Photo taken on November 25, 1909 showing prisoners from the Cebu Provincial Jail nearby digging burial plots for the dead during the Cholera epidemic of 1909. | Contributed photo
At the small plaza honoring Rajah Humabon just across the Archdiocesan Museum of Cebu today is an obelisk that very few recognize. It is but a miniature version of gargantuan Egyptian obelisks of old but intended to honor a man who loomed large in the life of Cebuanos during the early years of the American Colonial Period: Judge Lyman Carlock.
Carlock, best remembered today as a street in the southern part of the city, fell victim in 1902 to the most vicious cholera epidemic Cebu and the rest of the country had ever experienced since it first appeared in Manila in the late 1800s.
Cholera is a disease caused by strains of the bacteria Vibrio cholerae which infect the small intestine. It is largely spread through unhygienic practices relating to human fecal waste. The revolution against Spain, followed by a devastating war against a new colonizer, the Americans, created the right conditions for the return of cholera in 1902.
History records this particular recurrence as the most devastating the Philippines has ever seen, at least before the COVID-19 pandemic came to the picture.
The bacteria enters the food chain through water, raw food or food prepared by unclean hands. Seafoods are a very high-risk source when, due to poor sanitation, human fecal matter is washed out to sea and then devoured by fish and other marine animals. Wells and springs are also at high risk especially when not covered.
Unfortunately, only humans were and still are the only species that can be infected by the nasty bacteria. The result is acute diarrhea and vomiting that begins to manifest between two hours and five days after ingestion, assuming you survive the excruciating pain.
Death toll
According to H. Stanfield, the military surgeon assigned in Cebu in 1902, this nasty cholera rerun reached Cebu on January 27 that year when a banca carrying a dead passenger from Caraga, Leyte, attempted to dock at Tuburan.
It was refused entry by the municipal president who knew that the disease was raging in Carigara. The banca operator was allowed entry instead at Catmon where a less vigilant municipal president permitted the burial. Days later the epidemic began to spread from town to town.
The Bureau of Health reported that the entire province of Cebu registered a total of 4,083 cases of cholera, resulting in 3,420 deaths, during the period between September 1, 1903 and August 30, 1904. The year before, the annual report of the US Secretary of War estimated 20,000 deaths in Cebu, Bohol, Leyte and Samar, with Cebu registering the highest at 6,520 out of 13,511 cases. This translates to something like 48.2 deaths for every 100 persons infected.
Compare this with the Spanish influenza pandemic of 1918, where, according to the same Bureau, Cebu registered only 1,880 fatalities. That explains why there is virtually no news report in publications of the period about how Cebuanos reacted to that pandemic.
Cholera, on the other hand, was a different story altogether; for it continued to stalk the land, rearing its ugly head once again in 1909, killing Cebu’s beloved American bishop Thomas Hendrick, who succumbed to the disease on November 29, 1909, the eve of his supposed departure for Manila on the way to his hometown of Chicago.
Even with the Buhisan Dam completed by February 1912, finally providing safe, potable water to residents in the city, cholera was never really stamped out in the rest of the province, registering cases by the hundreds per town in 1913 and onwards.
Eusebius James Halsema, the young American builder of the dam, had the most frightening experience of his life when he rested at a small village in Labangon to drink water at a nipa house on the way to inspect the dam construction. As soon as he had his sip he asked why the village was eerily quiet and was promptly told that cholera had just broken out in that locality. Thankfully he survived and went on to become mayor of Baguio City in his senior years.
Controlling the epidemic
Then as now, social distancing was recommended by the very few health professionals, mostly US military medical officers, who were aghast at the indigenous practice of converging on the house of the dying to prepare for a sumptuous feast.
In one instance, the American military surgeon in Cebu reported seeing 35 residents in a nipa hut that had a cholera patient! Ditto, the observation of another one decrying the makeshift toilets of the poor, which allowed pigs and other animals to feed on the human waste nonchalantly dumped below. Pigs were often seen on the streets with their snouts full of human waste! (Thankfully, along with the march of modernity, Filipinos now enjoy, more or less, the trappings of the flush toilet.)
Everyone was required to boil water before drinking it. All ships entering the port of Cebu had to undergo a five-day quarantine at a safe distance. A makeshift hospital of sorts was also hastily constructed in the capital town of Cebu, which had the only doctor then in the entire province.
While foreign steamships and other big boats dutifully observed quarantine procedures, operators of native bancas, which stayed longer than the former, often skirted the rule and contributed much to the spread of the disease.
Some suspected cases refused to be sent to the hospital, resorting instead to superstition and quack doctors. Hastily trained native sanitary inspectors had to comb house after house to check for cholera patients as families would hide them for fear of being stigmatized by their neighbors. The death toll thus rose faster than anticipated such that prisoners from the nearby Cebu Provincial Jail (now Museo Sugbo) had to be called in to bury the dead daily at the Carreta cemetery before the day’s end.
No cure then
Like the COVID-19 of the present, there was no cure for cholera then. Some who were infected only showed mild symptoms or none at all. But, unlike COVID-19, which takes longer to manifest, one could be much alive in the morning, according to one observer, and end up dead of before sundown. Strangely, the cholera epidemic ended just as suddenly as it had started for some inexplicable reason.
Today, as climate change has caused sea levels to rise and encroach on human settlements, the fear of a return of the cholera epidemic looms ever larger. But for now, it is not a simple and already-treatable bacteria but a more difficult one, a virus, that threatens the very existence of humanity. /dbs