Sanitation in Panama

by William Crawford Gorgas

Our force of unacclimated whites liable to yellow fever rapidly increased during the winter of 1904 and spring of 1905. Yellow fever increased with still greater rapidity. The authorities became more and more alarmed. In January, 1905, the first Commission was asked to resign, and a new Commission was appointed.

Even after this change the Sanitary Department was in no better condition than it had been under the former Commission. The chief sanitary officer was still subordinate to the governor of the Canal, and had no means of access to the chairman, except through the governor. Such sanitary measures were carried through the importance of which the chief sanitary officer could impress upon the governor. Those, the importance of which the governor could not see, were with great difficulty carried into effect.

This condition of affairs was unfortunate. The authorities had no sanitary training, and as they looked upon the ideas of the sanitary officials with regard to the method of conveyance of yellow fever by the mosquito as being wild and visionary, they could not be expected to have rose-colored views as to what would be the results of attempting to carry these views into effect.

The sanitary authorities had no doubt of their ultimate success, and felt confident that they could eradicate yellow fever in Panama, as they had just done in Havana, if they could only hold on long enough and get reasonable support from the superior authorities.

Conditions with regard to yellow fever kept going from bad to worse during the first six months of 1905. In April, 1905, several of the higher officials died of yellow fever. This caused widespread panic among the whites, and very great demoralization to the work itself. A considerable sprinkling of our white force had either been in Cuba with us, or knew what had been accomplished there with regard to yellow fever, but the rank and file of the men began to believe that they were doomed just as had been the French before them.

Finally, in June, 1905, the Governor and Chief Engineer, members of the Executive Committee of the Commission, united in a recommendation to the Secretary of War that the Chief Sanitary Officer and Dr. Carter and those who believed with them in the mosquito theory, should be relieved, and men with more practical views be appointed in their stead. They stated that the sanitary authorities had visionary ideas with regard to the cause of yellow fever, and no practical methods even for carrying these ideas into execution.

Fortunately for the cause of sanitation, the then President of the United States had been in office when the work at Havana had been done by us. He told the Commission that the mosquito theory had been established beyond peradventure; that its application had been entirely successful at Havana, where yellow fever had been more firmly established and established for a longer time than at Panama. He declined to sanction the change recommended, and directed that every possible support and assistance be extended to the sanitary officials. It was really fortunate for the sanitary work that matters were brought to a head in this way.

Mr. John F. Stevens about this time was appointed chief engineer and member of the Commission, to fill a vacancy which had been caused by the resignation of the former Chief Engineer. From his arrival on the Isthmus Mr. Stevens expressed confidence in the Sanitary Department, and gave us his undivided support. The moral effect of so high an official taking such a stand at this period, when the fortunes of the Sanitary Department were at so low an ebb, was very great, and it is hard to estimate how much sanitation on the Isthmus owes to this gentleman for its subsequent success.

During the fall of 1905 the Chairman of the Commission recommended that the Sanitary Department be made an independent bureau, reporting directly to himself. This enabled the chief sanitary officer to make known directly to the chairman of the Commission the needs of the department. The chairman, also, when thus informed of our needs, gave us loyal support.

This period was the high-water mark of sanitary efficiency on the Isthmus, and more sanitation was done at this time than during any other period of the construction of the Canal.