But to Army officials, a strategy of wholesale compulsory vaccination—of the troops and the most proximate natives—had proven its merits. For the people of Manila, the U.S. vaccination campaign far exceeded anything they had experienced under their previous rulers. The Spanish regime’s chief vaccinator had reported just 9,136 vaccinations performed in the city during the four years prior to October 1898. During the next five months, the U.S. military government vaccinated 80,000 inhabitants.90
The U.S. Army took the war beyond Manila to the provinces, across the central Plain of Luzon and to other islands. By 1900, Aguinaldo’s forces adopted guerrilla warfare, which the Americans derided as uncivilized. The Army countered with increasingly violent tactics, including interrogation of suspected insurgents and spies using a form of torture known, in an especially perverse marriage of medical metaphor and military technique, as the “water cure.” The Medical Department had its hands full, establishing military hospitals, caring for the wounded, and moving with the line. Controlling infectious diseases remained a high priority. During 1899, the most deadly year of the campaign for the Army, 475 soldiers and officers died from wounds of battle, another 139 died from “other forms of violence,” and 709 succumbed to disease, “principally diarrhea and dysentery, small-pox and typhoid.” During the same year, nearly two thousand soldiers were sent home due to sickness. Throughout the war, smallpox weighed heavily on the minds of the military surgeons. They vaccinated the troops with great regularity.91
Preserving the health of the troops called for measures to sanitize their environment and the peoples who inhabited it. Many of the soldiers were stationed in one of five hundred garrison towns, which soon grew overcrowded with migrants fleeing the war-torn countryside. Stationed indefinitely in garrison towns, the troops mixed promiscuously with the inhabitants, consuming palm wine, gambling, and fraternizing. “The most crying need in the early days of our occupancy of the Provinces was to check the ravages of smallpox,” Greenleaf recalled. He advised the U.S. military governor, General Arthur MacArthur, that each garrison should have an army surgeon designated as “health officer,” “special orders being given for the vaccination of the population of the towns and neighboring barrios as far as the people could be reached.” As one U.S. colonial official reported, the garrison surgeons “had great latitude, and under their direction compulsory vaccination was usually enforced.” The surgeons also used “arbitrary military compulsion” to enforce “simple regulations as to cleaning streets, putting dirty premises in order, [and] tying up pigs.”92
A comprehensive plan for vaccination in the provinces emerged. The idea appears to have originated with a military surgeon named Major Louis M. Maus. Major Maus knew how infection could rip through an army. He began the Spanish War as chief surgeon with the VII Corps in Miami and Jacksonville, bearing witness as more than 5,000 of the soldiers in his care were hospitalized with typhoid fever. Reporting from Bautista, Pangasia, in February 1900, he warned that smallpox prevailed among the people of the towns and was “not rare among our troops as a consequence.” It would be impossible, he said, to “stamp out this disease among our soldiers, in spite of the frequent and careful vaccinations among them, until the natives are themselves protected.” Not long after this report, the Army issued orders to vaccinate all people within the reach of the division of the Philippines, which at that time included seven provinces north of Manila. Within five months, more than 600,000 Filipinos certified by the medical department as protected from smallpox by vaccination or previous infection.93
For the remainder of the war, the Army enforced vaccination wherever it went. Sometimes that meant rounding up the inhabitants with bayonets in order to inoculate them. By 1901, the American vaccine farm in Manila was turning out a million points a year, and more farms were being established in the provinces. The U.S. Marine-Hospital Service established a quarantine station at the entrance to Manila Bay, vaccinating crews and passengers aboard ships approaching the principal harbor of the colonial government. On December 2, 1901, the Philippine legislature put its seal on this emerging American regime, mandating the compulsory vaccination of the entire population of the Philippines. The law ensured that the Army’s wartime policy would continue under the colonial regime long after the war’s end.94
