The roots of the infant health movement in the Philippines can be traced back to the last decades of Spanish colonial rule in the Philippines. During this time, more and more educational opportunities became available for Philippine elites. Especially the educational reforms of 1863 under Spanish colonial rule had facilitated the engagement of those elites in European networks of science and education.205
Starting during the last decades of the 19th century, elite Filipinos increasingly
ventured to European universities to obtain their university degrees.206 Many of
those who had access to wealth and capital in the Philippines had profited from an education in Europe.207 As Julian Go noted, “the political elite had already come to
occupy high positions within local status hierarchies before American arrival.”208
Many Filipino students who went to Europe started out in Spain by enrolling
205 Kramer, The Blood of Government, 42.
206 This phenomenon was not limited to the Philippines. Parallel movements can be
observed in other colonial settings such as British India or the Dutch East Indies. Reyes, “Sex, Masturbation and Foetal Death: Filipino Physicians and Medical Mythology in the Late Nineteenth Century,” 1.
207 Go, “Colonial Reception and Cultural Reproduction,” 340f. 208 Go, 340.
Producing Citizens: Infant Health Programs in the Philippines, 1900-1930
49 in the Universidad Central de Madrid.209 Even though in most instances Spain was
their preferred destination, France soon became similarly important for
ilustrados.210 This was mainly due to the fact that Paris in particular had become a
center for medicine in the 19th century and was still a magnet for physicians from
all over the world when European educational opportunities started to open up for Filipinos.211 In addition to the growing mobility, translations of French medical
literature increasingly became available in the Philippines and were frequently read among students who studied at the Universidad de Santo Tomás.212 Becoming part
of European “civilization” outside of Spain also held the potential for criticizing Spanish rule while evoking membership of European “civilization” at the same time.213
Hence, with travel and circulating knowledge in form of medical research literature, there were a number of ways young Filipinos got exposed to French and Spanish discourses of science, culture and politics even before the American occupation. The growing nationalist movement in the Philippines also stems from this exposure.214 While ilustrados drew from a variety of streams, including French
political thought and scientific knowledge, to form their political culture, Western medicine had a particularly crucial influence.215 As historians Warwick Anderson
and Hans Pols recently suggested, medicine was usually the first exposure to science that colonial elites acquired and which thus constituted their “port of entry” to the world of biological and natural sciences.216 Moreover, for young elite men
209 Reyes, “Sex, Masturbation and Foetal Death: Filipino Physicians and Medical
Mythology in the Late Nineteenth Century,” 8.
210 Reyes, 8. 211 Reyes, 8. 212 Reyes, 8.
213 Kramer, The Blood of Government, 44.
214 For an analysis of the growing nationalist movement, see in particular Kramer, The
Blood of Government.
215 Go, American Empire and the Politics of Meaning, 95.
216 They further argued that “to extricate immersion in a world of scientific thought and
Producing Citizens: Infant Health Programs in the Philippines, 1900-1930
50 from Asia, as Raquel Reyes observed, “a career in western medicine offered a path to modernity, even a discourse for articulating patriotic aspirations.”217
Moreover, engaging in transnational medical discourses and the new approaches to viewing the population that came with it, allowed those elites to see themselves as intellectuals and reformers rather than colonial subjects.218 For
ilustrados, being exposed to science and medicine fundamentally influenced their perceptions of the population and the duties of the state that those elites intended to build. Consequently, increasing access to education and knowledge helped elite Filipinos to challenge both Spanish rule and their stigmatization as “backward” and undeserving of political representation.219 The availability of scientific and medical
discourses from different sources thus allowed Filipinos to form an alternative and distinctive medical discourse which, as Reyes explained, extended not only to political culture, but also to bodies and environment. Western medical thought helped to “refute colonialist allegations that the Philippine environment was intrinsically unhealthy and that Filipino bodies were markedly diseases and pathological.”220
Because of their potential for reform, European medical discourses thus became central to the nationalist movement in the Philippines and in particular for the emergence and further establishment of a unified concept of “the Filipino” at the end of the 19th century. This idea of “the Filipino” as a unified group refers back
to the last decades of the 19th century when Philippine ilustrados attempted to seek
political recognition in Spain. In order to demonstrate political capability, ilustrados
to the national awakening would be reductive and anachronistic.” Anderson and Pols, “Scientific Patriotism,” 96.
