THE SANITATION OF THE ZONE
The seal of the Canal Zone shows a galleon under full sail passing
between the towering banks of the Culebra Cut, with the motto, “The land
divided; the world united”. Sometimes as I trudged about the streets of
Colon or Panama, or over the hills and through the jungle in the Zone, I
have thought a more significant coat-of-arms might be made up of a
garbage can rampant and a gigantic mosquito mordant for verily by the
collection and careful covering of filth and the slaughter of the
pestilential mosquito all the work done on the Zone has been made
possible. As for the motto how would this do--“A clean country and a
salubrious strait”?
It is the universal opinion of those familiar with the Canal work that
if we had approached the task with the lack of sanitary knowledge from
which the French suffered we should have failed as they did. No evil
known to man inspires such dread as yellow fever. Leprosy, in the
individual, does indeed, although well-informed people know that it is
not readily communicated and never becomes epidemic. Cholera did strike
the heart of man with cold dread, but more than one generation has
passed since cholera was an evil to be reckoned with in civilized
countries. Yellow fever is now to be classed with it as an epidemic
disease, the spread of which can be absolutely and unerringly
controlled.
The demonstrated fact that yellow fever is transmitted only by the bite
of a _stegomyia_ mosquito which has already bitten, and been infected
by, a human being sick of the fever has become one of the commonplaces
of sanitary science. Yet that knowledge dates back comparatively few
years, and was not available to mankind at the time the French began
their struggle with tropical nature. Over the honor of first discovering
the fact of the malignant part played by the mosquito there has been
some conflict, but credit is generally given to Dr. Donald Ross, a
Scotchman in the Indian Civil Service. His investigations however were
greatly extended and practical effect was given them by surgeons in the
United States Army engaged in the work of eliminating pestilence from
Havana. To Majors Walter Reed, Jesse W. Lazear and James Carroll the
chief credit is due for testing, proving and applying the theory in
Havana. Lazear bravely gave up his life to the experiment, baring his
arm to the bite of a mosquito, and dying afterward of yellow fever in
terrible agony.
[Illustration: _Photo by Underwood & Underwood_
COL. W. C. GORGAS
The man who changed the Isthmus from a pest-hole to a spot as fit for
human habitation as any place on the globe]
[Illustration: WHAT COL. GORGAS HAD TO CORRECT]
The fact of this earlier application of the mosquito theory does not in
the slightest degree detract from the great honor due to Col. W. C.
Gorgas for his work in changing the Isthmus of Panama from a pest-hole
into a spot as fit for human habitation as any spot on the globe.
Unfortunately, as the impending success of the Canal enterprise became
apparent, rivalry for the prime honor grew up between the followers of
the two chief figures, Col. Goethals and Col. Gorgas. That either of
these gentlemen shared in this feeling is not asserted, but their
friends divided the Isthmus into two hostile camps. Rivalry of this sort
was unfortunate and needless. In the words of Admiral Schley after the
battle of Santiago: “There was glory enough for all”. But the result was
to decry and to depreciate the work of Col. Gorgas in making the Isthmus
habitable. As a matter of fact no historian will for one moment hesitate
to state that only by that work was it made possible to dig the Canal at
all. Col. Goethals himself in his moments of deepest doubt as to the
size of the appropriations for sanitation purposes would hardly question
that statement. That some other man than Gorgas might have done the work
with the experience of the French and the discovery of the malignant
quality of the mosquito to guide him is undoubtedly true. That some
other man than Goethals might have dug the Canal with the experience of
two earlier engineers, as well as of the French to serve as warnings, is
equally true. But these two finished the work and to each belongs the
glory for his part.
[Illustration: ADMINISTRATION BUILDING, HOUSING THE SANITARY
DEPARTMENT]
[Illustration: _Photo by Underwood & Underwood_
DREDGING A COLON STREET
So near tide level is the surface of Colon that the dredges made canals
in the public streets]
Col. Gorgas first visited the Isthmus in 1904. In a little pamphlet
which I have before me he then described simply the essence of the
problem he had to meet. He found camped on a hill, perfectly drained and
supplied with good water, 450 marines--who of course were men of
exceptionally good physique, robust and vigorous. Yet in four months 170
out of the 450 were infected with malaria, and Col. Gorgas said, “if
these men were our laborers, working daily in Culebra Cut, exposed to
the sun and weather, many of these cases would be severe in type and at
the end of the year we would be approaching the mortality of the
French”. The cause for the infection was apparent. Though the marines’
camp was clean and sanitary there was at the foot of the hill, on which
it was perched, a village of 400 or 500 Jamaica negroes. Examination of
the people showed that all suffered from chronic malaria. The marine
strolling in the village would be bitten by a mosquito--the _anopheles_
which is partial to malaria--which had already bitten an infected negro.
The result was the spread of the infection among the marines. As Col.
