by Ma. Cielito G. Reyno

      On April 15, 1805 the vaccine against smallpox, one of the deadliest and most physically disfiguring diseases ever known to man, arrived in the Philippines.  Headed by Dr. Francisco Xavier de Balmis, court physician of the Spanish crown, the medical life-saving mission in charge of transporting the vaccine to the Philippines set out from La Coruña, Spain on November 30, 1803 and journeyed to Acapulco, Mexico.  There, 25 Mexican children were drafted to take on the most important part of the mission: hosting the vaccine in their bodies until the mission reached the archipelago.  Starting with the first human repository, the vaccine was transferred from one child to the other every ninth or tenth day when the smallpox vesicle or blister developed on the host’s skin, from which a portion of the lymph or fluid within the vesicle was extracted and inserted into the arm of the next child-host.

      Historical findings indicate that smallpox was not originally endemic to the Philippines, specifically during the early part of Spanish colonial rule.  This is shown by the persistency of destructive outbreaks of the disease as recorded by Spanish officials starting from as early as 1574, only three years after Spanish colonization formally began in 1571.  An excerpt from the report from that year of the Augustinian missionary Martin de Rada to the Philippine Governor General gives a stark picture of the yearlong destructiveness over the native population of Manila then: “A general epidemic of smallpox has raged here this year, which has spared neither childhood, youth, nor old age.  I believe there are few who have not had it…and many people have died of it.”  According to historian Ken de Bevoise, data show that virus that came from Mexico, entering the archipelago through Manila, the “principal port of entry for infections” at the time, may have caused this epidemic.  However, there were other points of entry such as the ports in Northern Luzon: in 1789 the disease entered the Ilocos region through a Chinese vessel, quickly unleashing an epidemic in the region.

      Since Manila was under the control of the Spanish colonial government the disease spread more easily to other points in the archipelago through the  pacification campaigns.  This is exemplified by the military operations carried out in Cagayan province (then known as Nueva Segovia), which sparked an epidemic that left a trail of death and sickness not only on the province but in the nearby islands as well.  After the initial contagion, outbreaks became periodic, prompting an official to describe smallpox “like a plague among the Indians.”  It would seem that no region was spared (including the Visayas and Mindanao) for where there was a military campaign, smallpox eruptions inevitably followed.  Thus, during the government’s operations in Bohol “more than a century later”, (probably referring to the Dagohoy Revolt, 1744-1829), an outbreak occurred, as also in the islands of Samar and Leyte in the 1760s of which it was reported that  “a third of the population” was wiped out.  In the Mindanao region, smallpox was recorded to have struck Sulu in 1608.  With its record of death and annihilation, no wonder smallpox was acknowledged during the 19th century Philippine society along, with malaria, as one of the “major causes of mortality since the [Spanish] conquest” (De Bevoise).  The high birth rate of the native population, moreover, abetted the frequency of the outbreaks since this facilitated a quick replacement of persons vulnerable to the disease.

       Fortunately, by 1798 in Europe, a vaccine against the disease had been developed by the English physician Dr. Edward Jenner, using the cowpox virus.  This provided the longed-for deliverance from the plague.  Spain lost no time in acquiring or developing its own vaccine, and in September 1803, Spanish King Carlos IV ordered the organization of an expedition which would send the smallpox vaccine to Spain’s Asian colony, the Philippines.    Dr. Balmis, who had initiated the public vaccination programs in Spain’s colonies, headed the Philippine expedition.  On the local front after the arrival of the vaccine, Philippine Governor General Mariano Fernandez de Folgueras, created the Insular Bureau of Vaccination in 1806 and ordered the carrying out of public vaccination to institutionalize the system of vaccination in the country.

       Meanwhile, as token of gratitude, upon the Filipino people’s clamor the erection of a monument in honor of King Carlos IV was initiated in 1824, and finally accomplished during the term of Governor Emilio Terrero y Perinat (1885-1888).  The statue was placed in Plaza McKinley (formerly Plaza del Palacio) fronting the Manila Cathedral.  Part of the Spanish inscription read:

      “Al Rey D. Carlos IV.  En gratitude Al Don Benefico de le Vacuna.- Los Habitantes de Filipinas.”  (“To the King Charles IV of Bourbon, to the express the gratitude of the inhabitants of the Philippines for the beneficial gift of vaccination.”).

      On April 15 2004, 99 years after the Balmis expedition reached the Philippines, a marker was installed at the Research Institute for Tropical Medicine (RITM) in Alabang, Muntinlupa honoring the expedition, its leading lights- Carlos IV and Dr. Balmis- and the 25 Mexican children, who, despite the long and risky voyage, took part in the noble task of saving other children on the other side of the world.

      Official records show that the implementation of the public vaccination of the Filipinos was not exactly successful even until the arrival of the Americans in 1898, mainly due to geographical inaccessibility of far flung barrios and villages, the unwieldy method of preserving the vaccine, and the instinctive resistance of the people themselves to immunization.  Notwithstanding these failures, the vision that the Balmis Mission of 1803-1805 presented to the Filipino people of the 19th century was that of a more hopeful, better life free of the scourge that was smallpox.