217 Reyes, “Sex, Masturbation and Foetal Death: Filipino Physicians and Medical
Mythology in the Late Nineteenth Century,” 1.
218 Anderson and Pols, “Scientific Patriotism,” 100–101. 219 Kramer, The Blood of Government, 37.
220 Raquel A. G. Reyes, “Environmentalist Thinking and the Question of Disease Causation
in Late Spanish Philippines,” Journal of the History of Medicine and Allied Sciences 69, no. 4 (August 2013): 558.
Producing Citizens: Infant Health Programs in the Philippines, 1900-1930
51 tried to develop a new version of the “Filipino” as an authority in between the Spanish colonialists and other parts of the Philippine population.221 As Paul Kramer
noted, ilustrados broadened the term “Filipino” “for diasporic and propaganda purposes to contain, and mitigate, their diversities of race. It was a term of convenience, but it was also an insurgent category that could be used in assertions of civilization and claims to recognition and politico-legal assimilation.”222 As Paul
Kramer noted, ilustrados thereby “unraveled the dense fabric of Spanish imperial racial formations” which justified the Philippines’ status as unrepresented in the Spanish Cortes.223 As opposed to Cuba and Puerto Rico, the Philippines had not
been included within those frameworks of political rule.224
The attempt to gain political representation through the invention of the “Filipino” as a Spanish-speaking intellectual loyal to Spain, consequently excluded a number of groups from the new racial formation and thus from eligibility for political participation.225 This was mainly because race in the Philippines was
organized by “territorial nativity, mestizaje (blood mixture), and religious “civilization” during Spanish colonialism.226 The newly emerging concept was
therefore shaped not only along racial, but also along religious and cultural lines.227
Denying Filipinos the eligibility for self-government on the basis of race persisted during the American occupation as the strategy for legitimizing colonial rule even after the establishment of a civil government. Especially during the early years of the American administration, racist discourse was pervasive and backed- up by scientific reports and anthropological research.228 American scientists often
221 Kramer, The Blood of Government, 37. 222 Kramer, 66. 223 Kramer, 37. 224 Kramer, 36. 225 Kramer, 37. 226 Kramer, 37. 227 Kramer, 67.
228 Kramer, The Blood of Government; Paul Kramer, “Making Concessions: Race and
Empire Revisited at the Philippine Exposition, St. Louis, 1901-1905,” Radical History
Producing Citizens: Infant Health Programs in the Philippines, 1900-1930
52 emphasized the idea that the people living in the Philippine Islands consisted of various groups representing different stages of human development, to argue that Filipinos were not racially “coherent” enough to form an independent nation.229
This way of thinking was shaped by the studies of anthropologists such as Dean Worcester, who conducted research in the Philippines attempting to categorize and thus establish a racist anthropological hierarchy.230 While American colonial
administrators quickly established educational programs that were supposed to “advance” Filipinos, they argued at the same time that it might take centuries until Filipinos had achieved the same bodily and mental capacities that Americans had acquired.231
For writers and revolutionaries such as José Rizal, as well as for the physician reformers under U.S. rule, medicine provided a counterpoint to those discourses as well as a language for analyzing social conditions in the Philippines.232 Medicine
in particular offered the practical tools to rebuild the population and to reformulate the racial image of Filipinos that shaped American rule in the Philippines. As
229 Michael Salman, The Embarrassment of Slavery: Controversies Over Bondage and
Nationalism in the American Colonial Philippines (Berkeley: University of California
Press, 2001), 149 Salman describes that those categories of describing the Philippine population were shifting during U.S. rule. While at the beginning Americans used analogies to American Indians to described the population of the Philippines and saw them as a conglomeration of different tribes, the discourse eventually shifted towards describing only Muslims and other Non-Christians as “tribal” peoples.
