MANILA, December 22, 2005 (STAR) By Jose Luis Danguilan, MD - For the Philippines, the early years of the last century were an age of decay, despair and degeneration. From 1896 to 1902, hundreds of thousands of Filipinos perished during wars of resistance against both Spain and the United States.

It was an era when concepts about physical health and well-being were ruled by superstition and illness was attributed to religious or spiritual phenomena. Smallpox, beriberi, malaria, cholera and even venereal disease plagued the cities. In an attempt to curb the spread of communicable diseases, the Americans filled up the stagnant centuries-old moat surrounding the walled city of Intramuros and instituted draconian health measures to in Manila. It is during this time of struggle that the birth of the University of the Philippines College of Medicine is set.

The Philippine Medical School, as the College was known then, was an outgrowth of an educational system instituted throughout the Philippine Islands by the occupying American administrator through the Philippine Commission Five, the original governing body of the United States after the Spanish-American War of 1898, headed by William Howard Taft.

As early as 1900, Dean C. Worcester, then Secretary of the Interior, formulated a plan to establish a central government laboratory, a medical school and a hospital all in one integral group–"Worcester’s crazy dream", it was called.

In 1905, at the Second Annual Meeting of the Philippine Islands Medical Association, the proceedings demonstrated the great need for physicians in the countryside. The American director of the Bureau of Health, Dr. Victor Heiser, who later served as the first director of the Philippine General Hospital, wrote: "The ancient Santo Tomas University already had a medical school attached to it, but it was inadequate... Statistics at the time showed that there was one physician for every 21, 209 persons, or one for every 430 square miles of territory."

On December 1, 1905, the Philippine Medical School was established by the Philippine Commission as the first department of the future University of the Philippines under Act No. 1415, and was opened on June 10, 1907.

With American curricular requirements, it was first housed in the old building of the School for the Deaf and Blind on Malecon Drive (now Bonifacio Drive). The present-day main building of the college was built along what is now Pedro Gil Street with an appropriation of P250,000 and was opened on July I, 1910. It accommodated the classrooms, laboratories and the morgue: only a handful of students were in attendance using very limited equipment loaned by various government institutions.

Until 1912, Dr. Paul Freer was the medical school’s first dean. Dr. Fernando Calderon became the first Filipino dean and first Filipino director of the Philippine General Hospital in 1916.

The construction of the Philippine General Hospital was started in 1908 when the Philippine commission appropriated P780,000. It was patterned after the Hamburg-Eppen-dorf Hospital in Germany. The 350-bed hospital was opened to the public on September 1, 1910.

"Filipinos made excellent physicians, once their dislike of dirtying their hands was overcome," Heiser wrote. The establishment of the Postgraduate Institute of Medicine in 1939 marked the start of residency and fellowship training and continuing medical education programs.

The Japanese Occupation of the Philippines from 1942 to 1944 changed the landscape of Manila and left enduring marks on the history of the University. At the time, all units of the University of the Philippines except for the College of Medicine were closed down. To prevent disruption of work at the Philippine General Hospital, Dr. Antonio G. Sison, who was then college dean, also served as president of the university. It was felt that the people needed continued medical and hospital ministrations more during those crucial days than at any other period.

During the liberation of Manila in early 1945, the buildings suffered heavy damage from shell and incendiary fire. The medical annex was completely destroyed. With the help of the U.S. Army Medical Corps, buildings were rapidly rebuilt and renovated. Within six months of the liberation of Manila, classes resumed with the College of Medicine at the nucleus of the resuscitated university. Through the US-Philippines War Damage Commission and the Mutual Security Agency (later the International Cooperation Administration of the US government), construction of many of the buildings resumed with the acquisition of teaching equipment, apparatus and books.

The succeeding post-war deans continued to respond to the challenges of their times. The academic curriculum was revised in response to the apparent lack of social consciousness and migration of U.P. medical graduates. The role of the college in the national health care delivery system was studied. Its financial position, modernization, relevance, teaching, research and training programs were studied vis a vis its responsibilities in the changing political climate.

Among the developments and improvements through the years, graduate degree programs were initiated and new courses introduced. There are presently 17 masteral and doctoral programs offered in 12 departments and units of the College.

On June 17, 1967, RA No. 5163 authorizing the establishment of the Philippine Health Sciences Center was signed info law. Budgetary problems, however, prevented the realization of this center at the Diliman campus. In 1977, the Health Science Center became an autonomous unit of the University of the Philippines system with former Dean Florentino Herrera, Jr. assuming the post of the first chancellor. The Health Sciences Center was later renamed UP- Manila, which then absorbed the College of Medicine as decreed by the Board of Regents on December 17, 1982.

In an innovative experiment in medical education, the U.P. College of Medicine established the Institute, now School of Health Sciences (SHS) in Tacloban, Leyte in 1976. It aimed to develop community-oriented health workers who would return to render service in the underserved places from where they were recruited. The school was a "model for shifting health sciences education towards community orientation and community-based learning", representing a bold strategy to neutralize the dual problems of brain drain or the continuing exodus of more than 50 percent of Filipino physicians to more affluent countries like the Unites States, and the unbalanced distribution of available health manpower, which concentration in urban areas left 70 percent of Filipinos in rural areas without adequate health and medical services.

In another experiment, a seven-year curriculum that integrated the premedical course with medicine proper (intarmed or Integrated Arts-Medicine Program) was launched in 1982. This pioneering effort provided exposure to the humanities and synchronized the basic and clinical disciplines. Exceptional high school graduates entered the College of Medicine through the intarmed program and graduated at the end of seven years

Through the years, the college grew and expanded in relation to the needs and demands of the times. Three years ago, the first and only Social Medicine Unit in the country was organized to enhance social accountability and to develop areas deemed under-emphasized in medicine, like bioethics, history of medicine, human rights, medical anthropology. medical economics and health policy, medical jurisprudence and reproductive health and rights.

One hundred years from now, the college will celebrate its bicentennial and will look back to the previous hundred years. The teaching and the practice of medicine as we know them today will have changed, perhaps to something very different. The U.P. College of Medicine will continue to evolve and transform itself to adapt to a constantly shifting landscape of health and technology, science and society. It will meet ever-emerging ethical, social and cultural issues. Smallpox, beriberi and cholera will give way to cloning, molecular medicine, stem cell and gene therapy.

"Everywhere, the old order changes," Sir William Osler wrote, "and happy are they who can change with it."

Chief News Editor: Sol Jose Vanzi

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