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An American Colonialism:

The Colonial Application of Eradication Programs from Cuba and in 1905 New Orleans

By Daniel J. Muller

Thesis Submitted in Partial Fulfillment of the Requirements for the Degree of Bachelor of Arts In the Department of History at Brown University

Advisor: Professor Daniel Rodriguez

April 7, 2017

Table of Contents

Introduction 1

Chapter 1 - and Eradication 11 in Cuba: The Intersection of Race, Medicine, Government, and Empire

Chapter 2 - Turning the White Man’s Grave into 36 the White Man’s Paradise: Racism, Colonialism, and the American Canal Project in Panama

Chapter 3 - The Menace at Home: Yellow Fever and 64 the Incorporation of Colonial Efforts in 1905 New Orleans

Conclusion 97

Bibliography 106

Table of Illustrations

Figure One - Graph of Yellow Fever Rates in Panama 40

Figure Two - Application of Larvacide and Controlled 48 Grass Burning Techniques

Figure Three - A White Man on Horseback Directs 49 Non-White Laborers

Figure Four - Dr. Gorgas and Other Officials 50 Conduct Inspections While Laborers Work in Background

Figure Five - A Postcard Depicting Judge Owen’s 52 Home in Ancon

Figure Six - Gold Workers’ Living Quarters in 53 the Zone

Figure Seven - Graph of American Expenditures 55

Figure Eight - Map Showing Colonial Powers in 97 1910

Acknowledgements

This project, which began over a year ago, would have been impossible if I didn’t have the support of those around me. First and foremost, I would like to thank Professor Daniel Rodriguez for his infinite wisdom and guidance. You pushed us to do our best at every point, and kept us on a schedule from the beginning of the fall semester. Your kindness, guidance, advice, and motivational speeches did not go unnoticed, and you made this process so much easier. I would also like to thank Professors Harold Cook and Michael Vorenberg, who met with me at the beginning of this process and pointed me in Professor Rodriguez’s way. One of the hardest components of writing a thesis is narrowing down the topic far enough, so I would like to extend a heartfelt thank you to Professor Ethan Pollock, for wrangling all of our beginning thoughts into final, cohesive projects. I am indebted to David Lazris, Vi Mai, Camille Garnsey, Nora Ellman, and Madeline Chin, for keeping me sane this year, convincing me everything was going to be okay, and sharing some truly wonderful memories I won’t soon forget in the Pavillion Room. There are many people who helped make this project possible, but I would specifically like to thank the Williams family - Michael, Susan, Drew, Risa, Albert, Frank, and Leo - for letting me stay in your home for two weeks this year as I conducted research at the Library of Congress. I owe all of you a deep gratitude. Thank you to the incredibly helpful staffs at the Library of Congress, the National Library of Medicine, and Harvard Widener Library, who pointed me in the right direction and were always friendly and helpful. Last but not least I would like to thank my friends and family for their incredible support on this academic journey. Thank you Ben, for all your help and moral support, thank you Sarah for always telling me to look on the bright side, and thank you to all the people who have bits and pieces of my thesis at one point or another. Mom, Dad, Julia, and Benjamin - I would never have known how to achieve this level of deep inquiry if it weren’t for the values I learned growing up. You all make me smile every day, and your phone calls of support and constant love. Writing a thesis has truly been one of the most challenging yet most rewarding experiences of my life. If I could choose to do it all over again, I might wait a month or two first, but count me in.

Introduction

Residents of the Fourth Ward filed quickly into Rocheblave Market. It was August 17th,

1905, a hot summer night in New Orleans, and the presence of the crowd served as a testament to the fame of the special guest scheduled to speak that night. The people eagerly anticipated the speech of the renowned Cuban physician Dr. Juan Guiteras, one of the men responsible for the anti-mosquito work and yellow fever eradication efforts in . Dr. Beverley Warner, normally the expert welcomed by each ward into its meetings, kicked off the evening, describing the work each ward had been doing to eliminate yellow fever, before finally introducing the guest lecturer. Guiteras spoke in front of a New Orleans crowd for the first time that evening, telling of the work proving that the mosquito was the vector for yellow fever and what measures had been taken to halt the spread of the disease in his native country. Though this was his first speech, it was not his last; by the time Guiteras left New Orleans at the beginning of September, he had shared a similar message with numerous wards and communities.1 As one of the architects behind the Cuban anti-mosquito campaign, Guiteras played an important role in ridding the island of yellow fever. Now, a few years later and in New Orleans, he was hoping to help them accomplish the same feat.

Guiteras arrived in New Orleans knowing that he could provide assistance, for Havana had experienced its own problem with yellow fever. After hundreds of years of nonimmune populations dying horrific and prolonged deaths, Havana was almost disease-free thanks to a successful anti-yellow fever campaign that began in 1899 and continued through the first few years of the twentieth century. Now New Orleans had its own epidemic, and Guiteras could be of

1 “General Fumigation Programme for Sunday,” New Orleans Daily Picayune, August 18, 1905, 7. 2 Mariola Espinosa. Epidemic Invasions: Yellow Fever and the Limits of Cuban Independence, 1878-1930 (Chicago: University of Chicago Press, 2009), 5. 3 Joseph A. LePrince and A.J. Orenstein. Mosquito Control in Panama: The Eradication of Malaria and Yellow

1 service. He had lived through the American colonial government in Cuba, and now he was full of knowledge about the implementation of their health programs.

