Health measures during the construction of the Panama Canal
Encyclopedia
One of the greatest challenges facing the builders of the Panama Canal
was dealing with the tropical disease
s 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 mosquito
es from the area.
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
. 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.
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 disease
s. 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 spread by mosquitos.
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 larva
e 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 swamp
s and wetland
s 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.
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. 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. 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.
Panama Canal
The Panama Canal is a ship canal in Panama that joins the Atlantic Ocean and the Pacific Ocean and is a key conduit for international maritime trade. Built from 1904 to 1914, the canal has seen annual traffic rise from about 1,000 ships early on to 14,702 vessels measuring a total of 309.6...
was dealing with the tropical disease
Tropical disease
Tropical diseases are diseases that are prevalent in or unique to tropical and subtropical regions. The diseases are less prevalent in temperate climates, due in part to the occurrence of a cold season, which controls the insect population by forcing hibernation. Insects such as mosquitoes and...
s 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 mosquito
Mosquito
Mosquitoes are members of a family of nematocerid flies: the Culicidae . The word Mosquito is from the Spanish and Portuguese for little fly...
es from the area.
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 HillAncon Hill
Ancon Hill is a steep 654-foot hill which overlooks Panama City, Panama adjacent to the township of Ancón.-Natural Features:It was under U.S. jurisdiction as part of the Panama Canal Zone for much of the 20th century and therefore was never developed like most of the surrounding urbanized parts of...
near Panama City
Panama City
Panama is the capital and largest city of the Republic of Panama. It has a population of 880,691, with a total metro population of 1,272,672, and it is located at the Pacific entrance of the Panama Canal, in the province of the same name. The city is the political and administrative center of the...
with a smaller hospital at Colon
Colón, Panama
Colón is a sea port on the Caribbean Sea coast of Panama. The city lies near the Atlantic entrance to the Panama Canal. It is capital of Panama's Colón Province and has traditionally been known as Panama's second city....
and a convalescent sanitarium at Tabago which were placed under control of Dr. Louis Companyo, the former head of sanitation at the Suez Canal
Suez Canal
The Suez Canal , also known by the nickname "The Highway to India", is an artificial sea-level waterway in Egypt, connecting the Mediterranean Sea and the Red Sea. Opened in November 1869 after 10 years of construction work, it allows water transportation between Europe and Asia without navigation...
. 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
Quinine
Quinine is a natural white crystalline alkaloid having antipyretic , antimalarial, analgesic , anti-inflammatory properties and a bitter taste. It is a stereoisomer of quinidine which, unlike quinine, is an anti-arrhythmic...
. 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
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
took control of the Panama Canal
Panama Canal
The Panama Canal is a ship canal in Panama that joins the Atlantic Ocean and the Pacific Ocean and is a key conduit for international maritime trade. Built from 1904 to 1914, the canal has seen annual traffic rise from about 1,000 ships early on to 14,702 vessels measuring a total of 309.6...
project on May 4, 1904, the isthmus of Panama
Isthmus of Panama
The Isthmus of Panama, also historically known as the Isthmus of Darien, is the narrow strip of land that lies between the Caribbean Sea and the Pacific Ocean, linking North and South America. It contains the country of Panama and the Panama Canal...
was notorious for the terrible problem of tropical disease
Tropical disease
Tropical diseases are diseases that are prevalent in or unique to tropical and subtropical regions. The diseases are less prevalent in temperate climates, due in part to the occurrence of a cold season, which controls the insect population by forcing hibernation. Insects such as mosquitoes and...
s. It is estimated that 12,000 workers had died during the construction of the Panama Railway
Panama Railway
The Panama Canal Railway Company is a railway line that links the Atlantic Ocean to the Pacific Ocean across Panama in Central America. It is jointly owned by the Kansas City Southern Railway and Mi-Jack Products...
, and over 22,000 during the French effort to build a canal. Many of these deaths were due to disease, particularly yellow fever
Yellow fever
Yellow fever is an acute viral hemorrhagic disease. The virus is a 40 to 50 nm enveloped RNA virus with positive sense of the Flaviviridae family....
and malaria
Malaria
Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...
