Leonard Wood's vision: leprosy eradication

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Part of The American Chamber of Commerce Journal

Title: Leonard Wood's vision: leprosy eradication
Language: English
Year: 1929
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Fulltext: July, 1929 THE AMERICAN CHAMBER OF COMMERCE JOURNAL 5 number employed to 21%; six normal schools have been built and a training-department building added to the parent school in Manila. In 1925, the legislature provided for an expert survey of the islands’ schools which was carried out by the Monroe commission (headed by Dr. Paul Monroe of Columbia University). The original sum provided being too little, more was voted at a subsequent date. The legislature checked up on the report with a survey of its own, and agreed with most of the fundamental conclusions of the Monroe report, which is a book of 700 pages. The surveys had a wholesome effect. Though the schools administration is an entrenched bureaucracy, it is no longer heresy to voice a reasonable criticism of the schools and some eventual good may come of the public information imparted by the Monroe and legislative reports. Some good has already come, in fact, in the grant from the legislature for employing experts in rural vocational education, curriculum construction, elementary education, teacher training, and health education. There is valid argument on the side of the schools administration which discounts the enormity of an abnormally large proportion of college students going in for law, medicine and other professional courses whose graduates might be expected to join the parasitical class; for the attractiveness of other professions consists largely in there being opportunities for professional employment in them, and in the Philippines such chances are few. Besides, here the lawyer buys a farm as soon as he is able, and the doctor does so too; so there is a working back to the land from professional life. Gilmore realizes that for the farm-school graduate there should be a career in farming Leonard Wood’s Vision: Leprosy Eradication During the first half of this year 400 cured lepers were set at liberty from Culion, and nobody knows where they have gone or how they are faring. This is almost equal to the total number cured and discharged during 1928, which was but 480; and it is 10% of the lepers under treatment at Culion, who number 4,000. It is expected that fully 800 lepers will be cured and discharged from custody at Culion during this year; that is, it is believed that the record of the first half-year will be equaled during the second. The Philippines are on the way to mastery of leprosy. Since Culion was reorganized under Wood’s leadership in 1922, no less than 2,000 lepers have been cured there. Where are they? The whereabouts of but few of them are known. It is important to the science of leprosy treatment, as well as to the sociological side of the work, to ascertain where these cured lepers are living, how they are making a livelihood, and under what conditions they have been received into the communities where they are to be found. The Philippine AntiLeprosy Society plans to undertake this investigation with a corps of field workers on full time. To this end it is seeking financial aid from the public; it wishes to raise P20,000 to be awaiting. In setting aside the reservation for the pineapple industry he stipulated that among the homeseekers applying for lands on the reservation, farm school and agricultural college graduates should be given preference. Controversy aside, he inaugurated a movement in education which will be more thoughtfully guided than the progress of Philippine public education has been guided in the past. There is at least some thought given now to what the schools are doing; formerly the public was practically constrained to be satisfied with the mere fact that the schools functioned. It is just that Leonard Wood’s name be associated for all time with the leprosy work which was such a dominant interest of his administration. He took all the leadership in this, only the details of carrying out projects falling to Gilmore as head of the department. Gilmore has been directly instrumental in establishing a system of provincial hospitals, in providing the hospital for the insane at Manila, and in effecting other betterments in the health service. On June 27, but a few days ago, the plans of two years came to fruition in the incorporation of a governing entity—'associated with the government, but independent of it—to create fifty fellowships in the field of research in pure science. An objective is, to give applied science the benefit of this research. It is a reasonable hope that Manila will thus become a center of scientific investigation along many lines. Money for the work is to derive from private sources in the Philippines and the United States, the expectation being that the laboratory, library and other facilities of the government will be available to the fellows in research. —W. R. devoted solely to the cured-leper survey. Progress in curing leprosy, then, has reached the stage where the fate of the cured patient becomes important. He numbers so very many, and soon there will be an augmentation of 1,000 a year in his ranks. Necessity must find a way of looking after him, if he needs looking after. If he doesn’t, what a credit it is to the islands that they accept the verdict of science on leprosy and take the cured leper back into their communities. The exact situation in which the cured leper finds himself should be reliably known and reported. The Philippines have 4,900 lepers under medical treatment at present: Culion, 4,000; Cebu, 200; Manila, at San Lazaro, 400; Iloilo, 100. There are 1,600 lepers at Culion who are not under treatment, so the total number segregated is 6,300. Treatment consists in the regular injection of chaulmoogra ethyl esters with iodine (1/2%) into the patient’s blood. The technic has been improved recently at Culion by making the injections directly into the leprous lesions, instead of just at any convenient point on the body. Under the new method, lesions sometimes disappear entirely within three months. After a patient shows no further clinical and laboratory signs of leprosy—when all lesions are gone, and microscopic examination of the blood reveals no leprosy germs—he is kept under observation at Culion from six months to two years