Guiteras’ presence represented the willingness of American officials to incorporate his knowledge and expertise into the anti-mosquito campaign in New Orleans. However, the

American project in Havana of which Guiteras had been a part was not an ordinary health project; rather, it was meant to serve the interests of the Americans, the colonizers, over the interests of the Cubans, the colonized.2 The American coastline and southern population was threatened by the presence of yellow fever in Havana, while many Cubans did not feel threatened by a disease to which they had gained immunity through exposure as children.3 Upon American arrival in Havana, the U.S. began working on the disease that mattered most to American health, rather than on diseases such as tuberculosis that regularly affected the Cuban population.4 By valuing American healthcare interests over Cuban healthcare interests, and instituting policies that benefitted American lives over Cuban lives, the U.S. indicated that the American bodies had more worth than the Cuban bodies. Yet the relationship between the two countries was more colonial than imperial; American authorities were more interested in preserving power, not controlling all facets of life. The Americans needed the Cubans to help defeat the disease, and many Cubans actively worked with the American authorities. Cuban physicians were actively involved in the yellow fever work, while most of the laborers working with the Sanitary

Department both on the ground and as supervisors were Cuban as well.5

2 Mariola Espinosa. Epidemic Invasions: Yellow Fever and the Limits of Cuban Independence, 1878-1930 (Chicago: University of Chicago Press, 2009), 5. 3 Joseph A. LePrince and A.J. Orenstein. Mosquito Control in Panama: The Eradication of Malaria and Yellow Fever in Cuba and Panama (New York: The Knickerbocker Press, 1916),70. 4 Gorgas, William C. Gorgas to Baker. Letter. From Library of Congress: William C. Gorgas Papers. Accessed January 9, 2017, 4. 5 Espinosa, Epidemic Invasions, 99.

2 Cuba was not the only site of American intervention at the beginning of the twentieth century. The U.S. began working on a canal in Panama in 1904, the year before the New Orleans outbreak, with the goal of constructing the first canal connecting the Atlantic and Pacific oceans.

In the Canal Zone, the Americans made no false pretense about its goals; in order to construct the canal, the U.S. needed to eliminate the yellow fever and malaria threats that were deadly for its workers. Dr. William Crawford Gorgas, the Chief Sanitary Officer in Panama, had just served in the same role in Havana and was intent on minimizing the loss of American life in Panama.

Here, the colonial project was focused on the differences between the Americans and the colonized populations, with foreign and native people of color utilized for the sole purpose of working under the white American occupying force to rid the isthmus of yellow fever and malaria.6 The colonial and racial nature of the project manifested itself in other ways, from the superior living conditions of the white Americans to labor conditions to the quality of care received from the hospitals in the Canal Zone. However, just as in Cuba, the bodies of the white

Americans were deemed more important than the bodies of the colonized population.

The mosquito campaign in New Orleans, therefore, was the first anti-mosquito campaign in the U.S. following the start of either of these campaigns. Yet, New Orleans was not just an

American city, argues Natalie Ring, for like the rest of the South, it suffered from “climatic handicaps.”7 She frames New Orleans and the rest of the South as part of the tropical “South,” meaning it was radically different from the rest of the .8 The word tropical carries with it a negative connotation, implying a danger reflective of unhealthy lifestyles. The tropics were poor, primitive, and unhealthy, according to literature at the time, and lumping New

6 Isthmian Canal Commission. Report of the Isthmian Canal Commission. Washington DC: Government Printing Office, 1904. P. 114. 7 Natalie J. Ring, “Mapping Regional and Imperial Geographies,” Colonial Crucible: Empire in the Making of the Modern American State (2009): 297. 8 Ring, “Imperial Geographies,” 297.

3 Orleans in as a tropical region alongside Cuba and Panama signified the need for similar colonial solutions as had been practiced in these foreign lands.9 New Orleans, for all intents and purposes, took on an identity that made it exotic and alien.10 In this context, it is impossible to examine the

New Orleans yellow fever campaign without contextualizing it in the larger framework of

American colonial mosquito eradication projects.