Gorgas put it, “The condition is very much the same as if these four or
five hundred natives had the smallpox and our marines had never been
vaccinated”. To correct this condition he proposed, “to take this
village, put it under a systematic scheme of inspection, whereby we will
be able to control all water barrels and deposits of water, so that no
mosquitoes will be allowed to breed, look after its street cleaning and
disposal of night soil, etc., so as to get it in good sanitary
condition, then have the population examined and recorded, so that we
will have on a card a short history of each individual and keep track of
them in this way. Those suffering from malaria will be put under
treatment, and watched as long as the malarial parasite is found in the
blood. I hope, in this way, to decrease to the smallest limit the
number of _anopheles_, the malarial-bearing mosquito, and, at the same
time, to gradually eliminate the human being as a source of infection,
so that at the end of a year it will be entirely safe for an
unacclimated man to live in this village”.
[Illustration: THE WAR ON MOSQUITOES. I.
The men are oiling the surface of the streams to kill the larvae]
[Illustration: THE WAR ON MOSQUITOES. II.
Burning the grass that affords cover]
Being appointed Chief Sanitary Officer Col. Gorgas put this plan into
effect not only in that village but in every part of the Canal Zone,
particular attention being given to the cities of Panama and Colon. In
these cities the visitor will be impressed with the comparative
cleanliness of the streets and sidewalks and the covering of all garbage
receptacles. No other Central American city shows so cleanly a front.
Screening, however, is little in evidence. How great the mortality had
been under the French it is impossible to tell. Their statistics related
almost wholly to deaths in their hospitals and very largely to white
patients. Men who died out on the line, natives who worked a day or two
and went back to their villages to die were left unrecorded. In the
hospitals it was recorded that between 1881 and 1889, 5618 employees
died. The contractors were charged a dollar a day for every man sent to
the hospitals, so it may be conjectured that not all were sent who
should have been. Col. Gorgas estimates the average death rate at about
240 per 1000 annually. The American general death rate began with a
maximum of 49.94 per 1000 sinking to 21.18, at or about which point it
has remained for several years. Among employees alone our death rate was
7.50 per 1000. The French with an average force of 10,200 men employed,
lost in nine years 22,189 men. We with an average force of 33,000 lost
less than 4000 in about an equal period.
[Illustration: THE WAR ON MOSQUITOES. III.
Spraying the brooks with larvacide]
[Illustration: _Photo by Underwood & Underwood_
THE WAR ON MOSQUITOES. IV.
Cutting down brush which will later be burned thus destroying mosquito
covert]
When Col. Gorgas came to the Isthmus the two towns Panama and Colon were
well fitted to be breeding places for pestilence. Neither had sewers nor
any drainage system. The streets of Panama were paved after a fashion
with cobblestones and lined with gutters through which the liquid refuse
of the town trickled slowly or stood still to fester and grow putrescent
under the glowing rays of the tropic sun. Colon had no pavement
whatsoever. Neither town had waterworks and the people gathered and
stored rainwater in cisterns and pottery jars which afforded fine
breeding places for the mosquito. As a matter of fact, the whole
Isthmus, not the towns alone, furnishes plenty of homes for the
mosquito. With a rainy season lasting throughout eight months in the
year much of the soil is waterlogged. The stagnant back waters of small
streams; pools left by the rains; the footprints of cows and other
animals filled up with rain water quickly breed the wrigglers that
ultimately become mosquitoes. Mr. A. H. Jennings, the entomologist of
the Commission, has identified 125 varieties of the mosquito, of which,
however, the _anopheles_ and the _stegomyia_ are the ones peculiarly
obnoxious to man. The others are merely the common or summer resort
variety of mosquito with a fondness for ankles and the back of one’s
hand, which can be observed any time on Long Island or in New Jersey
without the expense of a trip to Panama. A careful study of literary
authorities indicates to me that at this point in the description of the
mosquito plague on the Isthmus it is proper to indulge in humorous
reflections upon the fact that the bite of the female only is dangerous.
But, given the fact, the humorous applications seem so obvious that the
reader may be trusted to draw them for himself--it would be idle to say
“herself”, for the women will not see anything humorous about it at all.
[Illustration: COPYRIGHT, 1913, BY F. E. WRIGHT
PANAMA BAY FROM ANCON HOSPITAL
There are few more beautiful spots in the world than the grounds of
Ancon Hospital. French taste selected the site, a French nun set out the
first trees and shrubs, and nature has completed a charming picture.]
