Medical Modernity: Rethinking U.S. Colonial Practices in the Philippines and the Health Work of Non-elite Women (1870-1948)

 

Victor Heiser, director of health in the Philippines in the early 1900s, once wrote, “It is rather an interesting commentary that the health work of the United States for its dependencies has been more thorough and advanced than that done at home.” Additionally, Heiser noted that the health work in the Philippines was achieved, “not in spite of the Filipinos, but with their cooperation and assistance.” His comments raise two points: First, specific medical advancements and programming were achieved in U.S. territories before they were executed in the U.S. Second, Heiser alludes to a Filipino labor force that worked together with Americans to develop U.S. colonial medical projects in the Philippines. When we put these two comments in conversation with one another, it becomes evident that these faceless Filipino practitioners played a critical role in the development of medical knowledge production not only for the Philippines, but for the U.S. as well.  This leads to the question, who were these native medical practitioners and what role did they envision their health work playing in the Philippines?

 

Furthermore, Heiser’s comments expose a paradoxical deceit in the mainstream understanding of how modern medicine developed in the Philippines. Many often view the U.S. as a hegemonic force that imposed its medical will on a group of aggrieved and backward natives, an assumption that constructs Filipinos as lacking agency in the advancement of health and medicine in their country.  Indeed, Heiser himself popularized this false narrative, most famously in his autobiography which depicted Filipino ignorance as a foil to heroic American medical and scientific intervention. However, his aforementioned comments gesture to a more complicated exchange of medical knowledge. Drawing on this significant complication, my project investigates the multi-cited transits of medical knowledge that circulated throughout U.S. empire, and the Filipino actors, particularly women, who despite being unrecognized for their intellectual labor, participated in the creation of a trans-imperial U.S. modern medical system.

 

By examining narratives of nurses, midwives, native folk healers and physicians, my dissertation discusses the history of medical knowledge production in the Philippines from the perspective of Filipinos. What I have found so far is that native medical practitioners differed from their American counterparts in three key ways: they invested much earlier in the training of women for health work, they were equally concerned with infant mortality and childbirth as they were with the containment of communicable diseases, and they were invested in finding ways to integrate indigenous forms of healing within a modern medical knowledge system. These concerns reflect a key difference in priorities. While American medical officials were concerned with making the Philippines a more habitable and commercially profitable place for white Americans, Filipino health practitioners were more interested in creating a functioning independent nation state with a healthy population.  Therefore, my research focuses on four health programs that framed the medical training of Filipino women as a critical pathway to modernization. For over seven decades, Filipino health personnel labored to engineer a feminized care worker infrastructure because they believed it would be the best means to address the health needs of the general populace, and they also believed it to be an efficient method of indoctrination of everyday people into enlightened principles about the body and the ordering of the world. Therefore, the subjects I write about undermine the commonly held notion that modern medicine in the Philippines was solely a result of U.S. empire. Instead, I argue that Filipino women staked a claim in medical modernity and used it to express their own agency. 

 

With the assistance of a Consortium for History of Science, Technology, and Medicine research fellowship, I visited the Cushing/Whitney Medical Library at Yale University, the Rockefeller Archive Center, and the American Philosophical Society where I read colonial medical literature produced on the Philippines as well as records and diaries of medical officials who practiced in the Philippines. In particular, I traced the personal papers of Victor Heiser throughout his career with the U.S. colonial government in the Philippines and his position at the Rockefeller Foundation’s International Health Division. 

 

At the Rockefeller Archive Center I looked at the Rockefeller Fellowship cards. Similar to the U.S. colonial government’s pensionado system, the Rockefeller Foundation sponsored Filipino scholars to study primarily in the U.S., as well as in Canada and parts of Europe. I was able to look at all the Filipino fellows’ records from 1921 to 1941 and trace their migration patterns and their experiences abroad, which will help me contextualize the experiences of nursing students who participated in the fellowship program. In addition to the fellowship cards, I examined the work logs of various Rockefeller associates who worked in the Philippines. Victor Heiser and Alice Fitzgerald’s records are particularly illuminating since both played critical roles in the development of nurse training in the Philippines. In examining these documents, I found two exciting facets of early Filipino migration. I learned that a group of Filipino nurses were recruited to serve Filipino plantation workers in Hawaii in the 1920s, and that Thai nurses were sent to the Philippines for nurse training starting in 1929. These narratives complicate the idea of a unidirectional flow of knowledge. In other words, the movement of Filipino nurses and Thai nursing students to the Philippines demonstrates that the Philippines became a recognized node of advanced medical training, while also signaling U.S. imperial influence within other parts of the Pacific.  At Yale University I examined research produced by American medical officials in the Philippines. I specifically looked at material relating to tropical medicine and cholera in order to write about the 1902 cholera epidemic that impacted the working class colonial resistance movement in the Philippines and led to the medical criminalization of folk healers. I found Major John Monro Banister’s work on cholera particularly helpful.  

 

At the American Philosophical Society I read the personal papers of Victor Heiser. It was valuable to look at the writings that Heiser produced at multiple points of his career because it revealed his complicated relationship to the Philippines. There, he was in the paradoxical position of needing to demonstrate medical ignorance of Filipinos to rationalize his presence, while also needing to demonstrate Filipino medical progress in order to prove the efficacy of his work. His papers contained an extensive collection of Filipino popular press coverage of U.S. colonial medicine in the Philippines, as well as photos depicting Filipino medical practices. Particularly significant for my research were photos of Filipino medical physicians working with native midwives on house calls. I also examined the library’s collection of indigenous medical knowledge in the Philippines, such as Isabelo De Los Reyes’s Folk Lore Filipino. The APS’s collection also shaped my research after I left the library. For example, a slim volume entitled, An Abandoned Approach to the Philippine History by John Farrell detailed the importance of the insurrection papers housed at NARA. Farrell’s book inspired me to find more details of the cholera epidemic from the perspective of Filipino resistance through this set of documents.  

 

In conclusion, the Consortium fellowship gave me the opportunity to explore and identify Filipino medical actors and their participation in the development of medical knowledge that expanded across U.S. empire. Beyond these archives, all three places provided rich discussion with archivists, scholars, and other fellowship recipients that assited in the development of my research questions and enriched my research experience.