The similarities between these regions demonstrate why Guiteras was able to provide knowledge to the city of New Orleans in the midst of its epidemic. Since information about the

Cuban and Panamanian campaigns was readily available through newspapers and pamphlets in

New Orleans, city and state health officials could look to these models for how to successfully manage the disease back in the southern U.S. “An American Colonialism” will seek to examine the relationship between these three colonial projects, specifically looking at the application of colonial healthcare measures back in the U.S. A few fundamental questions arise that help guide the progression of my argument: first, how were the projects in Cuba and Panama colonial, and in what ways did they reflect the notion that the Americans valued their own lives over the lives of the colonized population? This first question, which establishes the background of my argument, will shed light on the practices of the Sanitary Departments abroad and the actions of

American officials in Panama and Cuba. Second, upon turning to the work in New Orleans, what did the incorporation of the anti-mosquito and health measures from these colonial projects indicate about the nature of the campaign in New Orleans? By comparing the similarities between the campaigns at home and abroad, I can more clearly classify the work in New Orleans and more critically examine the background and complexity of this third campaign. Finally, to push that question deeper, in what ways did the colonial nature of the Cuban and Panamanian

9 Ring, “Imperial Geographies,” 300. 10 Ibid., 301.

4 campaigns manifest themselves in the New Orleans campaign? This question involves looking closely at the measures and policies implemented in New Orleans, and how they impacted different populations within the city itself. Through my research, I consider the relationship between the colonial projects abroad and the public health campaign in New Orleans, analyzing the colonial components of the anti-mosquito work in 1905 New Orleans and shedding light on its relationship with the previous anti-mosquito campaigns in Panama and Cuba.

Historiographical Context

The colonial nature of the public health projects in Cuba and Panama have both been examined in recent secondary literature, which looks at how colonialism played a role in the development and implementation of anti-mosquito and public health policies. Olive Senior’s

Dying to Better Themselves discusses the ramifications of the American campaign in Panama on the laborers and the subjugation of the colonized population. Similarly, Jo Ann Carrigan’s The

Saffron Scourge provides a particularly detailed account of the work done in New Orleans to defeat the mosquito and how different factions of the population responded. Neither of these sources, however, examines the anti-mosquito project within a larger colonial setting.

Mariola Espinosa, in Epidemic Invasions, dives in much further than either of the aforementioned authors. She focuses specifically on the American involvement in Cuba and the implications for American settlers there. Her book is one of the first to provide extensive background on yellow fever in Cuba, the history of Cuba, how the U.S. intervened and executed public health projects, and how the U.S. was able to protect its own economic interests. The book further discusses the role that the idea of American superiority had to play in colonial relations, and helps build the argument of U.S. involvement in eliminating the disease for its own self-

5 interests and the interests of the nonimmune population on the island.11 As Espinosa claims in another one of her articles, “protecting troops and administrators from disease… was paramount to the maintenance of colonial rule.”12 Espinosa engages with the notion of colonialism, noting that American domination over Cuba relied on the control of the public health operation on the island.13

Espinosa and her fellow historians, however, do not look at how the Latin American health projects and the health projects in the southern U.S. are related. “An American

Colonialism,” using information drawn from sources describing the projects in each individual campaign, contextualizes the yellow fever campaign in New Orleans within the other two campaigns using frameworks established by current historians. Natalie Ring, in her essay

“Mapping Regional and Imperial Geographies,” first starts examining the South as a tropical region; with my focus on New Orleans, I further her argument of the South becoming interconnected with a region of the world not typically referred to as “American” in nature.14

American health officials at the time produced a wealth of documents that reveal

American motivations and further my argument that in these colonial settings, the U.S. valued white American bodies more than the bodies of the colonized population. L.O. Howard, the director of the Bureau of Entomology from 1894 to 1927, discussed the prospects for white people in the tropics in his preface to Mosquito Control in Panama, in which he praised Gorgas and stated that his work “has been an object-lesson for the sanitarians of the world and has demonstrated the vitally important fact that it is possible for the white race to live healthfully in

11 Mariola Espinosa, “A Fever for Empire,” Colonial Crucible: Empire in the Making of the Modern American State (2009): 290. 12 Espinosa, “A Fever for Empire,” 290. 13 Espinosa, Epidemic Invasions, 7. 14 Ring, “Imperial Geographies,” 308.

6 the tropics.”15 Howard’s views were by no means revolutionary; rather, they also reflected the opinions of Gorgas, who was in charge of the projects in Cuba and Panama.16 While the documents of Gorgas and his contemporaries have been dissected, they have not been used as part of a larger analysis tying colonial health practices to the southern U.S. My research, therefore, pulls together sources that have previously been studied and views them through a new framework, examining the interconnectedness and transnational nature of the projects in Cuba,

Panama, and New Orleans.

Paul Sutter is one historian who, in “Nature’s Agents or Agents of Empire?,” begins to explore Gorgas’ and Howard’s texts and how these projects abroad were indicative of colonialism: “under Howard’s leadership, American entomologists were no strangers to serving as careful ecological observers of and problem solvers within a colonizing mission. Indeed, they were well prepared to bring their ecological approach to another round of American expansion.”17 Like Espinosa, Sutter does not explore the ramifications of Gorgas’ and Howard’s work in other colonial settings, while historian Warwick Anderson takes his research on the

Philippines and focuses on the integration of state intervention methods from the Philippines into

American urban centers.18 Anderson’s research captures the influence of racialized Filipino projects back in the U.S., yet it does not look at the influence of Gorgas’ projects in Cuba and

Panama back in the U.S. South. Anderson says that we must “reexamine public health at various sites in the United States in order to make empire visible again at the level of bodies, behavior,

15 LePrince and Orenstein, Mosquito Control, IV. 16 William C. Gorgas Sanitation in Panama (New York: D. Appleton and Company, 1915), 63. 17Paul S. Sutter, “Nature’s Agents or Agents of Empire?,” Isis 98 (2007): 736. 18 Warwick Anderson, “Pacific Crossings,” Colonial Crucible: Empire in the Making of the Modern American State (2009): 277.