The fight then against disease on the Isthmus resolved itself largely
into a war of extermination upon the two noxious varieties of
mosquitoes. It involved first a cleaning up, paving and draining of the
two towns. Curiously enough bad smells are not necessarily unhygienic,
but they betoken the existence of matter that breeds disease germs, and
flies and other insects distribute those germs where they will do the
most harm. Colon and Panama therefore were paved and provided with
sewage systems, while somewhat stringent ordinances checked the pleasant
Panama practice of emptying all slops from the front gallery into the
street. It is fair to the Panamanians to note that in the end they will
pay for the vigorous cleaning and refurbishing of their towns by the
Americans. Our sanitary forces did the work and did it well, by virtue
of the clause in the treaty which grants the United States authority to
prosecute such work in the two cities and collect from the householder
its cost by means of water and sewage rates.
[Illustration: _Photo by Underwood & Underwood_
SANITARY WORK IN A VILLAGE
The scene is in the outskirts of Culebra, now a model of cleanliness]
This work was completed in 1908 and the final report of the Division of
Municipal Engineering which conducted it showed that nearly $6,000,000
had been expended, of which about $2,250,000 was for pavements, sewers
and waterworks in the two cities, and about $3,500,000 for work in the
Canal Zone. Nearly a million more was subsequently expended in the
towns.
The first thing to do with the towns was to fumigate them. The
Panamanians did not like this. Neither would we or any other people for
that matter, for the process of fumigating necessarily interrupts the
routine of life, invades domestic privacy, inevitably causes some loss
by the discoloring of fabrics, interrupts trade in the case of stores
and is in general an infernal nuisance. That much any people will say
against wholesale fumigation. But to the Panamanians it was peculiarly
offensive because they were immune from yellow fever anyway, and to some
extent from malaria as well, so to their minds the whole thing was an
imposition by which the Americans alone would profit. If the gringoes
weren’t able to live in Panama without smoking people out of house and
home, they had better stay away was the generally expressed public
opinion of Panama.
Here the peculiar personality of Col. Gorgas came into play. Had that
gentleman not been a great health officer he would have made a notable
diplomat, particularly in these new days when tact and charm of manner
are considered more essential to an American diplomat than dollars. He
went among the people of the two towns, argued, jollied and cajoled them
until a work which it was thought might have to be accomplished at the
point of the bayonet was finished with but little friction. The bayonet
was always in the background, however, for the treaty gives the United
States unqualified authority to enforce its sanitary ordinances in the
cities of Colon and Panama. We can send a regiment if necessary to
compel a man to keep his yard clean--which is perhaps more than we could
do in some benighted towns of our own United States.
The tone of the man in the street toward these American innovations is
partly surly, partly jocular. In Panama he will show you a very
considerable section of the town which is not yet fully rebuilt and
insist that the fire which started it was caused by the “fool
fumigators”. There is some difference of opinion as to the origin of
this blaze, and the matter of damages is, as I write, in the hands of
arbitrators, but the native opinion is solidly against the fumigating
torch bearers. On the subject of the extermination of mosquitoes the
native is always humorous. He will describe to you Col. Gorgas’s trained
bloodhounds and Old Sleuths tracking the criminal _stegomyia_ to his
lair; the corps of bearers of machetes and chloroform who follow to put
an end to the malevolent mosquito’s days; the scientist with the
high-powered microscope who examines the remains and, if he finds the
deceased carried germs, the wide search made for individuals whom he may
have bitten that they may be segregated and put under proper treatment.
[Illustration: THE MOSQUITO CHLOROFORMER’S OUTFIT
Used in tracking the criminal _stegomyia_ to his lair]
In reality there is a certain humor in this scientific bug hunting. You
are at afternoon tea with a hostess in one of the charming tropical
houses which the Commission supplies to its workers. The eyes of your
hostess suddenly become fixed in a terrified gaze.
“Goodness gracious”! she exclaims, “look there”!
“What? where”? you cry, bounding from your seat in excitement. Perhaps a
blast has just boomed on the circumambient air and you have visions of a
fifty-pound rock about to fly through the drawing-room window. Life on
the Zone abounds in such incidents.
[Illustration: _Photo by Dr. Orenstein_
THE MOSQUITO CHLOROFORMER AT WORK
Once subdued by chloroform the mosquito is removed for analysis]
“There”! dramatically. “That mosquito”!
“I’ll swat it”, you cry valorously, remembering the slogan of “Swat the
Fly” which breaks forth recurrently in our newspapers every spring,
though they are quite calm and unperturbed about the places which breed
flies faster than they can be swatted.
“Goodness, no. I must telephone the department”.
Speechless with amazement you wonder if the police or fire department is
to be called out to cope with this mosquito. In due time there appears
an official equipped with an electric flash-light, a phial and a small
bottle of chloroform. The malefactor--no, the suspect, for the
_anopheles malefactor_ does no evil despite his sinister name--is
mercifully chloroformed and deposited in the phial for a later post
mortem. With his flash-light the inspector examines all the dark places
of the house to seek for possible accomplices, and having learned that
nobody has been bitten takes himself off.
