“The First Mountain to Be Removed”: Yellow Fever Control and the Construction of the Panama Canal

Abstract

One of the most important achievements of the US era of canal building in Panama was the successful control of yellow fever, a disease that had plagued the region for centuries and had undone the French canal building effort two decades earlier. Indeed, many US commentators depicted the successful control of yellow fever as a form of tropical conquest. This essay argues, to the contrary, that yellow fever control was a process of reengineering urban Panama and of disciplining an urban Panamanian population that was largely immune to yellow fever.

INTRODUCTION

On July 22, 1905, Harper’s Weekly ran a cartoon by William Allen Rogers titled, “The First Mountain to Be Removed.”¹ In the background are the hills of “Panama,” presumably those of Culebra, which the Americans would need to excavate to complete their planned lock canal. The Culebra Cut was one of the most significant engineering challenges the Americans faced during the construction era. But looming in the foreground, rising up in front of President Theodore Roosevelt, in full Rough Rider gear, and Uncle Sam, the personification of American national spirit, is a symbolic mountain—or, more precisely, a sword-wielding skeletal bandit disguised as a mountain and lying in wait. He is identified only as “yellow jack,” a common moniker for yellow fever. The message of the cartoon was clear: before the Americans, and their vast labor force of West Indians and southern Europeans, could take on the task of riving the isthmus, they would need to clear the landscape of yellow fever and the threat it posed to the canal enterprise. Yellow fever, the cartoon suggested, was the first among many natural enemies to be conquered in Panama (see figure 6).

Figure 6.

This 1905 political cartoon, by the well-known Harper’s cartoonist William Allen Rogers, embodied American fears that yellow fever threatened their canal-building effort. Credit: Harper’s Weekly, July 22, 1905. Reproduced with permission.

The Americans had reason to be afraid. Long the scourge of the Caribbean and a force that shaped its geopolitics, yellow fever had haunted the French campaign to build an isthmian canal two decades earlier.² While official yellow fever deaths during the French era were only a fraction of overall worker mortality, the disease played an out-sized role in undermining the French effort.³ Yellow fever was (and is) a gruesome disease, which was part of the power it held to evoke fear among Americans. Sufferers developed jaundice, endured high fevers, and, during its terminal phase, hemorrhaged internally and vomited up coagulated blood. This final stage gave yellow fever another of its vernacular names, vomito negro. Unlike malaria, the other so-called tropical fever that Americans contended with, yellow fever came with high mortality rates, and an outbreak could sow panic among the communities of workers and administrators on the isthmus.⁴ In fact, Rogers’s cartoon appeared just as a spike in yellow fever cases was doing just that. Yellow fever also disproportionately attacked outsiders to the tropics while the “natives” (a freighted term that Marixa Lasso explicates in her essay) largely escaped unscathed. One of the chief lessons the Americans took from the French era of canal building, then, was the need to control yellow fever.

They did so with remarkable effectiveness. The American sanitary campaign in Panama, led by William C. Gorgas, is often celebrated as one of the great achievements of the construction era. American sanitarians entered Panama with a crucial edge over their French predecessors: they were the beneficiaries of the Reed Commission’s work in Havana in 1900 that confirmed the Aedes aegypti mosquito (then known as Stegomyia fasciata) spread yellow fever. The Cuban physician Carlos Finlay had long suspected this, but he had been unable to prove it—at least to the satisfaction of Americans. US officials also had the model of the successful campaign by American and Cuban physicians and sanitarians, led by Gorgas, that rid Havana of yellow fever in 1901.⁵ American sanitarians thus entered Panama confident that they could remove this mountain looming before them. By 1906 they had done so; there was no more yellow fever in the Canal Zone, or within Panama City and Colón, and the sanitary infrastructure was in place to isolate the few cases that reappeared later in the construction era.

