciscan Convent in Intramuros where Fr. Juan Clemente put up a
dispensary in 1577 for treating indigents in Manila. This eventually became the San Juan de Dios Hospital
 During Spanish time:
1. Creation of Board of Vaccinators to prevent smallpox
2. Creation of Board of Health
3. Construction of Carriedo Waterworks
4. First Medical School in the Philippines – UST
5. School of Midwifery
6. Public Health Laboratory
7. Forensic Medicine

 Hospitals before the Americans came to Philippines:

1. General Hospitals
a. San Juan de Dios Hospital
b. Chinese General Hospital
c. Hospicio de San Jose in Cavite
d. Casa dela Caridad in Cebu
e. Enfermeria de Santa Cruz in Laguna
2. Contagious Hospitals
a. San Lazaro Hospital
b. Hospital de Palestina in Camarines Sur
c. Hospital delos Lesprosos in Cebu
d. Hospital de Argencina in Manila for smallpox and cholera
3. Military Hospital
a. Hospital Militar de Manila
b. Hospital Militar de Zamboanga
4. Naval Hospital
a. Hospital dela Marie in Cebu
b. Hospital de Basilan
5. Other hospitals/Asylums
a. Hospicio de San Pascual Baylon in Manila
b. Asylum of St. Vincent de Paul in Manila for poor girls
c. Hospital of SanJose for orphaned children and mentally ill

II. AMERICAN MILITARY GOVERNMENT

 Control of epidemics such as cholera, smallpox and plague

 Fight against communicable diseases such as leprosy, diarrhea, malaria, beri-beri
 Projects and activities:
1. Established a garbage crematory
2. Approved the first sanitary ordinance and rat control
3. Amoebic dysentery – caused by contaminated water and unclean vegetables, and malaria – Anopheles minismus
flavirotris was pointed out as vector
4. Cholera vaccine was first tried
5. Confirmed that plague in man comes from infected rat
6. Opened a leper colony in Culion
7. Founded the Manila Medical Society and Philippine Island Medical Association
8. Opened the UP College of Medicine
9. Established Bureau of Science

III. PHILIPPINE ASSEMBLY

 New waterworks in Manila was inaugurated to control cholera

  Nursing students at Philippine Normal School
 Hygiene and Physiology were included in curriculum of public elementary school
 Anti-TB campaign was started
 Philippine Tuberculosis Society was organized
 Pasteur prophylaxis treatment against rabies was offered
 Opening of Philippine General Hospital (PGH)
 Use of anti-typhoid vaccine was initiated
 Hypochlorite of lime was first used for treating the water supply of Manila
 Etiology of Amoebic dysentery was made clear
 Dry vaccine against smallpox was first used

IV. JONES LAW YEARS

 Retrogression rather than progression in so far as the health was concern

1. Increase CDR
2. Increase IMR
3. Increase Morbidity
 Increased deaths from smallpox, cholera, typhoid, malaria, beri-beri and TB
 Re-organization happened (re-organized the health service and encouraged effective supervision

1. Study the cause and prevalence of typhoid fever

2. The composition, value and vitamin distribution of many Philippine foods were studied
3. Schick test was used to determine the causes of diphtheria
4. Campaign against Hookworm was launched
5. Anti-dysentery vaccine was first tried
6. The roles of seafood in transmission of cholera and the pollution of fishing sector to typhoid were studied
7. First training course for sanitary inspector was given
8. Women and child labor law was passed
9. The mechanism of transmission of dengue fever through Aedes aegyti was studied
10. Construction of Novaliches dam
11. Establishment of school of Hygiene and Public Health
12. National Research Council of the Philippines was organized
13. BS in Education major in Health Education was opened in UP
14. Philippine Public Health Association (PPHA) was organized

V. THE COMMONWEALTH PERIOD

 Process of gaining and maintaining altitude (because the later years under Jones Law was successful)
 The epidemiology of life threatening diseases was studied – diphtheria, yaws, dengue
 Research in the field of health was promoted
 UP School of Public Health was established to train public health leaders
 Construction of additional leprosaria and provincial hospitals
 Construction of Quezon Institute for PTB patients
 Research and control of TB, malaria, leprosy and yaws
 Development of Maternal and Child Health (MCH)
 1939, creation of Department of Public Health and Welfare – Dr. Jose Fabella as the first secretary
 1940, Bureau of Census and Statistics was created to gather vital statistics
 In spite of development:
1. Inequitable distribution of health services remained a problem
2. 80% of those who died were never given medical attention

VI. JAPANESE OCCUPATION

 During this time, all public health activities were practically paralyzed

THE WORLD WAR II

 After 5 years of Japanese occupation, public health tried to pick up the debris and rise from the ruins
 Survey: increased incidence of TB, VD, malaria, leprosy and malnutrition
 General sanitation has been reduced to level enough to constitute a national hazard
 US congress passed an emergency measures to control diseases: TB, VD, malaria, leprosy, malnutrition
 Immunization Program