[Illustration: ANCON HOSPITAL AS RECEIVED FROM THE FRENCH]
It does seem a ridiculous amount of fuss about a mosquito, doesn’t it?
But since that sort of thing has been done on the Zone death carts no
longer make their dismal rounds for the night’s quota of the dead, and
the ravages of malaria are no longer so general or so deadly as they
were.
Nowadays there are no cases of yellow fever developing on the Zone, but
in the earlier days when one did occur the sanitary officials set out to
find the cause of infection. When the French seek to detect a criminal
they follow the maxim “_Cherchez la femme_” (Look for the woman). When
pursuing the yellow-fever germ to its source the Panama inspectors look
for the _stegomyia_ mosquito that bit the victim--which is a little
reminiscent of hunting for a needle in a haystack.
A drunken man picked up on the street in Panama was taken to the
hospital and there died of yellow fever. He was a stranger but his hotel
was looked up and proved to be a native house occupied only by immunes,
so that he could not have been infected there. Nobody seemed to care
particularly about the deceased, who was buried as speedily as possible,
but the Sanitary Department did care about the source of his malady.
Looking up his haunts it was discovered that he was much seen in company
with an Italian. Thereupon all the Italians in town were interrogated;
one declared he had seen the dead man in company with the man who tended
bar at the theater. This worthy citizen was sought out and was
discovered hiding away in a secluded lodging sick with yellow fever.
Whereupon the theater was promptly fumigated as the center of infection.
Clearing up and keeping clean the two centers of population was,
however, the least of the work of sanitation. The whole Isthmus was a
breeding place for the mosquitoes. Obviously every foot of it could not
be drained clear of pools and rivulets, but the preventive campaign of
the sanitation men covered scores of square miles adjacent to villages
and the Canal bed, and was marvelously effective in reducing the number
of mosquitoes. Away from the towns the campaign was chiefly against the
malarial mosquito--the _anophelinæ_. The yellow fever mosquito, the
_stegomyia_, is a town-bred insect coming from cisterns, water pitchers,
tin cans, fountains in the parks, water-filled pans used to keep ants
from the legs of furniture and the like. It is even said to breed in the
holy-water fonts of the multitudinous churches of Panama, and the
sanitary officials secured the co-operation of the church authorities in
having those receptacles kept fresh. The malarial mosquito however
breeds in streams, marshes and pools and will travel sometimes a mile
and a half from his birth-place looking for trouble.
As you ride in a train across the Isthmus you will often see far from
any human habitation a blackened barrel on a board crossing some little
brook a few inches wide. If you have time to look carefully you will see
that the edges of the gully through which the brook runs have been swept
clear of grass by scythe or fire or both, and that the banks of the
rivulet are blackened as though by a tar-brush while the water itself is
covered by a black and greasy film.
[Illustration: _Photo by Underwood & Underwood_
THE CANAL COMMISSION HOSPITAL AT COLON BUILT BY THE FRENCH]
This is one of the outposts of the army of health. Of them there are
several hundred, perhaps thousands, scattered through the Zone. The
barrel is filled with a certain fluid combination of oil and divers
chemicals called larvacide. Day and night with monotonous regularity it
falls drop by drop into the rivulet, spreads over its surface and is
deposited on the pebbles on the banks. The mosquito larvæ below must
come to the surface to breathe. There they meet with the noxious fluid
and at the first breath are slain. Automatically this one barrel makes
that stream a charnel house for mosquito larvæ. But up and down
throughout the land go men with cans of the oil on their backs and
sprinklers in their hands seeking for pools and stagnant puddles which
they spray with the larvacide. So between the war on the larva at its
breeding point and the system of screening off all residences, offices
and eating places the malarial infection has been greatly reduced. It
has not been eradicated by any manner of means. The Panama cocktail
(quinine) is still served with meals. In one year 2307.66 pounds of the
drug were served out. But if not wholly obliterated the ailment has been
greatly checked. Dr. A. J. Orenstein, of the Department of Sanitation,
says in summing up the results of the policy:
[Illustration: FRENCH VILLAGE OF EMPIRE AFTER CLEANING UP BY AMERICANS]
[Illustration: THE BAY OF TABOGA FROM THE SANITARIUM]
“The campaign against malaria was inaugurated on the following plan: (1)
Treatment with adequate doses of quinine (about 30 grains a day for
adults) of all cases of malaria. First, because this treatment is
curative; and, second, because unless so treated, each case of malaria
constitutes a focus from which malaria spreads. In malarial regions
there are many persons who have what is often spoken of as chronic
malaria. Such individuals frequently do not suffer any serious
inconvenience. They more often suffer from occasional headaches, anemia
or slight fever. These are the people most dangerous from the standpoint
of the sanitarian. It is in the blood of these individuals that the
malaria-causing parasite has attained the form in which, if taken by a
female _anopheline_, it develops within this mosquito into the form
capable of causing malaria in the individual whom the _anopheline_ may
bite a week or so thereafter. (2) Protecting dwelling with copper wire
gauze against the ingress of mosquitoes. All houses occupied by
Americans and most of the others are screened. (3) Catching and killing
mosquitoes within the dwellings. This is done by negro “mosquito
catchers”, and is of great value in preventing malaria where other
prophylactic measures cannot be inaugurated. (4) Destroying the breeding
places of _anophelinæ_ by filling, draining, and training the banks of
streams. (5) Destroying the _anophelinæ_ in the larval and pupal stages
by oiling the water in which they are found, or applying a special larva
poison to this water. (6) Clearing the rank vegetation in the immediate
vicinity of dwellings and settlements, so as to destroy the shelter for
such mosquitoes as may find their way to the vicinity of the houses; to
hasten evaporation and the drying of small water collections and marshy
places; to expose to view small breeding places and to remove the
temptation to throw water containers into the vegetation.
