The Panama Canal and its Makers Part 6

Technically the Panama Railroad is not a department, but practically the construction of the Ca.n.a.l and the reconstruction of the Railroad are worked as parts of a single scheme.

In addition to the above are some smaller divisions, reporting directly to the Chairman, such as that of Accounts. The office of the Purchasing Officer is situate in Washington, practically all the supplies being obtained in the United States. This officer also reports to the Chairman resident on the Zone.

The numbers given above are subject to continual fluctuation, and are quoted more for the purpose of showing the general proportions of the different parts of the undertaking than to give an exact total of the force employed.

Some account has already been given of the activities of the men employed on excavation, on locks and dams, and on the railway. Those entered under the Department of Machinery and Buildings are charged not only with this work in the Zone, but also with the paving and other improvements in the cities of Colon and Panama. The Department of Sanitation also undertakes the hygiene of these two cities, no small part of its responsibilities. The Republic of Panama provides the cities with police, who are Panamanians. The police force of the Isthmian Ca.n.a.l Commission (Department of Civil Administration) numbers 200, of whom 88 are the West Indians already mentioned and the remainder white Americans. The force is numerically small, but the power to deport all undesirable persons is of great a.s.sistance. Moreover, as the Zone is practically inaccessible except from the ports of Colon and Panama, a fairly complete watch can be kept on all entries. After making due allowance for all these advantages, however, one cannot but be impressed, not only by the order, but by the respectability of the Isthmus, which is singularly free from anything unseemly.

A scattered force of 200 would be insufficient to deal with tumult among so large a population of men, but there is maintained at Obispo, a central point, a force of about 350 United States Marines.

The work of the Department of Sanitation is of such primary interest and importance, especially to geographers, that I deal with it separately in the next chapter.

CHAPTER V

HEALTH ON THE ISTHMUS AND THE FUTURE OF THE WHITE RACE IN THE TROPICS

_Yellow Fever._

THE cities of Colon and Panama have never been particularly unhealthy to the Panamanian born, whether white or coloured, or to the West Indian stranger.

This population has merely been subject to the malaria common to equatorial towns, especially when in the neighbourhood of swamps, and to the evils which attend imperfect sanitation in a hot climate.

The intervening country is very malarious in the low-lying parts, less so on the hilly divide, differing in no way from other similar localities in the same lat.i.tude.

[Ill.u.s.tration: READING ROOM, EMPLOYEES' CLUB, CULEBRA.]

[Ill.u.s.tration: HALL OF EMPLOYEES' CLUB, CULEBRA.]

The reputation of the Isthmus of Panama as a death-trap is due to the sickness which (previous to 1906) has always been prevalent among white strangers, and most other visitors, and particularly to the high percentage of death from yellow fever. To this short, sharp, and most deadly disease the native-born is immune; hence the affairs of the city of Panama have gone on well enough for centuries, as far as the residents are concerned, except that travellers by the Isthmian route tarried no longer than they could help. Whenever large numbers of strangers have congregated on the Isthmus, as during the Californian gold-rush, the construction of the railway, and the Ca.n.a.l construction of the French Companies, there has been an epidemic of yellow fever among them, and a very large proportion of cases have terminated fatally.

The immunity which the West Indian negro enjoys from this disease gave him a superiority over other labourers on the Isthmus which, since the extinction of the disease, is no longer his.

During the American occupation of Havana, after the American-Spanish War, yellow fever broke out among the strangers, and the mere cleaning up of the city, though carried out with military thoroughness, had no effect in checking the disease. A medical board was sent to study the matter. This was in 1900, four years after Major Ronald Ross, of the Indian Medical Service, had discovered the cause of malaria. Ross had proved that the cause of malaria in man was the presence in his blood of an organism introduced by the attack of the _anopheles_ gnat (or mosquito), and that the species was only poisonous to man if it had itself become infected with the germ of this organism in biting a man suffering from malaria. Thus man and _anopheles_ act alternately as hosts to the organism, which apparently requires their co-operation for the continuance of its species.

