Health measures during the construction of the Panama Canal

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One of the greatest challenges facing the builders of the Panama Canal was dealing with the tropical diseases rife in the area. The eventual success of the project is owed substantially to the health measures taken during construction. These included general health care, the provision of an extensive health infrastructure, and a major program to eradicate disease-carrying mosquitos from the area. These efforts were a great success, and contributed significantly to the overall success of the canal project.

[edit] Background

By the time the United States took control of the Panama Canal project on 4 May 1904, the isthmus of Panama was already notorious for the terrible problem of tropical diseases. It is estimated that 102,000 workers had died during the construction of the Panama Railway, and 22,000 during the earlier French effort to build a canal; and 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 organisers of the American effort that the problem of disease had to be tackled before any major work could begin on the canal. However, the United States had one advantage over the previous projects.

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 transmitted by mosquitos, and in 1900 a team lead by U.S. Army surgeon Walter Reed proved the theory of Cuban Dr. Carlos Finlay that yellow fever was spread the same way.

These crucial advances were immediately seized upon by the American canal effort. One of the first people to join the American work in Panama was William C. Gorgas, a surgeon in the United States Army who had been involved in the early work on yellow fever, including a successful effort to rid Havana of the disease in 1902. He was joined by Ronald Ross, who in 1902 had been awarded the Nobel prize for his work on malaria.

[edit] The Sanitation Effort

Under the leadership of Gorgas, 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, establishing quarantine facilities, and taking care of sick and injured laborers in hospitals. The government furnished all of its employees with free medicines, free medical attendance, and free hospital and burial services. It dispensed about a ton of quinine a year.

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.

Mosquitoes lay their eggs on the surface of standing water, and when their larvae hatch out, 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 can be destroyed.

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.

He also organised 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 oil 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.

As a result of Gorgas's actions, cases of malaria and yellow fever in the canal zone dropped dramatically in a short period of time

In addition to his draining program, Gorgas took another step in his efforts to irradicate Panama of mosquitoes: fumigation. Gorgas fumigated the houses of those who had been confirmed to have yellow fever. "Pans of sulphur 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). However, when the effectiveness of this procedure was realised, fumigation was extended to all of Panama. Within a year of Stevens' appointment, every single building in Panama had been fumigated (using up the entire US 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 then carrying the disease to other hosts. Gorgas also had the thousands of workers on the Canal sleep in screened verandas, as the mosquitoes which spread malaria are nocturnal.

[edit] 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 $20,000,000 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.

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. ^[1]

[edit] References

1. ↑  Travelers' Health: Yellow Book — Centers for Disease Control

• History of the Panama Canal, Ira E. Bennett

• Building the Panama Canal, Arthur M. 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.