The struggle against disease has progressed considerably over the years. Health conditions in the Philippines in 1990 approximated to those in other Southeast Asian countries but lagged behind those in the West. Life expectancy, for instance, increased from 51.2 years in 1960 to 69 years for women and 63 years for men in 1990. Infant mortality was 101 per 1,000 in 1950 and had dropped to 51.6 per 1,000 in 1989. In 1923 approximately 76 percent of deaths were caused by communicable diseases. By 1980 deaths from communicable diseases had declined to about 26 percent.
In 1989 the ratio of physicians and hospitals to the total population was similar to that in a number of other Southeast Asian countries, but considerably below that in Europe and North America. Most health care personnel and facilities were concentrated in urban areas. There was substantial migration of physicians and nurses to the United States in the 1970s and 1980s, but there are no reliable figures to indicate what effect this had on the Philippines. Hospital equipment often did not function because there were insufficient technicians capable of maintaining it, but the 1990 report of the Department of Health said that centers for the repair and maintenance of hospital equipment expected to alleviate this problem.
In 1987 a little more than one-half of the infants and children received a complete series of immunization shots, a major step in preventive medicine, but obviously far short of a desirable goal. The problem was especially difficult in rural areas. The Department of Health had made efforts to provide every barangay with at least minimum health care, but doing so was both difficult and expensive, and the more remote areas inevitably received less attention.
Although very few Filipinos have been infected with acquired immune deficiency syndrome (AIDS), concern about the disease has caused authorities to give it considerable attention. By April 1979, only three people had died from AIDS, two of whom were overseas Filipinos visiting the homeland and one an American civilian who had contracted the disease outside the Philippines. In 1985 the Department of Health and the United States Naval Medical Research unit tested more than 17,000 people, including some 14,000 hospitality girls in Olangapo and a number of other Filipino cities. They identified twenty-one women as human immunodeficiency virus (HIV) carriers. The American sponsorship of the study was seized upon as argument for ending the Military Bases Agreement with the United States. A June 1990 Philippine government study reported that at that time AIDS was growing at the rate of four cases a month and that twenty people had died from the disease. The study indicated that most AIDS cases in the Philippines were transmitted by heterosexual activity. An April 30, 1991, Department of Health report indicated that 240 Filipinos were infected with AIDS.
Like many other countries, the Philippines has a problem with illicit drugs. Official Philippine government statistics for 1989 indicate only 1,733 addicts, but the assumption was that the real number was from ten to a hundred times as great. The government has instituted both education and treatment programs, but it was uncertain how effective these programs would be. There also was a problem with inadequatedly tested legal drugs. In 1983, more than 265 pharmaceutical products were sold in the Philippines that were banned in many other countries. The Department of Health succeeded in eliminating 128 of them by 1988. Attempts to eliminate others have been blocked by the courts, which ruled that the department had acted without due process.
Malnutrition has been a perennial concern of the Philippine government and health care professionals. In 1987 the Department of Health reported that 2.8 percent of preschoolers were suffering from third-degree malnutrition and 17.6 percent from second-degree malnutrition. To alleviate this problem, the government targeted food assistance for nearly 500,000 preschoolers and lactating mothers.
Nutrition has shown some improvement. In 1955 government statistics estimated the daily per capita available food supply at only 80 percent of sufficiency. In 1986 it had improved to 101.8 percent. In the same period, the consumption of milk nearly tripled and the consumption of fats and oils more than doubled.
The Philippines has a dual health care system consisting of modern (Western) and traditional medicine. The modern system is based on the germ theory of disease and has scientifically trained practitioners. The traditional approach assumes that illness is caused by a breach of taboos set by supernatural forces. It is not unusual for an individual to alternate between the two forms of medicine. If the benefits of modern medicine are immediately obvious--eyeglasses, for instance--then there is little argument. If there is no immediate cure, the impulse to turn to the traditional healer is often strong.
One type of traditional healer that attracted the attention of foreigners as well as Filipinos was the so-called psychic surgeon, who professed to be able to operate without using a scalpel or drawing blood. Some practitioners attracted a considerable clientele and established lucrative practices. Travel agents in the United States credited these "surgeons" with generating travel to the Philippines.
Although medical treatment had improved and services had expanded, pervasive poverty and lack of access to family planning detracted from the general health of the Philippine people. In 1990 approximately 50 percent of the population was listed below the poverty line (down from 59 percent in 1985). A high rate of childbirth tended both to deplete family resources and to be injurious to the health of the mother. The main general helath hazards were pulmonary, cardivascular, and gastrointestinal disorders.
The Philippines had a social security system including medicare with wide coverage of the regularly employed urban workers. It offered a partial shield against disaster, but was limited both by the generally low level of incomes, which reduced benefits, and by the exclusion of most workers in agriculture. In April 1989, out of more than 22 million employed individuals, a little more than 10.5 million were covered by social security. In health care and social security, as with other services, the Philippines entered the 1990s as a modernizing society struggling with limited success against heavy odds to apply scarce financial resources to provide its people with a better life.
* * *
One of the best recent books synthesizing the social and geographic aspects of the Philippines is Jim Richardson's The Philippines. Robert Youngblood's Marcos Against the Church gives an excellent overview of contentious issues between church and government in the Marcos era and beyond. Religion, Politics and Rationality in a Philippine Community, by Raul Pertierra, is an insightful portrayal of socio-religious interaction on the barangay level. Kenneth Bauzon's Liberalism and the Quest for Islamic Identity in the Philippines clarifies the basic difference in political thinking between Muslim and Christian, and W.K. Che Man's Muslim Separatism is an excellent work on that subject.
Language Policy Formulation, Programming, Implementation, and Evaluation in Philippine Education (1565-1974), by Emma Bernabe, combines a historical approach to the language controversy with contemporary analysis and The Role of English and Its Maintenance in the Philippines, edited by Andrew B. Gonzales, provides a detailed report on that subject.
Philippine Society and the Individual: Selected Essays of Frank Lynch 1949-1976, edited by Aram A. Yengoyan and Perla Q. Makil, offers a careful treatment of Philippine values. James F. Eder's On the Road to Extinction: Depopulation, Deculturation, and Adaptive Well-Being Among the Batak of the Philippines is a provocative book on the upland tribes.
For information on the physical setting of the Philippines, the major work is still Frederick L. Wernstedt and J. E. Spencer's, The Philippine Island World: A Physical, Cultural, and Regional Geography.
The following periodicals also are excellent sources of information on contemporary Philippine society: The Philippine Sociological Review, Solidarity, Philippine Quarterly of Culture and Society, Philippine Studies, and Pilipinas.