Rogers’s Harper’s cartoon was correct in its depiction of yellow fever as a major threat to the American canal enterprise, but it was misleading in its rendering of yellow fever as a natural feature of Panama. While Rogers followed a long tradition of seeing yellow fever as a particularly tropical scourge, the cartoon—like much American rhetoric—obscured the profoundly social dimensions of the disease. In Panama, yellow fever control involved managing urban environments and the disease ecologies that thrived within them—variants on what John McNeill has referred to as yellow fever’s “creole ecology.”⁶ More than that, yellow fever control was an exercise in getting a population largely immune to the disease to alter its habits so that a large nonimmune workforce could flood the Canal Zone and terminal cities without stoking an epidemic. Although Americans celebrated their achievement as a tropical conquest that was of universal human benefit, yellow fever control in Panama was a more limited and instrumental campaign.

THE NATURE OF YELLOW FEVER

To understand this, we first need a brief primer on yellow fever and the shape it took in Panama. The yellow fever virus and its vector both migrated to the Americas from West Africa, likely in the middle of the seventeenth century as a result of the slave trade.⁷ The habits of the vector are one important part of this story. A. aegypti requires clean water at the larval stage and breeds almost exclusively in artificial containers. Moreover, the females of the species prefer human blood meals, and they have a limited flight range, which means they are exclusively found in and around human habitations. A. aegypti is a house-haunting mosquito, an urban, anthropophilic, and cosmopolitan species. While it requires warm temperatures to breed continually—and thus thrives in the tropics, spreading into temperate regions only seasonally—it is a species of tropical cities, not of tropical nature per se. In fact, tropical port cities that lacked modern water and sewer infrastructures were ideal habitat.

Another important part of the story was the virus and its interaction with human bodies. While yellow fever mortality rates were high, those who survived a bout gained lifelong immunity, and those who contracted it as children almost always survived a mild and unrecognizable case. Thus in many tropical cities where yellow fever was a regular visitor, a large percentage of the permanent population (who temperate outsiders usually racialized as nonwhite) was quietly inoculated against the disease. Yellow fever became epidemic only when large numbers of nonimmunes (whites, mostly) entered densely populated port cities that had active yellow fever cases and vector mosquitoes in sufficient numbers to spread the virus.⁸ If yellow fever was a mountain to be removed in Panama, it was one largely uplifted by the tectonic forces of human migration, urbanization, and commerce.

THE AMERICAN CAMPAIGN

For most of the quarter millennium during which yellow fever ravaged the American tropics, medical officials and observers only vaguely understood these dynamics, and, as a result, they were helpless to combat the disease. For the Americans entering Panama in the early twentieth century, however, the vector discovery was a remarkable gift that made yellow fever control relatively easy. Isthmian Canal Commission officials, though initially slow to give Gorgas the resources he needed, changed course when cases developed in late 1904 and early 1905.⁹ As they had in Havana, American sanitarians took a number of steps to control yellow fever. First, they insisted that all active cases be reported and then quarantined in screened quarters. Sanitarians also aggressively fumigated houses where cases had developed, as well as surrounding residences, to eliminate any infective mosquitoes. Since A. aegypti did not travel far and often rested on the walls of the homes in which they had fed, and because they could not spread the virus until it had undergone an incubation period of more than a week, such targeted control was effective in reducing the number of infected mosquitoes produced by an active case. Finally, American sanitarians attacked the breeding sites of A. aegytpi in the terminal cities of Panama City and Colón, over which they shared sanitary authority with the new Republic of Panama, and in the towns and villages of the Canal Zone, over which they had sole authority. While the Reed Commission had confirmed the A. aegypti vector, they had not studied its habits in any depth. So Gorgas and his fellow sanitarians, with an assist from American entomologists, put together a portrait of A. aegypti’s breeding habits by learning to identify its larvae and then scouring urban areas for them. Indeed, the tropical science that Pamela Henson and Megan Raby discuss in their essays had roots in these mosquito control efforts.¹⁰