. 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
Ronald Ross
Sir Ronald Ross KCB FRS was a British doctor who received the Nobel Prize for Physiology or Medicine in 1902 for his work on malaria. He was the first Indian-born person to win a Nobel Prize...
in India that malaria was spread by mosquitos.
The sanitation effort
The Canal Commission appointed Colonel William Crawford GorgasWilliam C. Gorgas
William Crawford Gorgas KCMG was a United States Army physician and 22nd Surgeon General of the U.S. Army...
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
Aedes aegypti
The yellow fever mosquito, Aedes aegypti is a mosquito that can spread the dengue fever, Chikungunya and yellow fever viruses, and other diseases. The mosquito can be recognized by white markings on legs and a marking in the form of a lyre on the thorax...
and anopheles
Anopheles
Anopheles is a genus of mosquito. There are approximately 460 recognized species: while over 100 can transmit human malaria, only 30–40 commonly transmit parasites of the genus Plasmodium, which cause malaria in humans in endemic areas...
, the carriers of yellow fever
Yellow fever
Yellow fever is an acute viral hemorrhagic disease. The virus is a 40 to 50 nm enveloped RNA virus with positive sense of the Flaviviridae family....
and malaria
Malaria
Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...
, 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
John Frank Stevens
John Frank Stevens was an American engineer who built the Great Northern Railway in the United States and was chief engineer on the Panama Canal between 1905 and 1907.- Biography :...
, who took over the post on July 26, 1905, Gorgas was finally able to put his ideas into action.
Gorgas divided Panama
Panama
Panama , officially the Republic of Panama , is the southernmost country of Central America. Situated on the isthmus connecting North and South America, it is bordered by Costa Rica to the northwest, Colombia to the southeast, the Caribbean Sea to the north and the Pacific Ocean to the south. The...
into 11 districts, and Colón, Panama
Colón, Panama
Colón is a sea port on the Caribbean Sea coast of Panama. The city lies near the Atlantic entrance to the Panama Canal. It is capital of Panama's Colón Province and has traditionally been known as Panama's second city....
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
Water stagnation
Water stagnation occurs when water stops flowing. Stagnant water can be a major environmental hazard.-Dangers:Malaria and dengue are among the main dangers of stagnant water, which can become a breeding ground for the mosquitoes that transmit these diseases.Stagnant or Stailment water can be...
could collect.
Mosquitoes lay their eggs on the surface of standing water, and when their larva
Larva
A larva is a distinct juvenile form many animals undergo before metamorphosis into adults. Animals with indirect development such as insects, amphibians, or cnidarians typically have a larval phase of their life cycle...
e 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 swamp
Swamp
A swamp is a wetland with some flooding of large areas of land by shallow bodies of water. A swamp generally has a large number of hammocks, or dry-land protrusions, covered by aquatic vegetation, or vegetation that tolerates periodical inundation. The two main types of swamp are "true" or swamp...
s and wetland
Wetland
A wetland is an area of land whose soil is saturated with water either permanently or seasonally. Wetlands are categorised by their characteristic vegetation, which is adapted to these unique soil conditions....
s 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
Fumigation
Fumigation is a method of pest control that completely fills an area with gaseous pesticides—or fumigants—to suffocate or poison the pests within. It is utilized for control of pests in buildings , soil, grain, and produce, and is also used during processing of goods to be imported or...
. Gorgas fumigated the residences of those Panamanians who had been confirmed to have contracted yellow fever. "Pans of sulfur
Sulfur
Sulfur or sulphur is the chemical element with atomic number 16. In the periodic table it is represented by the symbol S. It is an abundant, multivalent non-metal. Under normal conditions, sulfur atoms form cyclic octatomic molecules with chemical formula S8. Elemental sulfur is a bright yellow...
or pyrethrum
Pyrethrum
Pyrethrum refers to several Old World plants of the genus Chrysanthemum which are cultivated as ornamentals for their showy flower heads. Pyrethrum is also the name of a natural insecticide made from the dried flower heads of C. cinerariifolium and C...
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. 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. 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.