The Panama Canal: A history and description of the enterprise

by J. Saxon Mills

This loss of moral tone was the most dangerous symptom of all. A feeling of "let us eat and drink, for to-morrow we die" gained possession of the canal workers, and in the indifference of despair many tore down the nettings over the windows of the canal building and began to neglect all the sanitary precautions enjoined on them by the department. Evidently a calamity was in prospect which would have brought to an end, perhaps for ever, American canal ambitions at the isthmus. The restoration of public confidence and sense of responsibility seems to have been due largely to Mr. Charles E. Magoon, governor of the canal zone. He set himself to rebuke and remove the morbid bravado then prevailing. "He began by frankly and publicly declaring that he, personally, was afraid of the fever, and that in his opinion all non-immunes who professed not to be afraid were 'talking rot!' Then he ordered all the window-screens to be repaired and kept in place, and announced that if any man was caught leaving them open or tearing holes in them, something uncommonly unpleasant would happen to him. Now when a man of Judge Magoon's mental and physical stature admits that he is afraid, any lesser man is a fool to say he isn't; and when a man of Judge Magoon's resolution gives an order and prescribes a penalty for its violation, that order is very likely to be obeyed."[11]

[Clinedinst--Washington, D.C.

Col. William C. Gorgas,
Medical Dept., U.S. Army, Head of the Department of Sanitation, Ancon.

Governor Magoon arrived at the isthmus in May 1905, just as the yellow fever epidemic was reaching its climax. From that moment he and Colonel Gorgas, to whom he gave the most complete support, set themselves to fight the fever. The first thing to do was to get all the patients within screened buildings, whether the hospital or their own homes, so that no stegomyia mosquitoes could saunter in and take the poison. Then the towns of Colon and Panama were handed over to a campaign of spring-cleaning such as the world has never witnessed. Then the canal building was thoroughly fumigated with pyrethrum powder or sulphur, and not simply the official building but every single house in the city of Panama was similarly disinfected. Dust and refuse were everywhere burnt. A very efficient system of inspection was adopted, and a rigid quarantine enforced against all foreign places whence the yellow plague could be imported into the zone.

But more important than the immediate expedients were the more permanent sanitary improvements carried out in Colon and Panama. These towns were repaired with brick or cement, and provided with what they had never yet enjoyed, a proper system of drainage. Waterworks were also constructed outside the towns, and a supply of pure water made available for every household. Hitherto water had had to be stored during the dry season in tanks and cisterns, in which the stegomyia mosquito revelled exceedingly. These were now no longer necessary, and stagnant water, wherever it collected in the town, was drained away. In order to expedite these splendid reforms, Governor Magoon withdrew the workers from the canal and concentrated all efforts on the sewers and waterworks. So speedily was the work carried forward that the water was turned on for public use from the main in the Cathedral Plaza on July 4.

The results of this drastic campaign were soon apparent in the dwindling of the yellow fever returns. In July there were still forty-two cases and thirteen deaths on the isthmus, with twenty-seven cases and ten deaths among the employees. August showed a great improvement, with twenty-seven cases and nine deaths on the isthmus, and twelve cases and only one death on the canal. The improvement continued through September, October, November, and in December only one case was reported on the isthmus and one on the canal. Three months having elapsed since the last case, and, therefore, every stegomyia which could possibly be infected with malaria having departed this life, the epidemic was entirely past and over. As I have pointed out, there cannot possibly be any return of it under these conditions unless the infection is brought from without. And if any new cases are at once isolated and screened from afternoon calls of the mosquito, the outbreak may be easily and infallibly suppressed. We may say, therefore, that the yellow spectre at the isthmus has been shorn of all its terrors.

Malaria is, however, a very different proposition. A corresponding crusade has been carried on for six years against the little anopheles gnat, the little criminal who carries the malarial poison. His happy breeding-grounds are in open country marshes and pools, and there is no lack of these in the canal zone. It was impossible to deal with the entire three-quarters of a million acres of that territory, but wherever the canal workers were settled determined war was waged against the mosquitoes. It should be remembered that the anopheles can fly only about a hundred or two hundred yards. The jungle was therefore cleared away for a few hundred yards round each village and settlement, marshes and pools in this area were drained off, and into all the ditches where stagnant water had collected oil was poured, which so effectually turns the mosquito's stomach that it never recovers. Some 1,200 acres of the zone were thus treated, and of course the regulations as to house-screening applied to malaria no less than to yellow fever. The employees were also supplied freely and generously with quinine.

The result has been not the eradication of malaria, but the reduction of the cases to about one-third the number at which they stood in 1906. Yet even so, among the 40,000 employees on the canal during the year ending June 30, 1912, there were 7,000 malaria cases in the hospitals, with 32 deaths, 22 of these being white people. The heavy rainfalls at the isthmus will probably prevent the complete sanitation of the country in this respect, for the simple reason that the destruction of the anopheles mosquito or the eradication of the malarial germ can never be complete. There will always be people going about with the malarial organism in their blood, and always anopheles mosquitoes ready to become infected with it and to carry the infection about. But, as we have seen, much can be done by the means described to reduce the ravages of the disease. In 1906, out of a working force of 26,000, there were 21,739 cases of malaria. We have seen how this figure had been brought down in 1912. In 1906 it was almost certain that any white person coming to reside at the isthmus would catch malaria. Now it is quite possible to live there in perfect health, quite free from any malarial infection.