The narrow military imperative of the cordon sanitaire was, during the course of the war, yielding something grander, a more far-reaching system of public health. As it did so, Army surgeons, U.S. officials, and other commentators began to publicize these measures as not merely efficient but humane. As early as 1901, Colonel Greenleaf declared that the Army’s sanitary measures were winning hearts and minds. “This object lesson in one of the most important characteristics of the American people, humanity in war, has made a deep impression on the Filipinos, and has been an important factor in winning their allegiance to our Government.” The following year, James LeRoy declared that the surgeons’ “little and big services to the natives . . . not only helped make the name ‘Americanos’ more acceptable” but “were also genuine responses to the call of humanity.” But as Greenleaf and LeRoy well knew, willing submission to vaccination remained far from universal in the pueblos and barrios. Understandably, Filipinos associated the vaccinators, even those who were native physicians, with the foreign army they served. The work of vaccinating the natives, conceded Greenleaf, was “by no means devoid of danger, and several instances occurred where the vaccinators were captured by insurrectos or kidnapped by the inhabitants and killed.”95
A fuller articulation of the humanitarian argument did not emerge until the final, brutal months of the Philippine-American War. The argument gained momentum at precisely the moment when the American public learned of the scale of atrocities carried out by the U.S. Army in the Philippines and the devastating effects, upon Filipino civilians, of the Army’s counterinsurgency policy of reconcentration. That policy would forever be associated with a single forsaken place: Batangas.
In the days before Christmas, 1901—as anti-imperialists in the U.S. Congress denounced the nation’s Philippine policy (“We have witnessed the spectacle of an American Army numbering over 70,000 men engaged in conquering a people struggling for independence,” thundered Representative Samuel W. McCall of Massachusetts)—the peasants of Batangas province made their way, by winding paths and rough roads, to the pueblos. Market towns in a prostrated agricultural region with precious little left to sell or barter, the pueblos were fast taking on a new kind of urban life as Army “reconcentration zones.” Traveling alone, with families, or alongside their entire uprooted barrios, the Batanguenos stepped past soldiers, through fences, and around garbage into the teeming camps. They carried rice, chickens, and the pieces of their bamboo and nipa palm huts. On the day after Christmas, by order of Brigadier General James Franklin Bell of the Third Separate Brigade, all property remaining beyond the perimeters would be subject to confiscation or the torch. Any man they found out there without proper papers would be arrested, or shot if he dared to run away.96
Located in southwestern Luzon, just a few hundred miles from the offices of the U.S. colonial government in Manila, Batangas province was one of the last strongholds of the Filipino resistance, the base of operations for insurgent leader General Miguel Malvar. The Army command had organized the Third Separate Brigade for this chief purpose: to “pacify” Batangas and thus bring an end to an increasingly unpopular colonial war.97
By the fall of 1901, that war had seemed all but over. Guerrilla bands laid down their arms in one province after another. Then came Balangiga. In a village on the island of Samar, guerrillas and villagers wiped out a U.S. infantry company. American newspapers likened the “Balangiga Massacre” to Little Big Horn. Dispatched on a punitive campaign against Samar, Brigadier General Jacob H. Smith ordered his men to kill everyone over the age of ten and turn the island into a “howling wilderness.”98
In Batangas, too, the customary distinctions between hostiles and civilians yielded
to claims of military necessity. “Practically the entire population has been hostile to us at heart,” General Bell explained in a Christmas Eve circular to his officers. “To combat such a population,” the war must be made “insupportable.” By then Bell’s brigade had driven most of the province’s 300,000 inhabitants, already weakened by famine and disease, into the zones. American soldiers put the Batanguenos to work grading roads, digging latrines, and gathering rice in the countryside. With the rectitude of a Victorian charity official, Bell insisted “great pains” be taken not to “pauperize the people.” He told his men to exact respect in the camps for the American flag, the troops, and “the great nation to which they pertain.”99