American sanitarians found the terminal cities to be infested with A. aegypti, and they quickly focused on the two basic causes of vector ubiquity: the ways in which urban Panamanians provisioned themselves with water and the absence of municipal trash collection. Panama’s cities were littered with tin cans and other containers that collected rainwater and supported A. aegypti larvae. This was particularly problematic in areas where grasses and other vegetation quickly grew up, obscuring the presence of these containers. Sanitarians thus worked to clean up such trash and to get Panamanians to alter their disposal habits. But it was the nature of the water infrastructure that was most troubling. Neither of the terminal cities had a public water supply, so urban Panamanians used a combination of techniques to acquire their drinking water. Many had gutters attached to their residences that harvested rainwater, which they stored in barrels or cisterns. During the rainy season, this system was sufficient. But during the four-month dry season, water peddlers delivered costly fresh water to urban residents, which, again, they would store in barrels or cisterns on site. Panamanians then used ceramic vessels known as tinajas to collect water from barrels or cisterns and store it within their homes. Sagging or clogged gutters that held water were ideal A. aegypti breeding sites, as were uncovered barrels and cisterns, and so sanitarians quickly dispatched their carpenters to fix these problems. They repaired gutters and screened barrels and cisterns to keep mosquitoes from ovipositing within them, and they installed spigots so that residents could get water from barrels and cisterns without removing their screened lids. Tinajas, however, were the most troublesome breeding sites, as most were found to be teeming with A. aegypti larvae. Sanitarians thus insisted that residents routinely empty and rinse their tinajas to remove larvae. All of these steps were a prelude to developing a modern water supply piped into neighborhoods and homes that would do away with this older system of water provisioning and the A. aegypti breeding it generously facilitated.¹¹ As with the workings of the completed canal described by Ashley Carse, water management was essential to urban sanitation.

PANAMANIAN RESISTANCE

Sanitarians experienced considerable frustration from urban Panamanians resisting their mosquito control efforts. Joseph LePrince and A. J. Orenstein, the chief and assistant chief sanitary inspectors in Panama, respectively, recognized the pattern of uncooperative behavior, and the essential reason for it, from their time in Cuba. Havana’s residents, they noted, “being mostly immune, took small interest in yellow fever eradication.”¹² The same was true in Panama, a result of the inoculating effects of the very water system that the Americans wanted to eliminate. Panamanians were often indifferent to the campaign to control A. aegypti breeding sites in their midst because the disease control that it promised would not affect them directly, and because the changes that Americans asked from them, though not without their benefits, were intrusive and sometimes expensive. Thus while the campaign against A. aegypti breeding achieved success fairly rapidly, resistance by urban Panamanians betrayed the extent to which yellow fever control was an effort to protect a nonimmune outside labor force, not the Panamanians themselves, or, for that matter, the large number of canal workers who came from other places in the urban tropics and brought acquired yellow fever immunity with them. Indeed, as William Gorgas repeatedly made clear, yellow fever control was primarily about protecting white Americans, keeping their wages at a reasonable level, and maintaining political support for the enterprise.¹³

As yellow fever cases increased during the first half of 1905, and as Isthmian Canal Commission officials became alarmed about the impact that an epidemic might have on the canal’s fortunes, Gorgas came under increasing pressure to rid the isthmus of the disease: to fumigate all of the residences of Panama City to kill off any infected mosquitoes that might be hiding there; to inspect and police the city to make sure that all yellow fever cases were being reported and quarantined and that A. aegypti were not breeding in gutters, cisterns, and tinajas; and, despite Gorgas’s insistence that filth had nothing to do with yellow fever, to clean up the city so that it appeared to outsiders that US sanitary dollars had been well spent. This, in turn, increased the pressure on urban Panamanians to comply with sanitary ordinances and revealed the tenuous nature of their cooperation.

Panamanian resistance took several forms. One set of problems emerged as a result of the American insistence that sanitary inspectors empty and rinse all vessels found to contain A. aegypti larvae. American sanitarians did not initially appreciate the relative scarcity of clean drinking water in the terminal cities and the need among Panamanians to conserve those supplies, particularly during the dry season. Many residents of Panama City used dippers to retrieve water from their tinajas, and since the dippers would cease to work once the water levels dropped below a certain point, Panamanians tended to refill their tinajas before they were entirely empty. From a mosquito-breeding standpoint, this was a bad habit, since larvae often hid among the dregs of these vessels. But to immune Panamanians stewarding a scarce water supply, it made perfect sense. As a result, Panamanians became annoyed when sanitary inspectors summarily dumped out perfectly good water in the name of larvicide. Not surprisingly, American sanitary inspectors constantly complained that residents of the terminal cities hid their tinajas during inspections and were otherwise uncooperative. As Joseph LePrince noted of yellow fever control efforts in Panama, “We do not expect support from the house tenants and must achieve success in spite of their tendency to allow mosquitoes to breed near their premises.”¹⁴