7 and everyday life,” yet this colonial lens has not yet been applied for the 1905 yellow fever outbreak in New Orleans.19

Area of Study

“An American Colonialism” revolves around the incorporation of the Cuban and

Panamanian anti-mosquito campaigns into the campaign against yellow fever and the mosquito in New Orleans. Therefore, in order to contextualize the work occurring in New Orleans, I will first focus on the health projects in Cuba and Panama and their importance both as individual projects and as parts of a larger interconnected web with the other two case studies. Cuba and the

U.S. were trading partners located 90 miles apart, meaning a mosquito could travel from Cuba to the southern United States aboard a ship and the disease was very close to American shores.

While Cuba did have economic value to the United States, its proximity also meant that the climate was very similar to that of the southern U.S. and experiments abroad had direct repercussions on American day-to-day life. Panama, though largely an economic project due to the canal, still played a relevant role in American public health efforts; “the expertise created in

Panama helped sanitize military bases in the American South and contributed to the later formation of the U.S. Centers for Disease Control.”20 The work in Panama, though not as close physically, had profound effects on all future American public health campaigns.

The U.S. invested itself in both foreign campaigns to protect its own coastline and economic interests, yet I will focus on tying the health projects together in discussing New

Orleans. As part of a larger colonial project, studying New Orleans is a natural convergence for

19 Anderson, “Disease,” 287. 20 Alfred W. McCoy, Francisco A. Scarano and Courtney Johnson, “On the Tropic of Cancer: Transitions and Transformations in the U.S. Imperial State,” Colonial Crucible: Empire in the Making of the Modern American State (2009): 17.

8 the two foreign campaigns, as it was the first outbreak in the U.S. following the completion of the Cuban campaign and following the beginning stages of the Canal Zone project. In fact, Dr.

James Carroll, of the , discussed how following the protocol established through the work in Cuba could directly inform treatment methods in New Orleans, especially considering the very similar climates.21 My work will fill in an important gap in the current literature, which has largely ignored the incorporation of colonialist health measures into New

Orleans and the relationship tying together this campaign with U.S. campaigns in Cuba and

Panama.

A significant amount of primary literature comes from the personal papers of William

Gorgas, the architect of the health projects in Cuba and Panama, and helps paint the picture of the development and implementation of anti-mosquito work abroad. However, few sources explore the implications of this work, and how the measures devised by the United States served to not only favor the white and American population abroad, but also reflect how the U.S. instituted different brands of colonialism in Cuba and Panama. Gorgas himself wrote about the results of various projects and their implications, and while there may be some racialized language, inherent racial and colonial prejudices manifest themselves in the descriptions of certain projects and certain techniques for mosquito control. I will also examine the application of these projects to see how the Sanitary Department concentrated its efforts on projects that benefited only the colonizing population. Most of this information comes from documents and letters written by the government officials involved, while some material comes from books and secondary literature written at the time of these projects’ completion.

21 James Carroll et al., Yellow fever: a compilation of various publications. Results of the work of Maj. , Medical Corps, United States Army, and the Yellow Fever Commission (Washington: Government Printing Office, 1911), 219.

9 The primary source for the New Orleans portion, on the other hand, is the Daily

Picayune, the local New Orleans newspaper. The Picayune was a daily paper that published articles throughout the duration of the yellow fever epidemic in 1905, meaning it kept an extraordinary record of all the actions taken to combat both the disease and mosquitoes. The record will also enable me to draw parallels to the work in Cuba and Panama and examine how the New Orleans campaign incorporated elements of the colonial projects abroad. The newspaper, however, was a voice for the majority and did not give a voice to the minority populations disproportionately affected by yellow fever.

“An American Colonialism” analyzes how the United States created a colonial notion of medicine through its public health efforts abroad, and how the lessons learned abroad became part of a colonial public health project in New Orleans. Surprisingly, with the abundance of literature that exists, the only focus of research has been on the connection between work on colonial medicine in the Philippines and in the U.S., while little if any secondary literature written tying together the work in Cuba and Panama and the American South exists. In studying race and colonialism as important parts of the public health efforts, I examine the transnational nature of the anti-mosquito efforts, and the impact that this medicine had on different factions of the population. My work will fit naturally into what these other scholars have already started, but in scrutinizing the transnational nature of medicine, racism, and colonialism, I will be examining a branch of public health that has not yet been studied and exploring how these campaigns reflected the American position that the lives of white Americans were viewed as more important than the bodies of a colonized population.