A veteran of the late-century Indian Wars, General Bell did not invent the counterinsurgency tactic of reconcentration: the forcible removal of civilians from hostile areas into militarized towns in order to isolate guerillas from their base of support. The history of U.S.-Indian policy had been, in a sense, one long process of forcible removal. More recently, European armies had resorted to this specific tactic in colonial wars against indigenous, nonwhite populations. The Spanish general Valeriano Weyler’s brutal reconcentration campaign in Cuba during 1896–98 had failed to crush the independence movement, but it had caused the deaths of an estimated 100,000 Cubans and tilted American public opinion toward war. In 1900, the young Winston Churchill touted his nation’s forced reconcentration of rural South Africans in the Boer War. Still, the severity of the U.S. Army’s “concentration camps,” as some newspapers referred to them, shocked the American public. General Bell and his superiors defended the camps as a legal and necessary measure to protect the population from bandits and guerrillas. But within the United States the policy strengthened opposition to the war.100
Wherever it was undertaken, forced population concentration caused epidemics. In the British concentration camps for Boers and Blacks in South Africa, 42,000 civilians died. Public revelations of the policy’s human cost weakened public support for imperialism in England. Like rural people across the Philippine archipelago, the Batanguenos had already suffered mightily in recent years. The effects of the two successive wars—the collapse of the Spanish health system, the movement of troops about the provinces, the destruction of draft animals by rinderpest, and the dislocation and impoverishment of the rural population—intensified the health crisis that had been ongoing for some years. These events elevated the Filipinos’ susceptibility to disease while increasing their exposure to pathogens.101
The Batangas reconcentration zones seethed with disease and death. One Army officer described the camp he commanded as “some suburb of hell.” Vampire bats circled overhead awaiting the day’s supply of corpses. Thrown together with thousands of desperate strangers in the filthy zones, the Batanguenos suffered outbreaks of cholera, dysentery, and smallpox. With so many U.S. soldiers living in the camps, something had to be done.102
And so as U.S. infantrymen hunted down and killed General Malvar’s guerrillas in the coastal flatlands and rolling hills of Batangas, Army doctors enforced vaccination in the camps. The Army hired eighty Filipino vaccinators. According to the official “Directions for Vaccination of Natives,” sent in January 1902 to all station commanders in Batangas by Army Chief Surgeon William Stephenson, the vaccinators moved in pairs through the teeming reconcentration camps, each accompanied by an American soldier. As the vaccinating party entered the crowded huts and houses, they drove the inhabitants toward the rear walls. The vaccinators set to work at the doorway, scraping the arms of the men, women, and children as they were led, one by one, into the light. Only those showing recognizable pockmarks were exempt. General Bell himself took a special interest in the minute details of the compulsory vaccination effort. “It can easily be understood by all how serious the difficulty and detrimental to our plan of campaign [it] would be should an epidemic of small-pox break out in any protected zone,” he declared in an urgent telegram to his post commanders. “Whenever any opposition is met by vaccinators Commanding Officers will detail sufficient troops to round the people up and compel them to submit to vaccination.” While the Third Brigade “pacified” Batangas, the Army’s vaccinators performed 300,000 operations—a number roughly equivalent to the entire population of the province—in just two months.103
Along with General Smith’s Samar expedition, the Batangas military campaign led to Senate hearings on Army misconduct that sullied the Army’s reputation for years. Still, General Bell’s Third Separate Brigade accomplished its mission. By February 1902, several guerrilla bands had surrendered, some after killing their own leaders. On April 16, General Malvar, his wife seriously ill, surrendered, followed soon after by the remaining insurgents in Batangas and on Samar.
