TIPOS DE ACLARAMIENTO DENTAL

As Victor Heiser stated in the 1907 annual report of the Bureau of Health, “in the Philippines, one of the principal troubles has been the collection of statistics with regard to births. This may be partly explained by the fact that a large number of

Producing Citizens: Infant Health Programs in the Philippines, 1900-1930

93 children are born without medical attendance, but with proper credit given in this direction, it is still astonishing to contemplate the insignificant value that is attached to a birth certificate by a great many physicians.”394 As he explained, this was

especially true as “birth records, slightly regarded as they are, are among the most valuable documents in the files of vital statistics.”395

In the Philippines, and also within transnational discourses of public health and infant mortality, birth records and vital statistics became crucial documents of public health reform as they facilitated description and collection of knowledge about the population.396 As Dr. John N. Hurty, Secretary of the Indiana State Board

of Health, noted, “the accurate collection, tabulation, and analysis of records of births, stillbirths, deaths, marriages, divorces, and sickness may be said to constitute the bookkeeping of humanity. It is fundamental to the practical application of hygiene, to secure higher efficiency, longer duration of life, and fuller measure of happiness.”397 Surgeon George B. Young of the United States Public Health and

Marine Hospital Service for instance, explained that “vital statistics are the foundation of scientific public health work, which can not begin without access to compilation of vital statistics.”398

Despite their importance, these documents were difficult to obtain in the Philippines. While, as Heiser noted in 1907, the sanitary statistics of the city of Manila were relatively correct, “considerable trouble has been met with obtaining birth certificates.”399 As he explained, “three years ago not over 40 per cent of births

394 Victor G. Heiser, Annual Report of the Bureau of Health for the Philippine Islands, July

1, 1907, to June 30, 1908 (Manila: Bureau of Printing, 1908), 16.

395 Heiser, 16.

396 For Europe and the United States, see for example Meckel, Save the Babies, 104ff. 397 E. Dana Durand, Explanatory List of Diagrams Relating to Deaths of Infants (Prepared

for the Annual Meeting and Exhibit of the American Association for the Study and Prevention of Infant Mortality, Baltimore, November 9 to 11, 1910) (Washington:

Government Printing Office, 1910), 5.

398 Durand, 5.

399 Heiser, Annual Report of the Bureau of Health for the Philippine Islands, July 1, 1907,

Producing Citizens: Infant Health Programs in the Philippines, 1900-1930

94 were reported to the Bureau of Health; at present, fully 75 per cent are recorded. The difference is accounted for solely on the ground of persistent effort. Sanitary inspectors make inquiries as to new births at every house they visit, and baptismal data are obtained from various churches, and every other available source of information is exhausted.”400 Moreover, causes of birth were oftentimes randomly

selected when reported. Physicians chose, as Heiser explained, a “convenient diagnosis” that allowed them to avoid the hassle of performing autopsies to determine the exact cause of death.401

Furthermore, in the absence of adequate laws regarding birth registration, there was no legal foundation for thorough reporting. The researchers who compiled the government study on infant mortality remarked, “birth registration in the Philippine Islands is covered by a wholly inadequate provision of law, and the actual records secured regarding this very important subject are a farce.”402 Interestingly,

as they explained, this was not a specifically Philippine problem as the same was true for the United States. Within the U.S., “birth-registration laws, as a rule, are very poor, and in some places there are none at all. In some places not even a report of death is required. The Government can tell us exactly the number of immigrants from foreign countries, and a large number of inspectors record each arrival and tell us about his nationality, age, sex, etc., but it cannot tell us how many children enter each State by birth. The United States has no national bookkeeping to account for the ebb and flow of human life as an asset and liability in its civic organism.”403

Of course, not only the Philippine researchers criticized the state of U.S. birth registration. Within the United States, child welfare activists and social reformers denounced the problematic situation. If, as Julia Lathrop, chief of the U.S. Children’s Bureau, noted, “there is uncertainty as to the number of deaths,

400 Heiser, 18.

401 Bureau of Science Manila, Infant Mortality in the Philippine Islands, 298. 402 Bureau of Science Manila, 301.

Producing Citizens: Infant Health Programs in the Philippines, 1900-1930

95 there is still greater ignorance as to the number of children born. For not a single city, has complete registration of births. In the words of Dr. Durand, head of the Census Bureau: ‘It is certainly both strange and shameful that the United States should be so far behind the other leading countries of the world in the registration of deaths and even more so in the registration of births.’”404

While the enforcement of birth registrations was already complicated within the United States, Americans oftentimes did not see a responsibility for enacting laws or for setting standards within the public health service in the Philippines. As Carroll Fox noted in the 1911 annual report of the Philippine Bureau of Health, “the failure to have all births registered is not chargeable to the Bureau of Health but to the people themselves. The birth of a child among the poorer classes is too common an event to excite in its parents a realization of the requirements of the Revised Ordinances, and unless some sanitary inspector accidently discovers that the population has increased the fact my not be known.”405 Formations of class and race

deeply influenced the attitudes towards birth registration.

However, those views started to change as physicians and government representatives became increasingly involved in the collection of knowledge on infant mortality. Infant mortality shifted from a cause which inspired mostly local private initiatives towards a topic that interested not only individual reformers, but also government agencies. While the census had facilitated documenting and confirming U.S. rule in the Philippines and had functioned as an inventory of the newly acquired archipelago, the 1914 government study on infant mortality delineated a new way of gathering knowledge about the population and surveilling it. Thus, the 1914 report ventured into new territory regarding population study and

404 Julia Lathrop, “The Children’s Bureau, Being an Address before the Biennial Meeting

of the General Federation of Women’s Clubs,” The American Journal of Sociology 18, no. 3 (November 1912): 324.

405 Carroll Fox, Annual Report of the Bureau of Health for the Philippine Islands for the

Producing Citizens: Infant Health Programs in the Philippines, 1900-1930

96 considerably departed in its scope from previous research projects. With topics such as family histories, intimate relationships and living conditions, the report provided groundwork in order to assess the health status of the population. As discussed above, collecting data on these issues was particularly important, since almost no previous research on the Philippine population existed. Besides the incomplete census of 1903, no demographical statistics were available while the few existing birth and death statistics were incomplete and thus unreliable. The recommendations and measures, which were outlined within the report, preceded the infant health movement that will be discussed in a later chapter.