Gnats, or mosquitoes, as they are indifferently termed, being thus under more than suspicion as an immediate cause of tropical fevers, the medical board turned their attention to them, and Mr. Reed, a member of the board, tracked the yellow fever to another gnat, the _stegomyia_, and, aided by the heroic devotion of his a.s.sistants, proved beyond shadow of doubt that this disease is due to the activity of another minute organism, which lives a double life in man and _stegomyia_. Mere contact with the clothing, &c., of yellow-fever patients was proved to be no source of infection.

The _stegomyia_ lives three months. It becomes dangerous only by imbibing the organism through attacking man during the first three days of yellow fever, and, even then, twelve days elapse before its bite is infectious. Six days after a man has been bitten by an infectious _stegomyia_ he develops yellow fever, and for the next three days (as has been already said) he is infectious to the _stegomyia_.

During the American occupation of Cuba attempts were made to obtain immunity from yellow fever, but it was found impossible to regulate the disease when voluntarily communicated by the bite of the mosquito, and at present immunity is only enjoyed by persons who inherit the privilege.

The _stegomyia_ does not breed in open swamps or large bodies of water, but needs shelter, and is also incapable of sustaining a long flight. It breeds chiefly in and near towns, depositing its larvae upon the surface of cisterns or stagnant pools.

Colonel W.C. Gorgas, M.D., took charge of the Department of Sanitation of the Commission in July, 1904. "The experience of our predecessors,"

he writes,[27] "was ample to convince us that unless we could protect our force against yellow fever and malaria we would be unable to accomplish the work."

[27] "Sanitation in the Ca.n.a.l Zone," by W.C. Gorgas _Journ. Am. Med.

a.s.soc._, July 6, 1907, vol. xlix.

[Ill.u.s.tration: READING ROOM, EMPLOYEES' CLUB, CULEBRA.]

[Ill.u.s.tration: HALL OF EMPLOYEES' CLUB, CULEBRA.]

At this time there was but little yellow fever on the Isthmus, and, in spite of the arrival of a large number of non-immunes, no alarming outbreak occurred during the first ten months. During April, 1905, however, the administration building in Panama, in which worked some 300 non-immune employees of the Commission, became infected. In that month there were 9 cases and 2 deaths; in May, 33 cases and 8 deaths, of which 21 cases and 2 deaths were among employees of the Commission. In June there were 19 deaths from yellow fever on the Isthmus, and in July 13.

The Commission reported[28] that:--

"A feeling of alarm, almost amounting to panic, spread among the Americans on the Isthmus. Many resigned their positions to return to the United States, while those who remained became possessed with a feeling of lethargy or fatalism, resulting from a conviction that no remedy existed for the peril. There was a disposition to partly ignore or openly condemn and abandon all preventive measures. The gravity of the crisis was apparent to all."

[28] Annual Report, 1905, p. 30.

Colonel Gorgas writes[29] of this time:--

"We could readily see that if the conditions as they existed in 1905 were to continue the Ca.n.a.l would never be finished."

And he adds that:--

"The Executive Board of the Commission itself, as late as June, 1905, stated that the sanitary work of the Isthmus had been a failure and recommended that the _personnel_ be changed and other methods tried. But the Supreme Authorities ... gave us steady support, and by the following December yellow fever had disappeared from the Isthmus."

[29] "Sanitation in the Ca.n.a.l Zone."

The total deaths among employees of the Commission from yellow fever during the 12 months October 1, 1904, to September 30, 1905, was 37, among about 17,000.[30] The total from yellow fever among the whole population, including Ca.n.a.l employees, during the four months May 1 to August 31, 1905, was 47, while the number of deaths from malaria during the same period was 108. The effect of malaria in impairing physical efficiency was even more in excess than these figures indicate, for the fatal cases are a small proportion of the whole in malaria, and a very large proportion in yellow fever. The moral effect of the imminence of the more sudden and fatal form of disease was, however, as these reports show, much the greater, and it was this moral effect which caused the crisis above described.

