Health measures during the construction of the Panama Canal

One of the greatest challenges facing the builders of the Panama Canal was dealing with the tropical diseases rife in the area. The health measures taken during the construction contributed greatly to the success of the canal's construction. These included general health care, the provision of an extensive health infrastructure, and a major program to eradicate disease-carrying mosquitoes from the area.

Background

Health measures in the French era

The importance of controlling disease was recognized from the start by the French canal company which built a large hospital, regarded as the finest and most modern in the tropics, at Ancon Hill near Panama City with a smaller hospital at Colon and a convalescent sanitarium at Tabago which were placed under control of Dr. Louis Companyo, the former head of sanitation at the Suez Canal.^[1] However malaria and yellow fever were thought to stem from poor hygiene, exposure to victims and noxious air. Measures focused on improving sewage, quickly disposing of bodies and infected clothing as well as mass distributing of quinine. Mosquitoes were not yet recognized as the critical disease carriers. Most buildings, including the hospitals, did not have screens. Most famously, pans of water were placed around the legs of hospital beds and fruit trees in hospital gardens, providing perfect habitat for mosquito larvae.

US control

William Crawford Gorgas, Chief Sanitary Officer to the Isthmian Commission

By the time the United States took control of the Panama Canal project on May 4, 1904, the isthmus of Panama was notorious for the terrible problem of tropical diseases. It is estimated that 12,000 workers had died during the construction of the Panama Railway, and over 22,000 during the French effort to build a canal. Many of these deaths were due to disease, particularly yellow fever and malaria. At several times, construction on the Panama Railway had actually halted due to the lack of any healthy workers.

It was clear to the organizers of the American effort that previous efforts at disease control had been largely ineffective, as the causes of the two main diseases were unknown, but in 1897 it was proved by Britain's Ronald Ross in India that malaria was treatable.

The sanitation effort

The Canal Commission appointed Colonel William Crawford Gorgas in March 1904 as head of hospitals and sanitation. Under his leadership, many new departments of sanitation were founded, covering different aspects of the sanitation problem. Commissions were also formed to look after the basic welfare of the laborers.

The sanitation work included clearing land and establishing quarantine facilities. The most ambitious part of the sanitation program, though, was undoubtedly the effort to eradicate the mosquitoes Aedes aegypti and anopheles, the carriers of yellow fever and malaria, respectively, from the canal zone. There was considerable resistance to this program at first, as the "mosquito theory" was still considered controversial and unproven. However, with the support of chief engineer John Frank Stevens, who took over the post on July 26, 1905, Gorgas was finally able to put his ideas into action.

Gorgas divided Panama into 11 districts, and Colón, Panama into four. In each district, inspectors searched houses and buildings for mosquito larvae. If found, carpenters would be dispatched to the building, and work would be done to eliminate any objects or places where stagnant water could collect.

Mosquitoes lay their eggs on the surface of standing water, and when their larvae hatch out, they live just below the surface, breathing by means of a siphon in their tails. Hence, by eliminating standing water where possible, and by spreading oil upon the surface of any remaining pools, the larvae could be destroyed.

Gorgas organized a major program to drain and fill the swamps and wetlands around the canal zone. Many miles of ditches were dug, and grass and brush were cut back over wide areas. Oiling was used in a variety of means; workers with spray tanks were sent to spray oil on standing pools, and smaller streams were tackled by placing a dripping oil can over the waterway, which created a film of oil over each still patch of water in the stream. About 700,000 gallons of oil and 124,000 gallons of larvicide were used on the project per year. In addition to his draining program, Gorgas took another step in his efforts to eradicate mosquitoes in Panama: fumigation. Gorgas fumigated the residences of those Panamanians who had been confirmed to have contracted yellow fever. "Pans of sulfur or pyrethrum were then placed in the rooms, the right quantity of powder was weighed out (two pounds per thousand cubic feet), and the pans were sprinkled with wood-alcohol and set alight" (Cameron 132). When the effectiveness of this procedure was realized, fumigation was extended to all of Panama. Within a year of Stevens's appointment, every single building in Panama had been fumigated (using up the entire United States supply of sulfur and pyrethrum). In 1906, only one case of yellow fever was reported, and up until the end of the Panama Canal's construction, there were zero.

Gorgas's final means of attack upon disease was to quarantine those persons infected with yellow fever or malaria from the rest of the workforce. Those who were diagnosed with either disease were quarantined and put into "Portable Fever Cages", easily transportable screened structures used to prevent mosquitoes from biting an infected person and carrying the disease to others. Gorgas also had the thousands of workers on the Canal sleep in screened verandas, as the mosquitoes which spread malaria are nocturnal and would infect the most people at night.

The outcome

The first two and a half years of the American canal effort were substantially dedicated to preparation, much of it making the area fit for large-scale human habitation. A very significant part of this was the sanitation program put in place by Gorgas. Nearly $20 million was spent on health and sanitation during the ten years of the construction period.

In the end, these efforts were a success: by 1906, yellow fever was virtually wiped out in the canal zone, and the number of deaths caused by the other top disease, malaria, was also reduced significantly. The hospitals maintained were by far the best to be found anywhere in the tropics; some 32,000 patients were treated per year.

While disease reduction dramatically improved the health of white workers, Black workers, the majority of the canal workforce, continued to die in large numbers - ten times the rate of white workers in 1906.^[2] While medical care was provided to all, housing was not provided to Black workers, many of whom had to live in tents and tenements outside the mosquito controlled zone. In the end, 350 white workers had died compared to 4,500 Black workers.^[3] While the loss was tragic, it was far less than during the French era.

Today, the canal zone is regarded as free of yellow fever and malaria, a great benefit to the many people who live and work there.

References

1. ^ David McCullouch, The Path Between the Seas, Simon and Shuster (1977) p. 134
2. ^ McCullough, p. 501-502
3. ^ MCCullough, p. 610

• ^ Travelers' Health: Yellow Book—Centers for Disease Control
• History of the Panama Canal, Ira E. Bennett
• Building the Panama Canal, Arthur T. Schlesinger, Chronicles From National Geographic. Chelsea House Publishers, Philadelphia, 1999.
• Cameron, Ian (1972). The Impossible Dream: The Building of the Panama Canal. New York: William Morrow & Company, Inc.
• Mellander, Gustavo A.; Nelly Maldonado Mellander (1999). Charles Edward Magoon: The Panama Years. Río Piedras, Puerto Rico: Editorial Plaza Mayor. ISBN 1-56328-155-4. OCLC 42970390.
• Mellander, Gustavo A. (1971). The United States in Panamanian Politics: The Intriguing Formative Years. Danville, Ill.: Interstate Publishers. OCLC 138568.