VII. POST WORLD WAR II

 THE PHILIPPINE INDEPENDENCE

1. Completion of a research on Dichlorodiphenyltrichlorothanel (DDT) saw dust as larvicide and DDT residual
spraying of houses in the control of malaria
2. Construction of the National Chest Center – for control case registry for TB, mass immunization with BCG
 3. Industrial hygiene laboratory
4. Introduction of one-infection method for gonorrhea with penicillin
5. Creation of Central Health Laboratory in the Philippines
6. Creation of Institute of Nutrition under BRL, then it was transferred to National Institute of Science and
Technology and was renamed as Food and Nutrition Research Center, it was again renamed as FNRI
 Manila was selected as Headquarters for the WHO Western Pacific Office
 Strengthening Health and Dental services in rural areas
This is thru RHU program (per municipalities with 5,000-10,000 population)
1 Municipal Health Officer (MHO)
1 Public Health Nurse (PHN)
1 Midwife
1 Sanitary Inspector
 Re-organization of DOH – creation of several offices
1. Dental Health Services
2. Malaria Education Services
3. Disease Intelligence Center
4. Food and Drug Administration
5. National Schistosomiasis Control Commission
6. National Nutrition Program
 Initiation of programs with multilateral assistance
1. WHO and UNICEF assisted TB and BCG programs
2. TB control program as basic service of RHU
3. TB sputum case finding by microscopy
4. Serum and vaccine production in Alabang
5. Expanded MCH and Mental Health Program
6. Training programs for Midwives
7. Strengthened graduate health programs at the UP-CPH
 Development of Family Planning Movement
 Launching of programs in cooperation with private sectors – top provide services to periphery (indigents, minority
groups)

 Rizal Development Project

1. Restructuring of the DOH Rural Health Care Delivery System
2. Each barrio was provided with midwife
3. For, the first time, dengue virus was isolated from typical H fever cases

VIII. MARTIAL LAW YEARS

 Creation of National Economic Development Authority (NEDA)

 Department of Health was renamed as Ministry of Health (MOH)
 Accomplishments during this period:
1. Formulation of National Health Plan
- Implementation of restructure health care delivery system (primary, secondary, tertiary)
- Construction of tertiary hospitals (Phil. Heart Center, Lung Center, Kidney Center, Lund
Center, Lungsod ng Kabataan – PCMC)
2. Adaption of the Primary Health Care (PHC)
- Promotive and preventive are rather than curative care
- Philippines was the first country to implement PHC
3. Launching of Operation Timbang and Mothercraft
- Nationwide program providing supplementary food for infants and pre-school and school
children
4. Birth of Integrated Provincial Health Office (IPHO)
5. Oral Rehydration Therapy for the National Control of Diarrheal diseases
6. Community-based health programs
7. Progress in Public Health research:
a. Nutrition council of the Philippines – to address problems on malnutrition
b. RITM – for infectious and tropical diseases
c. PCHRD – mandated to lead, direct and coordinate science and technology activities in health
and nutrition

IX. EDSA REVOLUTION

 From Ministry of Health it was renamed again as Department of Health

 Increase in life expectancy slowed down
 Morbidity and Mortality rates from preventable causes stabilized at high rates
 Decline in infant and child mortality decelerated
 Increased incidence of malnutrition
 Declined practice of family planning
X. AQUINO ADMINISTRATION

 1987 Constitution – more provisions on health making comprehensive health care available
 Active participation of private sector and NGO
 Major activities influencing public health during this period:
1. Milk Code – required the marketing of breast milk substitute
2. Universal child and mother immunization
3. International safe motherhood initiative was launched to reduced maternal mortality rate
4. Act prohibiting discrimination against women (RA 6725)
5. National Epidemic Surveillance System (NESS) – this was made to track down the occurrence of 14 diseases with
potentials of causing outbreaks
6. National Drug Policy and Genetics Act – ensure the availability of safe, effective and affordable quality drugs (RA
6675)
7. Local Government Code – from national government to governors and mayors – devolution (RA 7160)
8. Organ Donation Act of 1991 (RA 7170) – Legalizing donation of all or body parts after death for specified purpose

XI. RAMOS ADMINISTRATION

 “Health in the Hands of People” and “Let’s DOH it” – by then Sec. Juan Flavier
 Continued to adopt PHC as a strategy
 Memorable initiative during the leadership of Flavier:
1. National Immunization Day – BCG, DPT, OPV, MMR
2. Mother and Baby- Friendly Hospital Initiative – this strategy ensures the survival and health of children through
breast feeding
3. Promotion of Philippine Traditional Medicine – DOH and DOST
4. Hospitals as Center of Wellness – transformed 45 government hospitals from disease places to centers of wellness
5. Yosi Kadiri – Anti-smoking campaign
6. Araw ng Sangkap Pinoy – aimed to prevent vitamin A, iron and iodine deficiency
7. Voluntary Blood Donation Program
8. Kung Sila’y Mahal Mo Magplano – Family planning program
9. Doctors to the Barrio
- Laws:
1. RA 7394 – Consumer Act of the Philippines- an act providing penalties for manufacture, distribution and sales of
adulterated foods, drugs and cosmetics
2. RA 7610 – Special protection of children against child abuse, exploitation and discrimination
3. EO 39 – which created the Philippines National AIDS Council as a national policy and advisory body in the
prevention and control of HIV-AIDS
4. RA 7432 – Senior Citizen’s Act – which grant benefits and special privileges in order to maximize the contributions
of senior citizens to nation building
5. RA 7719 – The National Blood Services Act of 1994 which was passed to promote voluntary blood donation
6. RA 8172 – An act for Salt Iodization Nationwide (ASIN) – providing salt iodization nationwide approved in 1996 and
renamed FIDEL (Fortified for Iodine Elimination)
- Reodica’s Seven Strategy Program:
1. Expanded Program on Immunization (Oplan Alis Disease) – to eliminate polio measles and neonatal tetanus
2. Nutrition – vitamin A, iron and iodine utilization (Araw ng Sangkap Pinoy)
3. Family Planning
4. Tuberculosis prevention (Target, Stop TB!)
5. Environmental Sanitation (Tubig, Kubeta, Oresol)
6. STD-AIDS awareness prevention
7. Healthy Lifestyle Program

Lecture notes c/o Mr. Joseph Joy Banzon, RMT, MPH