before being discharged as cured. There seem to be no recurrences of the disease, in persons pronounced cured, but only the careful survey proposed to be carried out by the anti-leprosy society can determine this point scientifically. Is the disease unique in this respect, as it is in others—does it recur after the lapse of years? It seems no one knows, at least no one in the Philippines. The leper expert would like ever so much to know; he would also like to know that patients cured and discharged are keeping up self-treatment as a precaution against reinfection, or recurrence of the old infection. Absolute triumph over leprosy waits upon this data. It is known that the health service has had to permit fifty cured lepers to return to Culion, they being unable to fit themselves into life outside the colony. Room is being made for more such residents of the island. Dr. Simplicio Chiyuto, colony chief, used lepers at the colony and built a road two kilometers along the coast, to Bayani. This gave access to some fields that can be tilled. The Leonard Wood Memorial Fund was then drawn upon to extend the road over the coastal hills to Baldad, about six kilometers, opening more fields to the colony market; and the antileprosy society is extending this road five more kilometers, at the cost of about P20,000. Altogether, the road opens considerable grazing and farming land up for settlement. Culion, an island 140 square miles in area, can support a much larger population than it is now supporting, if the road system is made extensive with the island’s boundaries and the skill of the forester and engineer is brought to the settlers’ aid. Fishing might employ many. If thousands of cured lepers were settled on the island, they would be accessible to scientific observation at all times—all doubts as to the permanency of the cure could be cleared up for all time. This seems to be an ideal solution of the difficulty the cured leper presents, but it depends upon the charity of the public. Then too, if a cured leper does not wish to live on Culion, if the cure is permanent there is no reason why he should live there; perhaps there is no legal way of holding him there. Five years hence, if the public is liberal, more about what may safely be done with him will be known. Properly, the Wood fund may only be spent for scientific research in the treatment of leprosy: using a little for the road may have been stretching a point rather hard, though it does get cured lepers under convenient observation in conditions normal to life outside the severely regulated colony. Therefore, the economic development of Culion as a place of residence for cured lepers must, in bulk, fall upon other resources than the Wood fund. This fund, it is expected, will be $2,000,000 (P4,000,000) before the end of the year. Leprosy exists in every part of the Philippines, but is rarer in some regions than in others. It is rare in Zambales; it is frequently encountered in Ilokos, the Bikol region, Cebu and Panay. Retail nine American D>< Wh01esa Importers íVVP» Agents BOTICA BOIE ° MANILA Heavy Chemicals—Fertilizer—Manufacturers We have been selling drugs for 98 years ADVERTISEMENTS PLEASE MENTION THE AMERICAN CHAMBER OF COMMERCE JOURNAL 6 THE AMERICAN CHAMBER OF COMMERCE JOURNAL July, 1929 It yields quickest when treated early, quite readily in the incipient stage. This means, of course, that treatment stations ought to be in operation in the various parts of the islands where leprosy is frequent; there are such stations at Manila and Cebu, and should be others at Legaspi, Iloilo, in Ilokos and in Mindanao. Dr. José N. Rodríguez has charge of the Cebu treatment station, just being completed with the Eversley Childs fund of $180,000. That’s about what the bill will be for any duplicate of this unit, but it is a well-equipped station and equal to its task. Dr. Rodríguez reports that lepers voluntarily go to the station for treatment. It seems reasonable to expect that among the patients will be many incipient cases, which diligent treatment can arrest in comparatively a short time. What about the P20,000 for the check-up on cured lepers? The Jo u r n a l sends its small donation, wishing the movement well. The Tariff Making Without Method By Th o ma s Wa l k e r Pa g e During the twentieth century American commerce with foreign nations has grown in volume and has changed substantially in character and in composition. Changes of no less moment have likewise taken place in nearly all branches of domestic industry. The proper adjustment, therefore, of commercial legislation to business needs has become more delicate and difficult at the same time that it has been assuming more vital importance. There has been increasing urgency in the demand that, in shaping legislation, instruments of greater precision should be substituted for the broadax and saw that have too often been used to roughhew measures for business regulation and to fit them into the structure of party politics. Particularly in regard to the tariff has this demand grown pressing. For twenty years it has been current in such expressions as “take the tariff out of politics,” or “make it scientific”—vague expressions which really mean that in some way the tariff, whether enacted for revenue or for protection, should be adapted more accurately and quickly to the varying exigencies of the United States Treasury and of American business. No little dissatisfaction with the manner in which the tariff is made grows out of the business disturbance caused by the prolonged uncertainty about the rates of duty. It is true that some disturbance must result whenever any effective duty is imposed or removed, but it is needlessly increased by protracting the anxiety and insecurity that prevail between the beginning and the completion of a tariff revision. Industry and commerce tend to adjust themselves to meet such new conditions as the revision may bring when once the conditions are known; but until the rates of duty and the The Eleventh Hour j VHIS week is the deadline—the eleventh hour—the last moment of preparation for the girls and boys who are venturing forth in search for wisdom. You, parents see to it that they are properly prepared to do the aidous tasks before them. Make sure their eyes are right by having them examined now. Always the best in quality but never higher in price government is probably giving to leprosy about all that may be expected