[Illustration: THE LITTLE PANGO BOATS COME TO MEET YOU]
“These measures, conscientiously and painstakingly carried out, resulted
in reducing the number of malaria cases treated in the hospitals from
6.83 per cent of the working force per month in 1906 to 1.53 per cent of
the working force per month in 1911, and the death from malaria among
employees from 233 in 1906 to 47 in 1911”.
[Illustration: OLD CHURCH AT TABOGA
The square box on the corner of the wall contains the mummied head of a
favorite priest]
[Illustration: THE RIO GRANDE RESERVOIR]
“The malaria sick rate for 1906, if continued to 1911, would give, on
the basis of the number of employees in 1911, about 40,000 cases of
malaria sick in the hospitals for the year, or a loss in labor of about
200,000 days of work. The total number of employees sick in hospitals
with malaria in 1911 was 8946--or a loss of 44,730 days of work. A gain
of about 155,000 days was, therefore, made. Placing the loss to the
Government for each day’s labor, plus treatment, at the rather low
figure of $3 per man, the gain in this one item of saving more than
offset the cost of sanitation proper. These figures do not include
malarial cases treated in the dispensaries and in homes. Among this
class of patients the gain has undoubtedly been proportionate to the
gain in hospital cases, and in addition it must not be forgotten that
malaria is a disease that undermines a man’s health insidiously and
lowers his working efficiency to an extent not approached by any disease
with the possible exception of hook-worm. The less malaria the fewer
inefficient workers in an organization”.
[Illustration: IN PICTURESQUE TABOGA]
Of course the screening system was vital to any successful effort to
control and check the transmission of fever germs by insects. But the
early struggles of Col. Gorgas to get enough wire netting to properly
protect the labor quarters were pathetic. “Why doesn’t he screen in the
whole Isthmus and let it go at that”? inquired one Congressman who
thought it was all intended to put a few more frills on houses for
already highly paid workers. The screening has indeed cost a pretty
penny for only the best copper wire will stand the test of the climate.
At first there was reluctance on the part of disbursing officers to meet
the heavy requirements of Col. Gorgas. But the yellow-fever epidemic of
1905 stopped all that. Thereafter the screening was regarded as much of
an integral part of a house as its shingling.
The efforts that were put forth to make the Canal Zone a liveable spot
have not been relaxed in keeping it so. A glance at the report of the
Chief Sanitary Officer for any year shows something of his continued
activity. You find records of houses fumigated for beriberi, diphtheria,
malaria, leprosy, and a dozen other evils. The number of rats killed is
gravely enumerated--during the year 1911 for example there were nearly
13,000. It may be noted in passing that the rats distribute fleas and
fleas carry the germs of the bubonic plague, hence the slaughter.
Incidentally guests of the native hotels in Panama City say that the
destruction was far from complete.
[Illustration: IN THE GROUNDS OF ANCON HOSPITAL]
Two large hospitals are maintained by the Canal Commission at Colon and
at Ancon, together with smaller ones for emergency cases at Culebra and
other points along the line. The two principal hospitals will be kept
open after the completion of the Canal, but not of course to their full
capacity. Ancon alone has accommodations for more than 1500 patients,
and when the army of labor has left the Zone there can be no possible
demand for so great an infirmary. Both of these hospitals were inherited
from the French, and the one at Colon has been left much in the
condition they delivered it in, save for needed repairs and alterations.
Its capacity has not been materially increased. The Ancon Hospital
however has become one of the great institutions of its kind in the
world. The French gave us a few buildings with over 300 patients
sheltered in tents. The Americans developed this place until now more
than fifty buildings are ranged along the side of Ancon Hill. When the
French first established the hospital they installed as nurses a number
of sisters of St. Vincent with Sister Rouleau as Sister Superior. The
gentle sisters soon died. The yellow fever carried them off with
heart-rending rapidity. Sister Marie however left a monument which will
keep her fair fame alive for many years yet to come. She was a great
lover of plants, and the luxuriance of the tropical foliage was to her a
never-ending charm. To her early efforts is due the beauty of the
grounds of the Ancon Hospital, where one looks between the stately
trunks of the fronded royal palms past a hillside blazing with hibiscus,
and cooled with the rustling of leaves of feather palms and plantains to
where the blue Pacific lies smooth beneath the glowing tropic sun.