10 Chapter 1 - Yellow Fever and Malaria Eradication in Cuba: The Intersection of Race, Medicine, Government, and Empire

William Crawford Gorgas, in 1900 Havana, rushed to Las Animas Hospital in the early hours of morning after hearing that his patient was in critical condition. He joined his fellow physicians, dressing in medical clothes and hoping the news was not as dire as it had seemed.

The patient lay in desperate condition, free from the mesh netting in which she had been caught and now attended to by a number of nurses and leading health practitioners of Havana.

Unfortunately for “Her Ladyship,” raising the temperature in the room by lighting the stove was to no avail, and she died on her soft bed of cotton in the early daylight hours. The death was a sad occasion, for the scientists using her for experimentation were without their most trustworthy patient. Of course, this was not a human being; the crowd had gathered for the death of the last female Stegomyia (also known as or Culex fasciatus) known to be carrying yellow fever. As Gorgas wrote describing her death, “she finally ceased to kick, about nine o’clock in the morning, and died with a larger attendance of doctors and nurses around her table than had ever been present around the deathbed of any mere human in the City of Havana.”22

Mosquitoes such as Her Ladyship had not previously held a reverence in the eyes of the medical community, as their role in the propagation of yellow fever was unknown. The disease had wreaked havoc on foreign occupying powers in Cuba for many years prior to the American occupation. Cuba became a Spanish colony following the arrival of Christopher Columbus on the

North American continent, and after a brief period of British occupation between 1762 and 1763 during which the British Lord Albermarle saw his forces drastically reduced due to yellow fever,

22 Marie D. Gorgas and Burton J. Hendrick, William Crawford Gorgas: His Life and Work (New York: Doubleday, Page and Company, 1924), 116.

11 fell back into Spanish hands.23 During the brief British rule, the Cuban population experienced life without the burden of Spanish taxes, and realized that life may be better off without Spanish rule.24 Time and again, the Cubans revolted, with a notable resistance movement between 1868 and 1878.25 Following a series of smaller resistance movements, a large coordinated revolt by

Cuban citizens took place beginning in 1895. The Spanish sent its military to quash the rebellion, enlisting 190,000 men in the largest overseas colonial war the world had ever seen.26 By 1898, there were 114,000 Spanish troops left in Cuba, of whom only 50,000 were healthy.27 For every

Spanish soldier that died of illness, four were so ill with mosquito-borne illness that they were unable to fight.28 At the time, Spanish doctors believed that yellow fever was spread through fomites, or infectious discharges from the body such as blood and other fluids, and that the only precautionary measures against the disease were burning and disposing of any possibly contaminated materials.29 While deadly, yellow fever was a disease that only struck an individual once, meaning a single exposure to yellow fever guaranteed a lifetime of immunity. The voracity of yellow fever shocked the Spanish forces.

Spanish physicians did not yet know that mosquitoes caused yellow fever. Santiago

Ramón y Cajal, a Spanish physician, recalled the alarming swarms of mosquitoes around living quarters.30 Troops regularly suffered from the disease brought by the mosquitoes, yet the doctors could do very little - as long as the Spanish were in Cuba, they would suffer from yellow fever.

Without adequate treatment or prevention available, the Spanish troops suffered and died at

23 John L. Tone, War and Genocide in Cuba 1895-1898 (Chapel Hill: The University of North Carolina Press, 2006), 15. 24 Tone, War and Genocide, 15. 25 Ibid., 2. 26 Ibid., 9. 27 Ibid., 98. 28 Ibid., 10. 29 Ibid., 99. 30 Ibid., 98.

12 alarming rates. When the U.S. assumed power in Cuba, its forces were also met with yellow fever. To combat the disease, the U.S. established a Sanitary Department, under the purview of

William Crawford Gorgas, aimed at minimizing their own casualties. The Sanitary Department realized that the presence of nonimmunes enabled the spread of yellow fever, and that the largely nonimmune American forces on the island were thus particularly susceptible.31 In order to temper the rates of yellow fever, believed to be a disease of filth, the Americans initiated a mass sanitary campaign to clean up the streets of Havana. This campaign shifted focus, however, upon the validation by Dr. Walter Reed’s Yellow Fever Commission of Cuban physician Dr. Carlos

Finlay’s theory that mosquitoes were the vectors for yellow fever. The focus of the campaign shifted from solely clean up to elimination of mosquito breeding grounds throughout the city; by dividing the city into twenty districts, each under the supervision of a sanitary inspector, the

Sanitary Department could monitor each home through house-to-house visits and ensure that no one had standing pools of water on their premises.32 Gorgas’ new goal was to monitor the population of Havana, simultaneously finding individuals responsible for perpetuating yellow fever in the city while keeping the rest of the population safe.33 At the end of the sanitation and mosquito eradication campaigns, American newspapers began declaring that Havana was “now clean enough to be a white man’s city…”34

This chapter focuses on the American sanitary work in Havana and its implications in the development of Cuba as an American colony. The Americans aimed to eliminate yellow fever in

Cuba to both protect its own southern coastline from the disease as well as protect its trade

31 Yellow Fever Commission, Report on Yellow Fever. Report. From Library of Congress: William C. Gorgas Papers. Accessed August 20, 2016, p. 11; Gray, George. Gray to Guiteras. Letter. From Library of Congress: William C. Gorgas Papers. Accessed January 9, 2017, p. 1. 32 Gorgas, Sanitation in Panama, 56. 33 Ibid., 92. 34 “Havana is Healthy,” The Newark Advertiser, March 22, 1901.

