Our difficulties were increased at the outset by the fact that many foreign medical men working in the Far East good-naturedly ridiculed our efforts to better conditions, claiming that in tropical colonies it was customary to take only such steps as would safeguard the health of European residents, and that it was really best to let the masses live as they would, since orientals were incapable of sanitary reform, and the attempt to bring it about involved a waste of effort that might be more profitably directed elsewhere.  Furthermore these men were, in their several countries, practising what they preached.

It has been very interesting to note the reaction of American methods upon those previously in vogue in neighbouring colonies.  At first our efforts to make Asiatics clean up, and to eliminate diseases like leprosy, cholera and plague, were viewed with mild amusement, not unmixed with contempt; but the results which we obtained soon aroused lively interest.

Foreign governments began to send representatives to the annual meetings of the “Philippine Island Medical Association,” [505] in order to learn more of our methods.  From these small beginnings sprang “The Far Eastern Association of Tropical Medicine,” the biennial meetings of which bring together the most experienced, skilful and widely known physicians and sanitarians in the East for an interchange of views and experiences which is invaluable, and greatly facilitates concerted action between the various governments concerned in dealing with what may be termed “international health problems.”

The first meeting of this Association was held at Manila, the second at Hongkong.  The third will take place at Saigon.

The results of a rigid enforcement of the “Pure Food and Drugs Act” are worthy of more than passing notice.  Such enforcement has been comparatively easy as the officials concerned are not hampered by politics.  The Philippines were at one time a dumping-ground for products that could not be sold elsewhere, but it is now possible for Filipinos to obtain wholesome preserved foods and unadulterated drugs, except in very remote places where none of any sort are available.

The cost of our medical and sanitary work has been comparatively small.  The per capita rate of taxation here is lower than in any other civilized country.  What we have done has been accomplished without spending vast sums of money or resorting to military measures.

The results obtained are very largely due to the faithfulness and efficiency of Dr. Victor G. Heiser, who was chief quarantine officer of the Philippines when he succeeded Major E. C. Carter as commissioner of public health on April 5, 1905, and was later made director of health when the original board of health was abolished as an administrative entity.  He has continued to hold the office of chief quarantine officer, and thus has been in complete executive control of the health situation for eight years.