Sanitation in Panama

by William Crawford Gorgas

Stoned Ditch near Tivoli Hotel. Ancon, Panama.

Bad Anopheles Breeding-ground on Artificial Fill. La Boca.

This hotel is practically unscreened. While the doors and windows are provided with screens, such screening, where there are many doors and windows, is so imperfect that in the tropics it gives little protection against yellow fever and malaria. No attempt at all was made to screen the galleries of this hotel. Hundreds of visitors spent the whole evening on these galleries until twelve and one o’clock at night, yet we had no cases of yellow fever or malaria developing from such exposure. If this had occurred ten years before and three hundred of these unacclimated visitors from the United States had sat for an hour or two after sunset on this gallery, exposed to the deadly night air, it would probably have meant that every single one of them would have contracted fever, and a considerable number of them would have died. The only difference between now and then is that we have drained and cleaned the country around this hotel, so that now there are no pools or puddles, or places of any kind within two hundred yards of the hotel where mosquitoes can breed, and consequently there are no mosquitoes.

The fact that unacclimated non-immunes can live in the Tivoli Hotel without contracting fever is evidence that we could do without screening in our wards at the hospital, but we thought it unwise to do away with the wire netting there. We thought it equally unwise not to screen the Tivoli Hotel, but the expense was large, and the architect thought it would mar the appearance of the building, so it was left off by the authorities, in spite of my advice on the subject. The first guests in the Tivoli Hotel were President Roosevelt and his party, who were there in November, 1906. I succeeded in getting the authorities to screen thoroughly the portion of the building occupied by the President.

As time went on and we found that we had freed the hospital grounds from mosquitoes, we began to replace the flowers and shrubbery which we had swept away in the early sanitary work. But we realized that we had to protect all vegetation from the ants; if we did not, it would be at once destroyed. While the methods used by the French for this purpose had been entirely successful and efficient as far as protection from ants was concerned, we could not use it on account of its mosquito-breeding qualities.

The umbrella ant, in leaving its nest on its foraging expeditions, makes a very distinct trail some four or five inches wide between its nest and the tree to be attacked. Next morning, by following the trail, you can easily find the nest. Colonel Phillips, the superintendent of the hospital, found that by pouring a little bisulphid of carbon into the ant-hole, allowing it to vaporize for a few minutes and then exploding it, the gas would penetrate into every part of the nest and kill all the ants. In this way, all the umbrella ants around Ancon Hospital were killed off. At first it was very laborious, and took the entire time of one man, but in the course of time all the nests in the neighborhood were destroyed, and it is now only at long intervals that a new colony comes in and has to be killed off.

At the present time the grounds are even more filled with shrubbery and flowers and tropical plants generally, than they were under the French, and they present as beautiful and attractive an appearance as can be found anywhere in the tropics. Entomologists tell us that this ant does not collect the leaf for food, but chews it up into a pasty mass, places it in the storehouses of its nest, and grows upon it a fungus which he uses for food.

The food for this large hospital of over two thousand people was cooked in a large and airy kitchen, situated about the center of the grounds. This kitchen was equipped with every modern convenience both for good and economical cooking. Cooking by steam was used in part, and cooking on the range, for such things as were best prepared in that way. The food when prepared was sent to the various wards, the receptacles being carried in hand carts.