Panama fever (66 page)

Williams was put on a train to Ancón hospital, where, fearing malaria, he was given two-hourly doses of quinine and an ice bed bath. He had never been in the hospital before, and it was a “fretting” and alarming experience. The next day, parched with thirst, he drank a bowl of water left out near his bed. This turned out to be poison to kill flies and mosquitoes and brought on severe vomiting in young Williams. That night his blood was tested and he was shortly afterward moved to the typhoid fever ward, where he made a slow but steady recovery. He remembered the staff who cared for him with great affection: “I can truthfully say those American nurses—my own dear mother could not be more kind and tender to me.” After a couple of weeks, Williams was eating again and being given “eggnog twice a day also real American Whiskey every day.”

But other accounts tell, as in the bad old French days, of men released from the hospital before fully well or able to return to work— and thus qualify for further free hospital care. Other men were sacked when they started to look ill. Saint Lucian Charles Thomas worked at the iron foundry at La Boca: “I was fired after two days,” he said. “I remember the foreman call to me & said to me you are fired, you are looking tired. I was not exactly tired but I was feeling quite sick & just trying to make a week so I could get a commissary book for $2.50 to get something to eat and drink.” As the West Indians, unlike the white Americans, had no paid sick leave, some, unwilling or unable to forfeit their wages, would work on to the point of dropping. One account, redolent of the worst horror stories of the railroad or French era, explains how men suffering the dysentery which often hit those weakened by malaria would sometimes just disappear, never to make it to the hospital (or onto the official casualty figures). Said Barbadian Clifford Hunt: “Men in my gang, tell the Boss I am going out to ease my bowels and they die in the bush and nobody look for you.”

Pneumonia may have been the biggest single killer in 1906, but malaria, it was judged, offered the greatest threat to the success and efficiency of the project. Pneumonia was almost unknown among the white workforce, and dead black workers were easily replaced, such was the glut of labor in the islands. Malaria, on the other hand, also affected the whites, and, because rarely fatal, usually resulted in expensive hospital treatment for the black worker. Virtually nothing would be done to counter pneumonia, while the campaign against malaria was on an undreamt-of scale, far surpassing even that against yellow fever.

he question of controlling malaria appeared at first sight to be utterly hopeless,” wrote Joseph Le Prince. Part of the reason that malaria was a greater challenge than yellow fever was in the different nature of the two diseases. Those unlucky enough to contract yellow fever either survived and were free of the virus and immune forever or were dead. Either way, they were no longer a source for the infection. If someone caught malaria, on the other hand, they were far more likely to live, but the disease seldom went away for good. Usually the patient would remain both a recurrent sufferer and, for about three years, an ongoing source for the continued propagation of the bacterial parasite. Gorgas's very earliest tests in 1904 had shown that some 70 percent of Panamanians carried the infection in some form. So the approach of keeping the mosquito away from the disease, successfully followed in the yellow fever campaign, was a nonstarter.

The only point of attack had to be the
Anopheles
mosquito itself. To an extent, the species was the same everywhere, and as such, it was accepted, was going to be a much more formidable enemy than its yellow fever–carrying cousin, the fastidious, house-dwelling
Aëdes aegypti.
The
Anopheles
was, in contrast, omnipresent in the deepest bush as well as the backyard. For Gorgas eradicating the
A¨des aegypti
was “making war on the family cat,” while a campaign against the malaria-carrying
Anopheles
was “like fighting all the beasts of the jungle.”

July 1904 had seen Joseph Le Prince, one day off the boat from New York, poking about in hoofprints below Ancón Hill looking for
Anopheles
larvae, and thereafter, although the yellow fever mosquito enemy had first priority, investigations continued into the “Isthmian
Anopheles
.” The researchers started by determining the local species most responsible for malaria transmission. Thousands of mosquitoes were captured and analyzed, and their behavior studied. Tests included getting human volunteers to sit in a mosquito-filled net. As Le Prince explained, “Very patient negroes were necessary… Conditions soon became unbearable even to those persons who were accustomed to be bitten frequently.”

By the end of the first year, it had been established that the insect most responsible for malaria on the Isthmus was the “white-footed”
Anopheles albimanus.
Unfortunately this was not only the most abundant, but also the species most determined to enter inhabited buildings. One of its tricks was to cling to dark clothing and thus gain entry to houses even if they were screened.

Thousands of eggs were collected, hatched, and observed at every stage. Adult specimens were dyed using an atomizer so that tests could be conducted on their flying distances and habits. When it was established that the mosquito could not fly far without alighting on some sort of vegetation, work started on clearing 200-yard-wide areas around where people lived and worked. Tests showed that
Anopheles
preferred to rest on a dark surface on the leeward side of buildings, so black bands 2 feet wide were painted on sheltered walls at a convenient height for mosquito catchers to collect them. When it was noticed that certain species of spiders and lizards started congregating there to feed, these were bred in great numbers and released to wage war on the enemy.

