In 1904 Major La Garde was sent to the Panama Canal Zone as superintendent of Ancon Hospital. He reorganized this old French hospital into a modern institution and in addition to its administration was head of the surgical service. After a year, he was ordered to Manila in the Philippine Islands as chief surgeon, Department of the Visayas, with headquarters at Iloilo. He held this post until February 1908, during which time occurred the Pulajan insurrection on the islands of Semar and Leyte, involving hard service for the troops and for the medical service. For additional duty he took command of the base hospital and headed its surgical service. He also did much of the surgical work in the Railroad and Mission hospitals at Iloilo. For his service on this tour he was warmly praised by the Department Commander, General Jesse M. Lee. He was promoted to the grade of lieutenant colonel on March 17, 1906, and returned to the United States in March 1908.