Beside the beauty of its surroundings the hospital is eminently
practical in its plan. The many separate buildings permit the
segregation of cases, and the most complete and scientific ventilation.
[Illustration: THE SANITARIUM AT TABOGA INHERITED FROM THE FRENCH]
Making the hospital attractive was one of the points insisted upon by
Col. Gorgas. Some of the doctors think that possibly it has been a wee
bit overdone. Some of the folks along the Zone look on a brief space
spent in the hospital as a pleasant interlude in an otherwise monotonous
life. As they have thirty days’ sick leave with pay every year they are
quite prone to turn to the pleasant slopes of Ancon Hill, with a week at
the charming sanitarium on Taboga Island as a fitting close--a sort of
café parfait to top off the feast. Surgery even seems to have lost its
terrors there. “Why, they even bring their friends to be operated on”,
said one of the surgeons laughingly when talking of the popularity of
the hospital among the Zone dwellers.
[Illustration: A FETE DAY AT TABOGA]
[Illustration: FEATHER PALM AT ANCON]
Charity cases have numbered as many as 66,000 a year and the records
show that during the period of greatest activity on the Zone as many as
70 different nationalities were ministered to. The question of color was
often an embarrassing one. The gradations of shades between pure white
to darkest African is so exceedingly delicate in Panama that there is
always difficulty in determining whether the subject under consideration
belongs to the “gold” or the “silver” class, for the words black and
white are tactfully avoided in the Zone in their reference to
complexions. “This is my plan”, said Col. Mason in charge of the
hospital. “On certain days the patients are allowed visitors. When the
color of the inmate is problematical, as is usually the case with women,
I ask if she wants her husband to visit her. If she does and he proves
to be a negro, she goes into the colored ward. If she still insists that
she is white, she can go into the white ward, but must dispense with his
visits”.
Under our treaty the Zone sanitary department takes charge of the insane
of Colon and Panama, and a very considerable share of the grounds at
Ancon is divided off with barbed wire for their use. The number of
patients runs well into the hundreds, with very few Americans. Most are
Jamaica negroes and the hospital authorities say that they are mentally
unbalanced by the rush and excitement of life on the Zone. I never
happened to see a Jamaica negro excited unless it happened to be a
Tivoli Hotel waiter confronted with the awful responsibility of an extra
guest at table. Then the excitement took the form of deep melancholy,
exaggerated lethargy, and signs of suicidal mania in every facial
expression.
Beside the hospital service the sanitary department maintains
dispensaries at several points on the line, where necessary drugs are
provided for patients in the Commission Service free. Patent medicines
are frowned upon, and such as are purveyed must be bought through the
Commissary. Medical service is free to employees and their families. All
doctors practicing on the Zone are on the gold payroll for wages ranging
from $1800 to $7000 a year. I could not find upon inquiry that the fact
that they were not dependent upon the patient for payment made the
doctors less alert or sympathetic. At least no complaints to that effect
were current.
To my mind the most notable effect upon the life of the Zone of this
system of free medical attendance was that it added one more to the many
inducements to matrimony. Infantile colic and measles are shorn of much
of their terror to the young parent when no doctor’s bill attends them.
Incidentally, too, the benevolent administration looks after the teeth
of the employees as a part of its care of their general health. One
effect of this is to impress the visitor with the remarkable number of
incisors gleaming with fresh gold visible where Zone folk are gathered
together.
[Illustration: TABOGA FROM THE BATHING BEACH]
The annual vacations of the workers during the construction period may
properly be considered in connection with sanitation work on the Zone,
for they were not permitted to be mere loafing time. The man who took a
vacation was not allowed to stay on the Isthmus. If he tried to stay
there Col. Goethals found it out in that omniscient fashion of his and
it was a case of hike for a change of air or go back to work. For,
notwithstanding the fact that Col. Gorgas pulled the teeth of the
tropics with his sanitary devices and regulations, an uninterrupted
residence in that climate does break down the stamina and enfeeble the
energy of men from more temperate climes. Every employee was given 42
days’ vacation with full pay, but he had to quit the Zone for some
country which would afford a beneficial climatic change. Of course most
went back to the United States, being encouraged thereto by a special
rate on the steamship of $30--the regular rate being $75. But beside
this vacation each employee was entitled to 30 days’ sick leave. It was
not an exceedingly difficult task to conjure up enough symptoms to
persuade a friendly physician to issue a sick order. The favorite method
of enjoying this respite from work was to spend as little of the time as
possible at Ancon, and the rest at the sanitarium on the Island of
Taboga.