[30] In 1883-84 the French Company lost by yellow fever 66 men out of about the same number of employees.

Previous to February, 1905, the Department of Sanitation had done little to improve the hygienic conditions of Colon and Panama, chiefly owing to the opinion until then maintained by the legal advisers that there was no authority to expend money in those cities, which are not within the Ca.n.a.l Zone.

In April the yellow fever broke out; the number of men employed by the Department of Sanitation was increased to the huge total of 4,100, and the battle with yellow fever began in earnest. All cases were either transported to screened buildings, or, if left in their own homes, these were carefully screened with fine-meshed copper gauze. The object of this isolation was to prevent the patient from infecting healthy _stegomyia_ mosquitoes.

Every dwelling in Colon and Panama was thoroughly fumigated with pyrethrum powder or with sulphur, and then cleared of dust and refuse, which, with the insensible but not always dead mosquitoes, was then burnt. The complete, and, it is hoped, final freedom from yellow fever in Colon and Panama has been obtained by means of a proper water supply and universal paving with brick or cement, as well as the supply of proper drainage. Formerly water for domestic use was stored in cisterns, tanks, tubs, jars, and so forth, and, after rain, water stood stagnantly in a thousand ruts and holes in the unpaved squares, streets, and lanes.

These breeding-places of the _stegomyia_ have now been done away with completely in Panama, and almost completely in Colon. The latter city is so low-lying and flat, and subject to such heavy rainfall, that pools of stagnant water will form. They can, however, be oiled, which kills the larvae, and, moreover, it is Panama, and not the wind-swept, salt-saturated, town of Colon, which has been the chief source of yellow fever.

The last case of the disease in Panama occurred in November, 1905, and in May, 1906, there was an isolated case in Colon. The infection is considered to be at an end in a city three months after the last case, that being the lifetime of _stegomyia_. After this period, all infected _stegomyia_ having died, those that remain are powerless for harm.

Nevertheless, the stringent measures for their destruction are not relaxed, as, while _stegomyia_ exists, the germ, if re-introduced, will be rapidly disseminated.

Thus the yellow fever, having taken toll for four hundred years of those who crossed the Isthmus, has been completely eradicated by. Colonel Gorgas and his a.s.sistants. It is a triumph of science and of despotic government combined; and only in this combination can preventive medicine achieve full success.

There is one other aspect of the yellow fever campaign which must be mentioned before going on to describe the fight with malaria.

Yellow fever, unlike malaria, does not occur in all tropical countries.

Its home is the West Indies, Central, and parts of South, America, and, before its extinction in Havana, it has been a serious scourge in the Southern United States. In the New World cases have occurred as far north as Quebec, in Europe cases have occurred in Wales and France, and there have been serious epidemics in Spain. It has never been known east of Genoa, whether in Europe or elsewhere. Thus in Africa it is known on the west but not on the east coast. The fact that it is unknown in India is very remarkable, seeing that _stegomyia_ is a very prevalent variety of mosquito there. It follows from this that if yellow fever once got hold in India it would probably spread and might work great havoc. The same is true of China in an even greater degree, for such preventive measures as have been taken in Panama would be far more difficult to carry out in the great cities of India, and altogether impracticable in those of China. Thus, as Colonel Gorgas has pointed out, if the Ca.n.a.l had been constructed in spite of yellow fever, and if that disease had been allowed then to persist at Panama, the disease might not improbably have been carried to Asia, for the three months of life of _stegomyia_ is ample for the voyage. In this event the Panama Ca.n.a.l might have proved a curse rather than a boon to mankind.

[Ill.u.s.tration: CUT SOUTH OF CULEBRA, LANDSLIP ON LEFT.]

[Ill.u.s.tration: LOOKING NORTH, THE SCARPED FACE OF GOLDEN HILL ON THE RIGHT.]