230 Dean C. Worcester, The Non-Christian People of the Philippine Islands (Washington,
D.C.: The National Geographic Society, 1911); Dean C. Worcester, The Philippine Islands
and Their People: A Record of Personal Observation and Experience, with a Short Summary of the More Important Facts in the History of the Archipelago (New York:
Macmillan Company, 1899); Dean C. Worcester, The Philippines Past and Present (New York: The Macmillan Company, 1921); United States Bureau of the Census, Census of the
Philippine Islands, Taken Under the Direction of the Philippine Commission in the Year 1903 (Washington, D.C.: Government Printing Office, 1905).
231 Kramer, The Blood of Government, 199.
232 Raquel A. Reyes, Love, Passion and Patriotism: Sexuality and the Philippine
Propaganda Movement, 1882-1892, Critical Dialogues in Southeast Asian Studies
Producing Citizens: Infant Health Programs in the Philippines, 1900-1930
53 Anderson and Pols put it, for those elites “the laboratory represented an exemplary space of control, purity, and precision, a model disciplinary site, a place of surveillance and transformation – a space of infinite possibility. They believed they could diagnose and treat social and political pathologies just as they restored frail human constitutions.”233 Thus, for Philippine elites, the medical laboratory became
a site that was not limited to the exercise of colonial rule in terms of surveillance, but at the same time held the possibility for changing the population.
Especially the influences of Spanish colonial rule, which still prevailed during the time of the American occupation, were to be targeted by using medicine as a “modernizing tool.”234 Reformers thought that through biomedical science,
superstitions that were rooted in Catholic mythology and animism could be eradicated. This is particularly important, since in the eyes of ilustrado reformers, the Spanish imperial legacy hindered the country from becoming a modern nation state.
Indigenous mythology and Spanish Catholicism were closely intertwined. Philippine elites argued that the friars in the Philippines had been responsible for the superstitions of the population.235 Mixing those different religious and cultural
practices was rooted in the specific strategies of religious rule and processes of conversion in the Philippines. As historian Vicente Rafael has shown, the friar orders had relied on the translation of the mass and other significant Catholic rituals into indigenous cultural forms since the sixteenth century.236 Americans attributed
the current health and living conditions of the population to the “backwardness” and lack of “civilization” in terms of race. Ilustrados, on the other hand, focused on the magical thinking of Spanish Catholicism and the lack of educational
233 Anderson and Pols, “Scientific Patriotism,” 100–101.
234 Reyes, “Sex, Masturbation and Foetal Death: Filipino Physicians and Medical
Mythology in the Late Nineteenth Century,” 5.
235 Kramer, The Blood of Government, 58. 236 Kramer, 61.
Producing Citizens: Infant Health Programs in the Philippines, 1900-1930
54 opportunities for the broader population to explain the differences between themselves and the rest of the Philippine population.237 Filipinos frequently talked
about the “ignorance” and “superstition” that characterized the majority of the “uneducated” population. In the eyes of those elite Filipinos, those beliefs hindered the building of a modern state.
For Philippine intellectuals, population reform was thus shaped much more by structures of class than by structures of race. Consequently, medical and public welfare reform highlighted the division between elite Filipinos who attempted to influence the building of the colonial state, and the rest of the population. By improving early infancy and by reducing the high number of infant deaths, those Filipinos intended to build a healthy – and modern – population that could move beyond remnants of the past such as Catholic mythology and animism. Within the context of medicine as population reform, Philippine elites increasingly reimagined themselves as reformers ready to change the conditions in their country.