Philippines

The Republic of the Philippines covers 7,107 islands and is located off the east coast of southeast Asia. It was occupied by the Spanish from 1565 who gradually expanded their rule over the whole archipelago. However they lost the Philippines in a war with the United States in 1898. During World War II, the Japanese occupied the Philippines, with the country gaining its independence in 1944. The Republic of the Philippines now has a population of 85,237,000 (2005), with 123 doctors and 418 nurses per 100,000 people.

During the Spanish colonial period, hospital services were largely restricted to the treatment of Europeans, wealthy Chinese and members of the local elites, with a combination of European and Chinese practices used. In the 1890s when the Philippines was trying to achieve independence from the Spanish, the great hero of the nationalist movement was José Rizal (1861–1896) who was, by training, a physician. On September 29, 1898, the new U.S. administration in the country established a Board of Health with Dr. Frank S. Bourns as its first president. Its initial aim was to treat the U.S. soldiers who had been injured in the fighting, but at the end of the war, in was changed into a civilian organization, with Dr. L.M. Maus appointed as the first health commissioner.

Soon after the start of U.S. rule, the country was devastated by an epidemic and as a result the Americans established a large medical infrastructure, with the Manila Medical Society founded in 1902, the Philippine Medical Association being established in 1903, and the University of the Philippines College of Medicine and Surgery opening in 1905. Four years later formal classes for nurses were held at the Philippine Normal School, with the Bureau of Health reorganized in 1915 and renamed the Philippine Health Service. With limited self-rule introduced in 1916, on January 1, 1919 the first Filipino to be in charge of the Philippines health service was Dr. Vicente de Jesus; and in the following year the Philippine Pharmaceutical Association was founded and incorporated. In 1923 some 76 percent of all deaths in the country were still being caused by communicable diseases.

In 1933 the health service was reorganized and became the Bureau of Health, and started publishing its official journal, The Health Messenger. The first chief of the Bureau, after the inauguration of the Commonwealth of the Philippines in 1935, was Dr. Jose Fabella. By this time there were 38 hospitals and 1,535 dispensaries in the Philippines, focusing on the treatment of malnutrition, malaria, tuberculosis, leprosy, and gastrointestinal disease. During World War II, the country [Page 1377]was occupied by the Japanese, and the provision of healthcare declined considerably. Claro M. Recto was appointed Commissioner working in the newly-created Department of Education, Health and Public Welfare.

After the war, there were attempts to rebuild the health services in the country, with the Department of Health created in 1947 by President Manuel Roxas, along with the Philippine Paediatric Society being founded in the same year. In the following year the Institute of Nutrition was established, and in 1958, President Elpidio Quirino instituted a wholesale reorganization of the Department of Health. Services were increased in the first years of the Ferdinand Marcos presidency, in the late 1960s – Marcos's brother, Pacifico Edralin Marcos being the president of the Philippine Medical Association and becoming nicknamed “Mr. Medicare” for his work at trying to get universal free healthcare, although he later distanced himself from his brother's policies.

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