13 interests in Cuba. To achieve this mission, the Sanitary Department attempted to sanitize, or clean up, all of Havana; following the Yellow Fever Commission’s experiments with the

Stegomyia mosquito, however, the campaign switched its focus to eradicating mosquitoes rather than general sanitation. This process, while beneficial to the Americans, did not benefit the

Cuban population as much, as most of the native-born Cuban population was already immune to yellow fever due to prior exposure. These occurrences, called “differential immunity” and

“differential resistance” by J.R. McNeill, referred to when children grew up in malaria and yellow fever zones and acquired the diseases at young ages, resulting in mild cases as children and significantly reduced likelihoods of illness or death as an adult.35 The Cuban population was therefore subject to an American campaign that tackled diseases that were not particularly harmful to their health, all without the consent of the Cuban people. This health project was not strictly imperial in nature, as many Cubans endorsed the American sanitation and anti-mosquito campaigns and the U.S. worked directly with Cuban physicians to accomplish its health goals.

However, the Sanitary Department in Havana prioritized American lives in its to make Havana a city clean enough for “white men.” The codification of the Platt Amendment, securing the

American right to intervene in Cuban sanitation when it was deemed unsatisfactory, indicated that the U.S. did not value Cuban lives to the same extent to which it valued its own.

Primary source documents, such as letters, early 20th century books, and government reports and memoranda, show the inner workings of the Sanitary Department and the orders coming from the American political network. These documents help shed light on why the U.S. felt the need to assume power in Cuba, and how the U.S. interacted with the Cuban population once in power in such a way that reflected its reliance on the cooperation of Cuban officials.

While the notion that the Americans valued white American lives over the lives of the Cubans is

35 J.R. McNeill, Mosquito Empires (New York: Cambridge University Press, 2010): 4.

14 inescapable, the government took steps to address the needs of the Cuban population as well.

This dynamic points to a version of colonialism that satisfied the American desire to rule over

Cuba while working closely with and at times respecting the Cuban population.

The Terror and Implications of Yellow Fever

The Sanitary Department decided to focus its resources on eradicating yellow fever in

Cuba because the city had been identified as the epicenter of previous deadly yellow fever outbreaks in the U.S.36 The Americans were not just worried about American lives in Cuba -

American lives in the southern U.S. were at stake as well. Conquering endemic yellow fever abroad meant that the sporadic yellow fever outbreaks throughout the southern U.S. could possibly be eliminated altogether, however very little was known about the disease when the

U.S. intervened in Cuba. The only common knowledge about yellow fever was that it fed on the nonimmune population, or people born outside of the areas where yellow fever was endemic and thus did not have prior exposure to the disease.37 This phenomenon, termed “differential immunity,” stemmed from the fact that one attack provides lifetime immunity against the disease.38 Therefore, those who had lived in regions of the world where yellow fever was prevalent, which included many Caribbean nations where the Aedes Aegypti lived naturally, generally had been exposed to the disease at a young age and had faced a less severe case of the disease as a child. Cubans therefore developed immunity to the disease long before the American and European foreigners entered the country.39

36 Espinosa, Epidemic Invasions, 14. 37 “Death Rate in Havana,” The Brooklyn Citizen, December 14, 1900. 38 Gorgas, Sanitation in Panama, 115. 39 Olive Senior, Dying to Better Themselves (Kingston, The University of the West Indies Press, 2014), 147.

15 The native Cuban population in the cities therefore feared the disease less than the average American, as the immunity of the population protected the continual spreading of the disease.40 The fear of the disease was completely justified in the U.S., and was so extensive that it could shut down a business and cause a mass exodus from an otherwise functional town.41 The first signs of disease included high fever, muscle pains, headache, nausea, and dizziness.42 The disease then lulled for a few days before coming back with a vengeance; the fever returned, the patient developed excruciating pain, jaundice, bleeding from the eyes, nose, mouth, and stomach, and vomiting of coagulated blood, and finally succumbed after a long, drawn-out death.43 This disease was particularly painful and frightening with mortality rates possibly as high as 85%, justifying the expedience with which the U.S. wanted to address the issue in Cuba and prevent it from coming back to American shores.44

However, yellow fever ceased to be a problem altogether without the presence of a nonimmune population.45 Gorgas himself compared the arrival of a nonimmune population to an

“exhausted fire wherein concealed embers lay in wait for fresh supplies of fuel. The arrival… of nonimmunes would be equivalent to heaping on dry kindling.”46 The implications of eliminating yellow fever were not lost on citizens and physicians of the south; Dr. H. B. Horlbeck of