President Theodore Roosevelt chose the anniversary of the Declaration of Independence—July 4, 1902—to declare a formal end to the Philippine “insurrection.” More than 4,200 American soldiers died in the war, adding to the toll of 2,910 killed by combat and disease in the Spanish-American War. The death toll among the Filipinos reached a different order of magnitude. In addition to some 20,000 Filipino soldiers, hundreds of thousands of civilians perished from causes attributable in full or in part to the war, including killing by U.S. soldiers, famine, and especially diseases such as typhoid, tuberculosis, bubonic plague, smallpox, and a horrific two-year epidemic of cholera. All of which helps to explain why so many of the Filipinos interviewed for an oral history project during the 1950s would remember the first lethal years of the American colonial regime less for its battles or its atrocities than for its plagues.104
In the spring and summer of 1902, the U.S. Senate hearings and newspaper reports confronted the American public with shocking stories of Army misconduct in the Philippine War: interrogations by water torture, summary executions, and scorched-earth tactics. To many, the most disturbing revelation was that the U.S. Army had resorted to methods reminiscent of the “Weylerism” that had helped arouse American support for a war against Spain in the first place. In the end, General Bell survived with his reputation impugned but his career intact. At the height of the postwar debate, a veteran of the Army Hospital Corps named Edward Curran tried to set the record straight. In a letter to The New York Times, Curran praised General Bell for the “humane and meritorious concentration” in Batangas, where the corpsman had proudly participated in the strenuous effort to “vaccinate all of these people.”105
Curran’s letter was one small entry in a much larger argument unfolding in American public life, an argument that extolled the exceptional humanity displayed by the U.S. Army and colonial governments during and after the Spanish and Philippine wars. Beginning in 1902 and extending to President Taft’s 1911 Philadelphia speech and beyond, an outpouring of official commentary, newspaper and magazine editorials, books, and personal remembrances urged that the sanitary work of the Army Medical Department had shown that characteristic which Chief Surgeon Greenleaf had described as distinctly American—“humanity in war.” Arriving in San Francisco in June 1902, Major General Loyd Wheaton offered a humanitarian balance sheet of the Philippine War. “The devastations of war have cost many lives and the loss among the natives has no doubt been large,” General Wheaton said, “but when one takes into consideration the hundreds of thousands of lives that have been saved by reason of the sanitary precautions of the American Army and Civil Commission, that loss by war seems infinitesimal.” Wheaton referred specifically to the “compulsory vaccination [that] was held in every province, town, and throughout the country. In that way we saved thousands of lives.”106
The New York Times, a stalwart supporter of American expansion abroad and compulsory vaccination of the urban masses at home, applauded Wheaton’s speech. “The anti-imperialist, with his tender regard for the inclinations and preferences of all races except his own, will doubtless object that it is no favor to save the lives of people by forcing them to follow customs and endure Governments distasteful to them,” the Times noted. “[B]ut w
ith the world as small as it is nowadays, this argument is decidedly weak. . . . The unsanitary have become public enemies, and modern war, with its enormous evils, does spread habits of clean living among ‘natives’ and the ‘unprogressives’ whom it leaves alive.” As American officials, commentators, and scholars praised the new levels of sanitation, hygiene, and health that the American efforts had brought to the peoples of Cuba, Puerto Rico, and the Philippines—from the old Spanish ports to the rural interiors—a new rhetoric of justification for military action crystallized. U.S. military medicine had preserved the health of the soldiers, protected American commercial interests, and saved the lives of countless natives.107
Health administration would remain an integral part of U.S. colonial rule in the Philippine archipelago—and also a principal means of justifying that rule. Americanized Manila stood as a model of the healthful city. In the 1904 fiscal year, the board of health had vaccinated 213,000 people in Manila and an additional 1,007,204 people in the provinces—well over one eighth of the entire population of the archipelago. American-made vaccine, packed for shipment in special boxes of ice, was reaching the people of the interior on horse-drawn carromatas, in water-borne bancas, and on the backs of Igorot runners. Local officials placed orders for vaccine over the telegraph wires the Americans had installed. Marine-Hospital Service surgeons vaccinated thousands of sailors each year in the harbors and pressed shipping firms to employ only persons holding the Service’s blue vaccination cards.108
Pox Page 20