uring the 1930s, under the direction first of Dr. Jacobo Fajardo and
Dr. José Fabella, the Philippine Health Service concentrated
on social welfare, tuberculosis control, mental hygiene, maternal and infant
health, and the education of ‘‘the masses.’’ Spurred on by enthusiasm for
the doctrines of social medicine—which recognized socioeconomic causes of
disease—Filipino physicians departed from the straight path of racial hygiene
to which Dr. Victor G. Heiser had pointed and from the narrower ecological
route that Dr. Paul F. Russell was taking.∞ Theirs was predominantly a pro-
gram of state medicine or national hygiene, similar to those undertaken in
postcolonial settler societies such as the United States itself and Australia to
the south.≤ Gone was the simple, though mobile, dichotomy of white Ameri-
can and Filipino; instead, class structure joined finer, generally unspoken
internal gradations of ancestry and color to frame public health interven-
tion. Of course, many continuities also were evident: colonial methods and
practices had come to haunt national health services. The emphasis on per-
sonal and domestic hygiene persisted, along with an assumption that medical
facts determined civic potential. Civilized or hygienic behavior, control of
bodily functions, limits on social contact, all still indicated eligibility for
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