from a popular treasury subject to pork-barrel invasions; it is giving Pl,500,000 this year, about 1/3 of the total appropriation for the health service. The .generalization seems to hold, that no funds asked of charity are more carefully and sensibly expended than those asked for the leper work in all its branches. None of these can be dispensed with, either, without injury to the work as a whole. Having mentioned two names, one or two more are in order. Dr. W. H. Wade, who was interviewed in preparation for this article, is chief pathologist at Culion. Technical medical work there is under Dr. Casimiro B. Lara. The chemical work is under Dr. Howard I. Cole, who succeeded Dr. Perkins. In Manila, at the science bureau, Dr. A. P. West has been engaged for years on research in the chemistry of chaulmoogra oil. His work is in the field of pure science, and very thorough-going. The accompanying article is Chapter I in Making the Tariff in the United States, by Thomas Walker Page, of the Institute of Economics, Washington, D. C. The book is published by the McGraw-Hill Book Co., 370 7th Ave., N. Y., and if memory serves the price is $2.50. The book is in its second edition. It is quite an informed and complete disquisition on the American tariff, and designed to inculcate knowledge about better ways of making the tariff than the method described here, which is the one which has always been followed. President Hoover has had occasion to denounce the 1929 tariff, just enacted, as in no wise his; indeed, it almost ranks as a foundling among Federal laws, no one wishing to acknowledge authorship of it. Dr. Page is well worth reading on the tariff, and all Institute books are erudite unbiased treatises. This one has 273 pages and an index. The Institute of Economics is a Carnegie foundation. It is vitally interested in the situation of the Philippines in relation to the American tariff. Dr. Page himself is interested, so here are friends at court.—Ed . terms of payment are fixed and understood adjustment is impossible, commitments are precarious, and business is enveloped in an atmosphere of insecurity. While Congress is preparing to legislate, radical and reactionary proposals are sure to find some advocacy in committee or on the floor, and the publicity given them adds to the general uneasiness. All sorts of rumors of impending action gain currency. The papers are filled with the baseless predictions of interested parties. Partisan spokesmen put out misleading estimates of the effects to be expected from the contemplated revision. Some members of Congress are accused of being swayed by unworthy motives; others are suspected of lacking decision, and pressure in many forms is brought to bear upon them to control their votes. Innumerable delegations and individuals visit Washington to argue, persuade, threaten, and plead. Many organizations open offices thdte to watch proceedings, keep their members informed, and mobilize all possible forces that might aid in securing the kind of tariff that would serve their particular needs. Intense jealousies and controversies arise among the conflicting interests and are reflected in committee deliberations and debates on the floor. So bitterly are they sometimes expressed that public welfare seems to be outweighed by personal antagonisms. “Blocs” and factions are formed to work primarily for some special advantage to particular industries or sections. Unrelated topics are dragged into the discussions both in Congress and in press in such a way as to becloud the issue and to prevent a reasoned and intelligent understanding of the particular matters under consideration. Doubt remains until the last vote is taken in regard to the outcome of a procedure attended by so much confusion, acrimony, and personal interest. The damage thus done to the orderly prosecution of business has compelled those that suffer from it to take thought on the need for a simpler and safer way of revising the tariff. No revision since the Civil War has met with general approval. After the passage of any new tariff, dissatisfaction naturally continues among those whose hopes and efforts have been disappointed. It is natural, also, that, knowing the circumstances under which the act was framed, they should impute its unfavorable features to improper influences. And since few obtain quite all they have wished for, the dissatisfied are always a majority. No matter how closely a new tariff may conform in plan and policy to platform pledges and campaign promises, its details are so numerous and it affects such a multitude of interest that it invariably offends more people than it pleases. The general discontent offers a fruitful field for work by the press and by spokesmen of the opposition party to discredit the act and all who are responsible for it. But when, as has sometimes happened, the opposition comes into power and itself undertakes a revision the result has been not so much to lessen the amount of discontent as merely to shift a part of it from one group of interests to another. Under control of neither of the two great parties has Congress succeeded in making a tariff that commanded enough approval to give promise of stability. Disappointment with the numerous revisions of the last thirty years has fostered the belief that Congress must either radically reform its methods of making the tariff or must empower some other agency to shape a measure that so intimately concerns the business welfare of the country. The damage caused by the confused and contentious activities that accompany tariff making, the disappointment of selfish interests, and the chagrin of some groups at their own failure and at the success of others in the use of personal and factional influence account for much of the prevailing discontent with the usual unmethodic procedure. A stronger ground for criticism is found in the outstanding truth that every one of the six general revisions of the past thirty years has contained numerous rates and provisions that were in accord neither with the public welfare nor with the policy announced, by the party entrusted with power. It would be invidious to specify such instances of offense in successive acts, although some are notorious and have been almost universally admitted. Indeed, no act in a generation has found defenders willing to assert that IN RESPONDING TO ADVERTISEMENTS PLEASE MENTION THE AMERICAN CHAMBER OF COMMERCE JOURNAL