Sanitation in Panama

by William Crawford Gorgas

Our force during the ten years of construction averaged thirty-nine thousand men. If we had had a similar constant sick rate, we should have had thirteen thousand sick employees in our hospitals every day during the ten years of construction. As it was, we had only twenty-three per thousand sick each day, a total of nine hundred for the whole force; that is, we had about twelve thousand fewer men sick every day than had the French. This twelve thousand men per day saved from sickness must be credited to the sanitary work done on the Isthmus.

Now let us consider the totals: We had an average of 900 men sick every day. For the year, this would give us 328,500 days of sickness, and for the ten years 3,285,000 days of sickness. If our rate had been 300 per 1,000, a very moderate figure compared with what it was under the French, we should have had 11,700 sick every day. For the year, this would have given us 4,270,500 days of sickness and for the ten years, 42,705,000, a saving of 39,420,000 days of sickness during this period. This saving must justly be credited to sanitation.

It cost us about one dollar a day to care for a sick man on the Isthmus. The Commission cared for the sick free of charge. Every day, therefore, of sickness prevented on the Isthmus lessened the expense which the Commission had to bear by one dollar. The Commission was therefore saved by this sanitary work, if we consider the whole ten years of construction, $39,420,000.

This represents only one phase of the saving due to sanitation, merely the saving due to decrease in the numbers of sick who had to be cared for. But the sanitary work really saved much more than this. If three hundred men out of every one thousand of our employees had been sick every day, the efficiency of the other seven hundred would have been correspondingly decreased. The other seven hundred would have been more or less debilitated, and more or less depressed, and the amount of work turned out daily by each man would have been considerably less than it actually was for the employee enjoying good health and cheerful surroundings. We should have had to pay considerably higher wages, if the Isthmus had continued to bear the reputation during our period of construction which it had always borne during the years preceding 1904; if, for instance, it had been known that three out of every ten men going to work on the Canal would be sick all the time, and that two out of every ten would die each year, and that the whole ten would be dead at the end of five years.

Great loss was caused to us in the first years on the Isthmus by the demoralization among the working force, and almost stoppage of work which took place during periods of exacerbation in the yellow-fever condition, or when prominent employees died of that disease. Great loss also occurred to the French on this account. Mr. Bunau-Varilla described very graphically the condition of his force as the result of such conditions. Mr. Bunau-Varilla was one of the most prominent of the French engineers for the old French Company, and was their chief engineer from 1885 to 1887.

I do not think that anyone familiar with the conditions would question the statement that a larger sum in dollars and cents was saved to the Commission in these ways than was saved by the direct decrease in the number of sick.

Considering all these factors, it will not be considered an exaggerated estimate to state that eighty million dollars was saved to the United States Government by the sanitary work done on the Isthmus during the ten years of construction. That is, granting that the construction work could have been accomplished under such conditions as had existed during the construction period of the old French Company, or which existed on the Isthmus of Panama at any time prior to 1904, and granting that public sentiment in the United States would have allowed the prosecution of the work with such mortality among the laboring force as had previously occurred, it would have cost the United States eighty million dollars more than it actually did cost to accomplish the results it has attained on the Isthmus.

I go into these figures to demonstrate that there is great financial profit resulting from money spent on such sanitary measures as we inaugurated on the Isthmus. This is the purely commercial side of the question. Of much greater importance is the moral argument that can be adduced from the saving of life and suffering that results from such measures.

During the ten years of construction, we lost by death seventeen out of every thousand of our employees each year. That is, from the whole force of 39,000 men, 663 died each year, and for the whole construction period we lost 6,630 men. If sanitary conditions had remained as they had been previous to 1904, and we had lost, as did the French, two hundred of our employees out of each one thousand on the work, we should have lost 7,800 men each year, and 78,000 during the whole construction period.

We therefore claim for the work of the Sanitary Department the saving of 71,370 human lives during the building of the Panama Canal. Where one man died, probably three would have returned home broken in health, with months and years of suffering and invalidism ahead of them. Sanitation on the Isthmus has saved this heavy toll to the devoted people engaged in this great work, and was, therefore a most wise and lucrative investment to our Government, and played a most important part in aiding the construction work in that great enterprise.