|
IMPORTANCE OF THE SANITATION BRIGADES
Upon the completion of all negotiations concerning
the assets of the Interoceanic French Canal Company, Colonel William C. Gorgas
arrived on the Isthmus of Panama in 1904, leading a distinguished team of
physicians.
On the heels of his triumph over malaria and yellow
fever in Havana, President Theodore Roosevelt picked Dr. Gorgas to attempt a
repeat of his previous success. He was to provide the appropriate working
conditions, with sanitation as the principal factor, and push forward this
monumental task at which the French had failed.
 |
|
Sanitary Conditions in the cities of Panama and Colon were dismal,
but in other areas close to the excavation works, they could be termed
non-existent. |
| Disorder reigned in a kingdom of mosquitoes. The anopheles (malaria)
and stegomya fasciata, later called Aedes Aegypti (yellow fever and dengue)
were the ever-present monarchs, daily increasing the mortality
statistics. |
|
Anopheles Mosquito
|
At that time it was not important whether it was
Finlay or Walter Reed who had identified the vector that propagated the
aforementioned dreaded disease. Eventually history would give each one his
rightful due and acknowledge their scientific contribution.
At that time, the situation in the Canal was very
politicized, above all, and required speedy action to prevent a repetition of
the dreaded mistakes of the previous company.
The powerful northern nation could not persist in
following disastrous work plans, and they obviously needed to change their
focus from the very start.
Gorgas had to wage long and hard battles to gain
acceptance for his theory that sanitation must precede construction. He had to
struggle persistently for the approval of budgets requesting large amounts of
money to acquire protective netting, large quantities of crude oil, fumigating
materials, and above all for labor in its early stages. These ideas were the
target of derisive sarcasm in high circles of government in Washington.
After the heated arguments surrounding this project,
it got a much-needed boost from the unconditional endorsement by President
Roosevelt who, after studying Gorgas’ proposal, made a wise decision to
support it.
Sanitation activities were undertaken quite
effectively and the success of the Panama Canal could now be viewed as more
viable.
Gorgas himself, appointed Chief of Sanitation,
described that one of his first visits after having arrived on the Isthmus was
to a camp of very robust and healthy soldiers who were living on a nearby
hillside, under the best possible environmental conditions. Nevertheless, after
only 30 days of living in Panama, 170 of the 450 had already contracted
malaria.
If this could happen to a group of strong, well-fed
soldiers, Gorgas reasoned, then what was to be expected of other workers of
lower physical conditions?
His appreciation of the problem, as well as his
response to it, was swift. If measures were not taken to improve the current
sanitary conditions, mortality figures would equal or exceed those of the
French period, and failure would be just as resounding.
The task at hand was clearly cut out for them. The
entire city had to be cleaned and placed under a strict system of sanitary
inspection and control; unnecessary deposits of water had to be dried up, and
mosquitoes controlled throughout.
Garbage collection had to be subject to sanitary
measures, and a test for malaria had to be administered to the entire labor
force to maintain accurate records.
A treatment of quinine was initiated for all
identified cases, which were given close follow-up until they were cured.
These measures technically eliminated man as a focus
of constant reinfection.
During the period the French were working on the
Canal, mortality statistics were never precise, nor even approximate. This was
owing to the fact that the contractors of the various works had to pay five
francs daily for the hospital care of their workers; inasmuch as they tried to
avoid paying the costs of medical care, it was speculated that many workers
died in their own homes.
Gorgas estimated that the number of deaths annually
during the French era could have been 240 for every 1,000, a very alarming
figure. It later decreased to 2.1 for every 1,000—bearing evidence to the
efficacy of the sanitation controls implemented.
Later, the real battle focused on the two mosquitoes
responsible for yellow fever and malaria.
The fumigation brigades began discharging their
duties immediately. In many instances they were rejected by the very
inhabitants of Panama and Colon, since the fumigation interrupted their daily
family activities, which is still true today, as it was inconvenient to have
strangers working in the home—not a very pleasant situation to endure.
Even in the face of this passive resistance from the
population, the diplomacy and tact displayed by Gorgas and his assisting staff
managed to prevail.
Other brigades that played an important role in these
tasks were those that used chloroform to anesthetize the mosquitoes for
subsequent microscopic study to determine whether they were vectors or not. Any
positive findings would immediately unleash a painstaking search of possible
existing contagion foci to isolate them and prevent the propagation of the
disease.
The oil sprayers were another important group in the
sanitation of canal townsites. Backpacking their containers, they would go
about spraying wherever they found water puddles, wells, latrines, or toilets.
They came to be very familiar figures back then.
The campaign against malaria was conducted within the
following parameters:
- Three grams of quinine
daily for all patients
- Mosquito netting for
doors and windows in hospitals and homes
- Capture and
destruction of all mosquitoes by special brigades
- Eradication of
anopheles by elimination of all puddles and accumulated fluids
- Oil sprayed over any
pools of water to exterminate the mosquito larvae
- Clearing grass and
underbrush from the grounds surrounding townsites.
The positive outcomes of these measures:
- In 1906 malaria
accounted for 6.8% of hospital cases
- In 1911 this figure
was down to 1.5%
- In 1906 employee
deaths numbered 233
- In 1911 it decreased
to 47
- Yellow fever was
completely eradicated
Little by little, the initial resistance from the
population in the terminal cities was being countered, until it turned into
full-fledged cooperation, as they were able to realize and value the greatly
beneficial results, which were very evident to the entire community.
Families now opened their doors willingly, affording
ready access now that their earlier rejection was overcome.
The Americans won a decisive victory in this
environmental battle of preventive medicine, a front on which the French were
not effective.
History has not bestowed the proper importance on the
quiet and intense work conducted by the various sanitation brigades of the
Panama Canal nor on their extraordinary contribution to the successful
conclusion of this undertaking.
It was with much care and dedication that they
carried out the roles they had to play in the monumental wonder of building and
interoceanic canal.
They were true anonymous heroes, among others, in the
overall contribution toward the success achieved. |
