Campaigning in Cuba

by George Kennan

CHAPTER XXI

THE SANTIAGO CAMPAIGN (Concluded)

IV. The wrecking of the army by disease after the decisive battle of July 1-2.

The army under command of General Shafter left Tampa on the fourteenth day of June, and arrived off the Cuban coast near Santiago on the 20th of the same month. Disembarkation began at Daiquiri on the 22d, and ended at Siboney on the 24th. On the morning of June 25 the whole army was ashore, and was then in a state of almost perfect health and efficiency. One week later the soldiers at the front began to sicken with malarial and other fevers, and two weeks later, according to General Shafter's report, "sickness was increasing very rapidly, and the weakness of the troops was becoming so apparent that I was anxious to bring the siege to an end." On July 21, less than four weeks after the army landed, Colonel Roosevelt told me that not more than one quarter of his men were fit for duty, and that when they moved five miles up into the hills, a few days before, fifty per cent. of the entire command fell out of the ranks from exhaustion. On July 22 a prominent surgeon attached to the field-hospital of the First Division stated to me that at least five thousand men in the Fifth Army-Corps were then ill with fever, and that there were more than one thousand sick in General Kent's division alone. On August 3 eight general officers in Shafter's command signed a round-robin in which they declared that the army had been so disabled by malarial fevers that it had lost its efficiency; that it was too weak to move back into the hills; that the epidemic of yellow fever which was sure to occur would probably destroy it, and that if it were not moved North at once it "must perish." At that time, according to General Shafter's telegram of August 8 to the War Department, "seventy-five per cent. of the command had been ill with a very weakening malarial fever, which leaves every man too much broken down to be of any use." In the short space of forty days, therefore, an army of sixteen thousand men had lost three fourths of its efficiency, and had been reduced to a condition so low that, in the opinion of eight general officers, it must inevitably "perish" unless immediately sent back to the United States. Early in August, after a stay in Cuba of only six weeks, the Fifth Army-Corps began to move northward, and before September 1 the whole command was in camp at Montauk Point, Long Island. Of the eighteen thousand men who composed it, five thousand were very ill, or soon became very ill, and were sent to the general hospital; while five thousand more, who were less seriously sick, were treated in their tents.[15] Eight thousand men out of eighteen thousand were nominally well, but had been so enfeebled by the hardships and privations of the campaign that they were no longer fit for active Cuban service, and, in the opinion of General Miles, hardly one of them was in sound health.[16] I think it is not an exaggeration to describe this state of affairs as "the wrecking of the army by disease." It is my purpose in the present chapter to inquire whether such wrecking of the army was inevitable, and if not, why it was allowed to happen.

A review of the history of campaigns in tropical countries seems to show that Northern armies in such regions have always suffered more from disease than from battle; but it does not by any means show that the virtual destruction of a Northern army by disease in a tropical country is inevitable now. When the British army under the Earl of Albemarle landed on the Cuban coast and attacked Havana in 1762, it lost nearly one half its efficiency, as a result of sickness, in about four weeks; but at that time the fact that nine tenths of all tropical diseases are caused by microscopic germs, and are therefore preventable, was not known. The progress made in sanitary science in the present century renders unnecessary and inexcusable in 1898 a rate of sickness and mortality that was perhaps inevitable in 1762. Northern soldiers, if properly equipped and cared for, can live and maintain their health now under conditions which would have been absolutely and inevitably fatal to them a century ago.

In April last there was an interesting and instructive discussion of this subject, or of a subject very closely connected with this, at a meeting held in the rooms of the Royal Geographical Society, London, and attended by many of the best-known authorities on tropical pathology in Great Britain. Most of the gentlemen who took part in the debate were of opinion that there is no reason whatever why the white man should not be able to adapt himself to the new conditions of life in the tropics, and protect himself against the diseases that prevail in those regions. The popular belief that the white man cannot successfully colonize the tropics is disproved by the fact that he has done so. It is undoubtedly true that many Northerners who go to equatorial regions contract disease there and die; but in the majority of such cases the man is the victim of his obstinate unwillingness to change his habits in respect to eating, drinking, and clothing, and to conform his life to the new conditions.