[Illustration: TABOGA IS FURTHERMORE THE CONEY ISLAND OF PANAMA]
That garden spot in the Bay of Panama where the French left the
sanitarium building we now use is worth a brief description. You go
thither in a small steamboat from Balboa or Panama and after about three
hours’ steaming a flock of little white boats, each with a single
oarsman, puts out from the shore to meet you like a flock of gulls as
you drop anchor in a bay of truly Mediterranean hue. To the traveled
visitor the scene is irresistibly reminiscent of some little port of
Southern Italy, and the reminder is all the more vivid when one gets
ashore and finds the narrow ways betwixt the elbowing houses quite
Neapolitan for dirt and ill odor. But from the sea one looks upon a
towering hill, bare toward its summit, closely covered lower down by
mango, wild fig, and ceiba trees, bordered just above the red roofs of
the little town by a fringe of the graceful cocoanut palms. Then come
the houses, row below row, until they descend to the curving beach
where the fishing boats are drawn up out of reach of the tide which
rises some 20 feet.
From the bay the village with its red-tiled roofs and yellow-white walls
looks substantial, a bit like Villefranche, the port of Nice, but this
impression is speedily dispelled when one lands in one of the boats,
propelled by the oarsman standing and facing the bow--a fashion seldom
seen save in Italian waters. For seen near at hand the houses are
discovered to be of the flimsiest frame construction, save for a few
clustering about the little church and sharing with it a general
decrepitude and down-at-the-heels air that makes us think they have seen
better days. As indeed they have and worse days too, for Taboga once
shared in the prosperity of the early Spanish rule, and enjoyed the
honor of having entertained for a few weeks Sir Henry Morgan, that
murderous pirate, who later became a baronet and a colonial governor, as
a fine finish after his deeds of piracy and rapine. Taboga must have
treated the buccaneer well, for not only did he forbear to sack the
town, but so deep was the devotion paid by him and his men to certain
tuns of excellent wine there discovered that they let a Spanish galleon,
deep-laden with gold and silver, slip through their fingers rather than
interrupt their drinking bout.
Tradition has it that the galleon was sunk nearby to save it and its
cargo from the pirates, and treasure seekers have been hunting it ever
since with the luck that ordinarily attends aspirants for dead men’s
gold.
[Illustration: BURDEN BEARERS ON THE SAVANNA]
Just now the wine and wassail of Taboga is limited to about six grog
shops, which seems an oversupply for the handful of fishermen who
inhabit its tumble-down hovels. Each bar, too, has its billiard table
and one is reminded of Mark Twain’s islands in the South Sea where the
people earned an honest living by taking in each other’s washing. One
wonders if the sole industry of the Tabogans is playing billiards. There
is indeed little to support the town save fishing, and that, if one may
judge from specimens carried through the lanes, must be good. Some of
the boats at anchor or drawn up on the beach attest to some prosperity
amongst them that go down to the sea in ships. One that I saw rigged
with a fore-and-aft sail and a jigger was hewn out of a single log like
a river cayuca and had a beam exceeding four feet. Before many of the
houses were lines hung with long strips of fish hanging out to dry, for
it is a curious property of this atmosphere that despite its humidity it
will cure animal tissues, both fish and flesh, quickly and without
taint.
[Illustration: HOTEL AT BOUQUETTE, CHIRIQUI
The only point in Panama at which Canal employees may spend their
vacations]
Agriculture in Taboga is limited to the culture of the pineapple, and
the local variety is so highly esteemed in the Panama markets that some
measure of prosperity might attend upon the Tabogans would they but
undertake the raising of pines systematically and extensively. But not
they. Their town was founded in 1549 when, at the instance of Las Casas,
the King of Spain gave freedom to all Indian slaves. Taboga was set
apart as a residence for a certain part of these freedmen. Now what did
the freedom from slavery mean but freedom from work? This view was
probably held in the 16th century and certainly obtains in Taboga today,
having been enhanced no doubt by the liberal mixture of negro blood with
that of the native Indians. If the pineapples grow without too much
attention well and good. They will be sold and the grog shops will know
that real money has come into town. But as for seriously extending the
business--well, that is a thing to think of for a long, long time and
the thought has not yet ripened. It is a wonder that the Chinese who
hold the retail trade of the island and who are painstaking gardeners
have not taken up this industry.
[Illustration: A BIT OF ANCON HOSPITAL GROUNDS]
We may laugh at the easy-going Tabogan if we will, but I do not think
that anyone will come out of his church without a certain respect for
his real religious sentiment. ’Tis but a little church, of stuccoed
rubble, fallen badly into decay, flanked by a square tower holding two
bells, and penetrated by so winding and narrow a stair that one
ascending it may feel as a corkscrew penetrating a cork.