Fumigation was also a contentious process. Targeted fumigation had been occurring since the Americans had arrived on the isthmus, but beginning on July 7, 1905, just two weeks before Rogers’s cartoon appeared, the Department of Health began a comprehensive six-week fumigation campaign, encouraged by Canal Zone governor Charles Magoon, throughout Panama City. Most Panamanians got only a few days’ notice that their houses were to be fumigated, and they had to leave for several hours or more while sanitary crews sealed and filled their homes with acrid smoke. Americans burned either pyrethrum or sulphur powder to kill adult mosquitoes, and in cases where sulphur was used—usually in poorly built dwellings that were difficult to seal—its smoke stained residents’ belongings. There were also isolated but high-profile cases in which fumigation scorched the floors of residences or even set them ablaze. Not surprisingly, some residents pretended to be sick or otherwise refused to allow their premises to be fumigated, delaying the work. Many others complained to American officials after the fact, claiming property damage.¹⁵

Americans shared sanitary authority over the terminal cities of Panama City and Colón with the Republic of Panama, which led to some annoyance. Frustrations sprang at times from Panama’s inability or unwillingness to enforce sanitary regulations, and at others from that nation’s resistance to measures that American officials thought essential. For instance, American inspectors constantly identified homes that, despite repeated warnings, were still breeding mosquitoes, but Panamanian officials rarely levied fines against their own citizens.¹⁶ Then, in 1906, as Americans made strides to provide urban Panamanians with a public water supply, Gorgas sought a new ordinance that required “the filling of wells and cisterns and the destruction of tanks and other water receptacles in the cities of Panama and Colón, and for the removal of gutters from all the buildings in those cities.” Panamanian representatives pushed back, citing citizen concerns about the destruction of an infrastructure that represented a significant investment. Most importantly, they rejected the requirement that gutters be removed. In a letter to Gorgas, Charles Magoon noted that the “officials and people of Panama are apprehensive that the removal of the tin gutters will permit the rain from the roofs to beat against the walls of the houses, and into their rooms, injuring property and increasing the perils of pneumonia.” If the medical records of the Isthmian Canal Commission are any indication, such concerns were legitimate, for pneumonia was the leading killer every year during the construction era, though Americans were slow to contend with pneumonia because they did not see it as tropical. “They are naturally averse to incurring this damage and hazard,” Magoon tellingly concluded of the residents’ resistance to gutter removal, “for the sole purpose of increasing the preventative remedies against yellow fever, a disease to which they consider themselves immune.” The Americans had to compromise, insisting that gutters be properly maintained so as not to collect and hold standing water.¹⁷

CONCLUSION

The acts of resistance that urban Panamanians offered against yellow fever control were modest, but such behavior nonetheless brings into relief the true nature of the American public health enterprise in Panama. The control of yellow fever was certainly a triumph of public health and modern environmental management. Within just a few years, American sanitarians eliminated arguably the most important threat to the successful completion and subsequent operation of the Panama Canal. Indeed, the control of yellow fever and other so-called tropical diseases contributed both to the opening of Panama and the American tropics to tourism, as Blake Scott explains, as well as to the growing scientific reconceptualization of Panama and the tropics as ecologically beneficent, as Pamela Henson, Megan Raby, and Christine Keiner demonstrate elsewhere in this Forum. But yellow fever control was not simply the conquest of a natural or tropical obstacle that stood in the way of universal human progress, as the Rogers cartoon suggested. Rather, Americans achieved yellow fever control by reengineering urban Panama, and by intrusively policing the habits of urban residents, to achieve public health benefits of little immediate import to urban Panamanians. Narratives that have seen successful yellow fever control as a conquest of Panama’s tropical nature obscure both the disease’s unique urban ecology and the extent to which such control was about protecting white outsiders and their massive engineering enterprise.