HEALTH CONDITIONS ON THE JSTHMUS OF 

 PANAMA. 



Bv Samuel Evans. 



Count Ferdinand de Lesseps faded in his efforts to construct 

 a canal across the Isthmus of Panama chiefly because of the high 

 mortality among the workers, and that notwithstanding a la\ish 

 expenditure on hospitals and on medical attention. The Ameri- 

 cans acquired the right to make the Panama Canal by a Treaty 

 which was ratified on February 26th, 1904, but it was not until 

 near the end of 1905 that the authorities in Washington fully 

 realised that the completion of the undertaking would depend on 

 the successful solution of the health problem,. The sanitation 

 work on the Canal Zone was placed under the direction of a 

 member of the United States x\rmy Medical Corps, Colonel 

 Gorgas, who had already distinguished himself as Chief Sanitary 

 Officer of Havana. 



In the 1903 edition of the West India Pilot, the Panama 

 Canal District is described as "one of the hottest, w^ettest, and 

 most feverish regions in existence." Sir William Osier in 

 " Man's Redemption of Man," states that " For centuries the 

 Isthmus had been the white man's grave." In an address deli- 

 vered before the Los Angeles Chamber of Commerce in June, 

 191 1, Colonel Gorgas said: — 



The present raih-oad across the Isthmus was under construction from 

 1850 to 1855. During this period the mortality was so great that several 

 times construction had to stop because the labouring force had died or 

 were sick. No statistics were retained concerning this period, so we can 

 judge of conditions only from individual instances. At one time the 

 construction company imported one thousand negroes from the West 

 Coast of Africa, and within six months these had all died off. At another 

 time, for the same reasons, they brought over one thousand Chinamen and 

 within six months these had all died off. 



Under the first French Panama Canal Company the work 

 was at its maximum from 1881 to 1889. In January, 1886. the 

 company had in its employ on, the Isthmus 14,605 negroes and 

 670 Europeans, making a total of 15,275 men. Colonel Gorgas, 

 in the address from which I have just quoted, states : 



From the best information which I can get, and which I, consider 

 accurate, I believe the French lost 22,189 labourers by death from 1881 to 

 1889. This would give a rate of something over 240 per thousand per 

 year. I think it due to the French to say that we could not have done a 

 bit better than they, if we had known no more of the cause of these 



Tropical diseases than they did We ourselves, with an average 



force of 33,000 men, in nearly the same length of time, have lost less 

 than 4,000. 



Colonel Gorgas gives a number of instances to illustrate the 

 deadly character of the Isthmus of Panama at that time, so far 

 as Europeans were concerned : 