Charleston, South Carolina knew that 10,000,000 lives in the southern U.S. depended on eliminating yellow fever, as few there were immune and leaving many in jeopardy as long as yellow fever in the Caribbean was a threat.47

40 Russell H. Fitzgibbon, Cuba and the United States (Menasha: George Banta Publishing Company, 1935), 38. 41 Gorgas, Sanitation in Panama, 2. 42 McNeill, Epidemic Invasions, 33. 43 Espinosa, Epidemic Invasions, 1-2. 44 McNeill, Epidemic Invasions, 37. 45 Fitzgibbon, Cuba and the United States, 38. 46 David McCullough, The Path Between the Seas (New York: Simon and Schuster, 1977), 421. 47 “Dr. H. B. Horlbeck,” The New York Times, November 10, 1900

16 American lives in the U.S. South were not the only lives threatened by the presence of yellow fever. Following the Cuban War of Independence, which took the lives of about 170,000 civilians, or roughly 10% of the population, there was a severe shortage of laborers on the island.48 Immigrants from countries such as Syria, France, China, Italy, and England arrived to work, but the most came from Spain; most of these immigrants had never previously been in regions where yellow fever was prevalent.49 Nevertheless, they poured into Cuba following the war in order to help rebuild the Cuban economy, yet only after the U.S. lifted its military blockade of the island.50 Prior to the war in 1894, 26,782 immigrants entered Cuba, but during the war that number dropped as low as 4,040 in 1898.51 After the war, more than 12,000 immigrants arrived in Cuba, about 60% of whom settled in Havana, between August and

December of 1899.52 Between January and , 16,859 people arrived in Cuba, a further increase from the war years.53 The immigrants, in the words of Dr. John Guiteras of

Havana, “came to work on the reconstructed sugar plantations, on the sewerage works, the electric light works and the railroad buildings.”54 The valuable work of the immigrants was not lost on the American government, and the health of this population helped ensure the economic of success of Cuba and thus the U.S. In order for the U.S. to retain its economic hold on Cuba, this population had to be protected from disease.

American investors were keen to exploit the countryside that had been destroyed in the

Cuban War of Independence, and thus supported the development of this new rural workforce.55

48 Tone, War and Genocide, 223. 49 Edwin Warren Guyol, “The Scourge of ‘’ in Havana,” La Lucha. 50 Office of Chief Surgeon, Sanitary Report 1902. Report. From Library of Congress: William C. Gorgas Papers. Accessed January 6, 2017, p. 3. 51 “Facts About Havana,” New York Mail and Express, November 22, 1900. 52 Office of Chief Surgeon, Sanitary Report 1902, p. 3. 53 “Facts About Havana,” New York Mail and Express, November 22, 1900. 54 “Dr. John Guiteras Talks of Fever,” The Jacksonville Times, November 13, 1900. 55 Espinosa, Epidemic Invasions, 45.

17 The companies soon followed this influx of immigrants, eager to use this new labor to generate agricultural success. For example, the United Fruit Company, which grew tropical fruit, acquired over 200,000 acres between 1898 and 1901 before switching its focus to sugar.56 Sugar was one of the main crops grown in Cuba, and it yielded large monetary gains. American companies invested heavily in Cuba, for as historian Louis A. Pérez noted, “Americans… recognized that hegemonial relations with Cuba depended on reconstructing the sugar system.”57 Therefore, if the Americans could reestablish the sugar export system, they would effectively control the

Cuban economy and use that power to fully establish their occupation in Cuba.58

The American shipping trade in Havana totaled close to one million tons each year, a majority of which was sugar destined for the United States.59 In 1894, Cuban port cities traded the equivalent of 3,538,539 tons of goods, and though the value of Cuban goods exported to the

U.S. dropped by about $60 million during the War of Independence, the pre-war trade statistics demonstrated to American companies how profitable trade with Cuba could be. Military

Governor-General also encouraged tariff reciprocity between Cuba and the U.S. in an attempt to make exporting to the U.S. more affordable for these Cuba-based American companies.60

Sanitation and Mosquito Elimination Techniques

When yellow fever was believed to be diseases of filth, officials considered sanitation an easy way to control the disease. According to many U.S. papers, Havana was the “filthiest city in

56 Jules R. Benjamin, The United States and Cuba: Hegemony and Dependent Development, 1880-1934 (Pittsburgh: The University of Pittsburgh Press, 1977), 8. 57 Louis A. Pérez, Cuba Between Empires, 1878-1902 (Pittsburgh: The University of Pittsburgh Press, 1983), 348. 58 Pérez, Cuba Between Empires, 348. 59 Robert T. Hill, Cuba and Porto Rico with the Other Islands of the West Indies (New York: The Century Company, 1909), 87. 60 Benjamin, The United States and Cuba, 9.