Analysis of the larval stage showed that, disappointingly, it was far hardier than that of
Aêdes aegypti
, able to survive in water only a fraction of an inch deep, or even in mud once the puddle had dried. It had no particular preference for clean or dirty water and would still be alive after up to two hours under a film of oil. Nevertheless, the larval stage was still the mosquito's most vulnerable time, so the challenge was to deal with the breeding grounds.

It was a massive, almost hopeless, task. During the wet season, when at Culebra, for example, it averaged twenty-four rainy days a month, there was simply water everywhere. But even during the short dry season, there were swamps, springs, or seepage outcrops near every settlement in the Zone. Fast-growing vegetation clogged streams, protecting the larva from its natural predators and providing still pools for egg laying. The ongoing engineering work made it difficult, too. Badly placed spoil dumps blocked natural drainage, and excavations constantly filled with water. Every time a railroad tie was moved, it left an indent in the ground that could collect water and therefore mosquito larvae.

Thus Gorgas was never going to defeat malaria in the way he had yellow fever. But he believed he could control it by reducing the
Anopheles
population of the Zone. Swamps were drained using hundreds of miles of ditches, or filled with spoil from the works. Elsewhere, further natural predators were encouraged or introduced, including a top-feeding minnow from Barbados. According to Le Prince, “larvae of dragon flies and water beetles were of great value.” But above all, vast quantities of poison and oil were deployed across the Isthmus. A special plant was built at Ancón to manufacture a larvicide consisting of carbolic acid, resin, and caustic soda. Some two hundred barrels were applied monthly around the edges of pools and streams. Vegetation that clogged up running water was cleared by burning or with phenol or copper sulphate. To smother the “wrigglers,” crude oil, mixed with kerosene to increase its spreading qualities, was sprayed everywhere. At its peak in early 1907, the campaign was getting through sixty-five thousand gallons of crude in a month. Unsurprisingly, visitors to the Isthmus started commenting on the pervasive smell of petroleum.

esults would come, but for the men in the field, particularly those near the jungle, work at the end of 1906 meant swarms of mosquitoes. Some took to rubbing exposed parts of their bodies with a mixture of kerosene and coconut oil, but they still got bitten and they still got malaria. The only treatment was quinine, either in a pill—”the size of a quarter and twice as thick”—or as a sickeningly bitter liquid. Mallet reckoned that quinine was “the cause of many break downs in the constitution, it ruins the stomach and digestive organs.” John Prescod, who arrived from Barbados in June 1906, described another nasty side effect: “Malaria fever have me so bad I has to drink plenty of quine tonic tell I heard singing in my ears murder murder going to quits drinking quine was getting me deaf.”

“The prevailing illness is malaria,” wrote Mary Chatfield in a letter home dated June 30, 1906. “Many and many are the corpses I see carried past the office … the majority of the victims of malaria are the negro laborers.” “I went to the Cristóbal dispensary this morning to get some tonic,” she wrote a month later. “It was a pitiful sight to see the sick coloured laborers. Many of them were so weak they could not sit up while their medicine was being prepared, but lay on the benches and the floor.”

Albert Peters, who reached the Isthmus in August that year, “eager for some adventure and experience,” caught malaria within a week. He survived, but there was a daily reminder of those who did not. “Every evening around 4:30,” he wrote, “one could see No. 5 engine with a box car and the rough brown coffins stacked one upon the other bound for Mt. Hope [cemetery] which was called Monkey Hill in those days. The death rate was high … If you had a friend that you always see and missed him for a week or two, don't wonder, he's either in the hospital or at Monkey Hill resting in peace.”

“That's the reason we all used to go to Church more regular than today,” said Barbadian Amos Parks, “because in those days, you see today and tomorrow you are a dead man. You had to pray everyday for God to carry you safe, and bring you back.”

Rose van Hardeveld had from the outset found “the horrible and unfamiliar noise at night” in Panama more nerve-racking than any other “trials and tribulations.” As well as the strange, unearthly sounds made by alligators, bats, night birds, or insects, “the very worst of all was the wailing for the dead that came from the labor camp below us.” “When one of their number died,” she continued, “the friends and kindred of the deceased would gather in the room where the corpse lay. All night long they would drink rum and wail and sing Old English Gospel hymns in the flattest, most unmusical way imaginable … These tones would sway and swing in the air like the dance of witches.” It would leave her sleepless and “utterly unnerved and filled with a vague, mounting dread.”