Health Conditions I had abundant opportunity to observe health conditions in the Philippines during the Spanish regime and they were shocking in the extreme.

There were no provisions for the sanitary disposal of human waste even in Manila.

If one had occasion to be out on foot at night, it was wise to keep in the middle of the street and still wiser to carry a raised umbrella.
Immediately after the American occupation some five hundred barrels of caked excrement were taken from a single tower in one of the old Manila monasteries.

The moat around the city wall, and the _esteros_, or tidal creeks, reeked with filth, and the smells which assailed one's nostrils, especially, at night, were disgusting.
Distilled water was not to be had for drinking purposes.

The city water supply came from the Mariquina River, and some fifteen thousand Filipinos lived on or near the banks of that stream above the intake.