The chief diseases, both acute and chronic, of tropical countries—those which formerly caused such ravages among the white settlers, and gave rise to the prevalent theory that Europeans can live only in the temperate zone—are all microbic in origin, and consequently in great measure preventable. We cannot expect, of course, to see them absolutely wiped out of existence; but their sting may be extracted by means of an improved public and private hygiene and other prophylactic measures. A comparison of the healthfulness of the West India Islands under enlightened British rule with that of the two under Spanish misrule shows what can be done by sanitation to convert a pest-hole into a paradise. Indeed, as Dr. L. Sambon, in opening the discussion, well said, sanitation within the last few decades has wrought wonderful changes in all tropical countries as regards health conditions, and the changes in some places have been so great that regions once considered most deadly are now even recommended as health resorts.

Dr. Patrick Manson, than whom there is no greater authority on the pathology of equatorial regions, began his remarks with the confession that in former years, under the influence of early training, he shared in the pessimistic opinions then current about tropical colonization by the white races. In recent years, however, his views on this subject had undergone a complete revolution—a revolution that began with the establishment of the germ theory of disease. He now firmly believed in the possibility of tropical colonization by the white races. Heat and moisture, he contended, are not, in themselves, the direct cause of any important tropical disease. The direct causes of ninety-nine per cent, of these diseases are germs, and to kill the germs is simply a matter of knowledge and the application of that knowledge—that is to say, sanitary science and sanitation.[17]

The fact that ninety-nine per cent. or more of the diseases that prevail in the tropics are caused by germs was known, of course, to the surgeon-general of our army, and ought to have been known to General Shafter and the Secretary of War. It was, therefore, their duty, collectively and individually, to protect our soldiers in Cuba, not only by informing them of the best means of escaping the dangers threatened by these micro-organisms, but also by furnishing them with every safeguard that science and experience could suggest in the shape of proper food, dress, equipment, and medical supplies. The rules and precautions which it is necessary to observe in order to escape the attacks of micro-organisms and maintain health in the tropics were well known at the time when the invasion of Cuba was planned, and had been published, long before the army left Tampa, in hundreds of periodicals throughout the country. Cuban physicians and surgeons, Americans who had campaigned with Gomez and Garcia, and travelers who, like Hornaday, had spent many years in tropical forests and jungles, all agreed that if our soldiers were to keep well in Cuba they should drink boiled water, they should avoid sleeping on the ground, they should have adequate protection from rain and dew at night, and they should be able to change their clothing, or at least their underwear, when wet.[18] By observing these very simple precautions Dr. Hornaday maintained his health throughout five years of almost constant travel and exploration in the woods and jungles of Cuba, South America, India, the Malay Archipelago, and Borneo. If our soldiers went to Cuba, or marched from Siboney to Santiago, without the equipment required for the observance of these precautions, it was not the result of necessary ignorance on the part of their superiors. As the Philadelphia "Medical Journal" said, ten days before the army sailed: "The climate and sanitary—or rather unsanitary—conditions of Cuba have been much discussed, and it is well known what our troops will have to contend against in that island." The "Army and Navy Journal," about the same time, pointed out the grave danger to be apprehended from contaminated drinking-water, and said: "The government should provide itself with heating and distilling apparatus on an adequate scale. Sterilized water is cheaper than hospitals and an army of nurses, to say nothing of the crippling of the service that sickness brings." In an article entitled "Special Sanitary Instructions for the Guidance of Troops Serving in Tropical Countries," published in the "Journal of the American Medical Association" for May, Dr. R. S. Woodson described fully the adverse sanitary conditions peculiar to Cuba, and called especial attention to the danger of drinking impure water and sleeping on the ground. Finally, the highest medical officers of our army, including the surgeon-general, the chief surgeon of the Fifth Army-Corps, and Dr. John Guiteras, published instructions and suggestions for the maintenance of the health of our soldiers in the field, in which attention was again called to the danger of drinking unboiled water and sleeping in wet clothing on the ground.[19]

In spite of all these orders, instructions, and suggestions, and in defiance of the advice and warnings of all competent authorities, General Shafter's army sailed from Tampa without its reserve medical supplies and ambulance corps, and, having landed on the Cuban coast, marched into the interior without wall-tents, without hammocks, without a change of clothing, and without a single utensil larger than a coffee-cup in which to boil water.