But within it shows signs of a reverent affection by its flock not
common in Latin-American churches. We may laugh a little at the altar
decorations which are certainly not costly and may be a little tawdry,
but they show evidences of patient work on the part of the women, and
contributions by the men from the slender gains permitted them by the
harsh land and the reluctant sea. About the walls hang memorial tablets,
not richly sculptured indeed, but showing a pious desire on the part of
bygone generations to have the virtue of their loved ones commemorated
within hallowed walls. Standing in a side aisle was an effigy of Christ,
of human size, bearing the cross up the hill of Gethsemane. The figure
stood on a sort of platform, surrounded by six quaint lanterns of panes
of glass set in leaded frames of a design seen in the street lamps of
the earlier Spanish cities. The platform was on poles for bearers, after
the fashion of a sedan chair, and we learned from one who, more
fortunate than we, had been there to see, that in Holy Week there is a
sort of Passion Play--rude and elementary it is true, but bringing to
the surface all the religious emotionalism of the simple people. The
village is crowded with the faithful from afar, who make light of any
lack of shelter in that kindly tropic air. The Taboga young men dress as
Roman soldiers, the village maidens take their parts in the simple
pageant. The floats, such as the one we saw, are borne up and down the
village streets which no horse could ever tread, and the church is
crowded with devotional worshipers until Easter comes with the joyous
tidings of the Resurrection.
[Illustration: THE CHIEF INDUSTRY OF THE NATIVES IS FISHING]
[Illustration: NURSES’ QUARTERS AT ANCON]
As to the part of Taboga in the economy of the Canal work, we have there
a sanitarium inherited from the French, and used as a place of
convalescence for almost recovered patients from the hospitals of the
Zone. After breathing the clear, soft air, glancing at the comfortable
quarters and enjoying to the fullest a lunch costing fifty cents that
would put Broadway’s best to the test, and make the expensive Tivoli
dining-room seem unappetizing in comparison, we could well understand
why every employee with thirty days’ sick leave to his credit gets just
such a slight ailment as needs a rest at Taboga for its cure.
Near Taboga is the leper hospital and the steamer stops for a moment to
send ashore supplies in a small boat. Always there are about 75 victims
of this dread and incurable disease there, mostly Panamanians with some
West India negroes. A native of North America with the disease is
practically unknown. The affliction is horrible enough in itself, but
some cause operating for ages back has caused mankind to regard it with
more fear than the facts justify. It is not readily communicable to
healthy persons, even personal contact with a leper not necessarily
causing infection unless there be some scratch or wound on the person of
the healthy individual into which the virus may enter. Visitors to the
Isthmus, who find interest in the spectacle of hopeless human suffering,
frequently visit the colony without marked precautions and with no
reported case of infection.
To what extent the sanitation system so painstakingly built up by Col.
Gorgas and his associates will be continued after the seal “complete”
shall be stamped upon the Canal work, and the workers scattered to all
parts of the land, is not now determined. Panama and Colon will, of
course, be kept up to their present standards, but whether the war
against the malarial mosquito will be pursued in the jungle as it is
today when the health of 40,000 human beings is dependent upon it is
another question. The plan of the army authorities is to abandon the
Zone to nature--which presumably includes the _anopheles_. Whether that
plan shall prevail or whether the United States shall maintain it as an
object lesson in government, including sanitation, is a matter yet to be
determined. In a hearing before a congressional committee in 1913 Col.
Gorgas estimated the cost for a system of permanent sanitation for the
Zone, including the quarantine, at $90,000 a year. As his total
estimates for the years 1913-14 amounted to $524,000, this is indicative
of a very decided abandonment of activity in sanitary work.
[Illustration: THE LEPER SETTLEMENT ON PANAMA BAY]
At all times during his campaign against the forces of fever and
infection Col. Gorgas has had to meet the opposition charge of
extravagance and the waste of money. It has been flippantly asserted
that it cost him $5 to kill a mosquito--of course an utterly baseless
assertion, but one which is readily met by the truth that the bite of a
single infected mosquito has more than once cost a life worth many
thousand times five dollars. To fix precisely the cost of bringing the
Zone to its present state of healthfulness is impossible, because the
activities of the sanitary department comprehended many functions in
addition to the actual work of sanitation. Col. Gorgas figures that the
average expenses of sanitation during the whole construction period were
about $365,000 a year and he points out that for the same period Chicago
spent $600,000 without any quarantine or mosquito work. The total
expenditures for sanitation when the Canal is finished will have
amounted to less than one per cent of the cost of that great public work
and without this sanitation the Canal could never have been built. That
simple statement of fact seems sufficiently to cover the contribution of
Col. Gorgas to the work, and to measure the credit he deserves for its
completion.