18 the world, inhabited by civilized people.”61 Apparently there were “unspeakable odours… streets were filled with decaying vegetables, dead animals, miscellaneous sewage, and refuse of all kinds.”62 The U.S. held Havana to American standards, as it was not accustomed to how other cultures may keep their cities, yet the Americans assumed that the Cuban way was inferior.

When Gorgas arrived as the sanitation officer, he too recognized yellow fever as a disease of filth: “yellow fever in 1898 was looked upon as the example of a filth disease… and it was thought that if Havana were put in a proper state of cleanliness, it might cease to be the great point of infection for the United States.”63 By eliminating this filth disease in Cuba, the U.S. and

American lives in the South would be kept safe from the impure disease that would wreak havoc on American shores.

Gorgas set out to implement sanitation reforms throughout the entire city. One of the major reforms implemented was the introduction of pickers. Each picker was given a two- wheeled can carrier, a broom, and a shovel.64 They were assigned to travel all over the city to collect any sweepings that may have been thrown out.65 Lieutenant W. J. Barden, the Chief

Engineer in Havana, claimed that the streets were constantly dirty due to servants of American and wealthy Cuban families throwing out the trash early in the day.66 In addition to the work of the pickers, sweepers cleared the streets at night. Each “gang” of men consisted of a foreman leading one or two “sprinkler boys” and one wheelbarrow man. Over the course of the sanitation project in 1901, the workers removed 25,000 cubic feet of sweepings and 118,000 cubic yards of

61 “The Cuban Menace,” The Meridian News, October 14, 1900. 62 Gorgas and Hendrick, William Crawford Gorgas, 82. 63 Gorgas, Sanitation in Panama, 3. 64 W. J. Barden “Report of Lieut. W. J. Barden,” in Civil Report of the Military Governor, 1901, Cuba (Washington DC: Government Printing Office, 1909), 109. 65 Espinosa, Epidemic Invasions, 35. 66 Barden, “Report,” 109.

19 garbage.67 U.S. officials, who conducted only minimal paving, were more concerned with the appearance of the public spaces where American officials could be found; modern paving was only conducted around public buildings, while other streets were paved with Boston and

Belgium Block.68 These surfaces were too rocky and uneven to be cleaned easily, slowing down the work of the cleaners and making sanitation that much more difficult.69 The U.S. maintained that sanitation was its underlying goal, yet made little effort to ensure proper and efficient sanitation of the streets.

In maintaining this veneer of proper sanitation while simultaneously not fulfilling the actual sanitary needs of the streets, the Sanitary Department introduced electrozone, which Lt.

Barden noted was more of a deodorizer than a general disinfectant as claimed. Electrozone consisted of seawater charged with an electrical current dumped over the streets.70 The

Department of Engineers created a large electrozone plant in 1899 that generated about 24,000 gallons of electrozone a day.71 Sprinkling carts moved along the streets, spreading the liquid mostly in busier areas and yellow fever districts long after the American officials knew that it had no effect on yellow fever rates. This measure gave the impression that the Sanitary

Department was actively fighting disease, when in reality electrozone just made the city look nicer. The use of electrozone and the continued employment of sweepers and pickers, long after the discovery of the Stegomyia as the vector of yellow fever, demonstrated that the U.S. kept performing these sanitary functions for their own aesthetic reasons rather than to positively impact yellow fever rates in the city.

67 “An American Triumph,” The Columbus Dispatch, September 2, 1901. 68 Barden, “Report,” 108. 69 Ibid., 108. 70 Espinosa, Epidemic Invasions, 35. 71 Ibid.

20 The lack of results from these general sanitation efforts on yellow fever rates disappointed American officials. According to American newspapers, which published before and after photos, two people could not have guessed that the street prior to American sanitation could be so clean.72 However, the rates of yellow fever after extensive cleaning were no different than when the city was in poor sanitary condition, a disappointing result given what had been invested into the street cleaning project.73

The Discovery of the Stegomyia as the Yellow Fever Vector

The first person to hypothesize that the mosquito transmitted yellow fever was Carlos

Finlay of Havana. After working with the 1879 Yellow Fever Commission, which was funded by the U.S. National Board of Health in response to the outbreak of yellow fever in the Mississippi

Valley region the year before, Finlay began his own yellow fever work.74 In a speech before the

Royal Academy of Medical, Physical, and Natural Sciences in August of 1881, he proposed the

Culex Fasciatus as the vector responsible for conveying yellow fever, noting that the mosquito must bite at the right time in the disease progression, live to bite someone else, and specifically bite someone susceptible to yellow fever.75 While Finlay had not uncovered the particulars of the disease, such as incubation time and specific period when a person was susceptible, he was the first to go into significant depth regarding the actual transmission of the disease, let alone the fact that mosquitoes transmitted it.

72 Gorgas and Hendrick, William Crawford Gorgas, 85. 73 “Surprising Increase of Cuban Yellow Fever,” The Brooklyn Eagle, October 26, 1900. 74 Espinosa, Epidemic Invasions, 57. 75 Carlos J. Finlay, “The Mosquito Hypothetically Considered as the Agent of Transmission of Yellow Fever” (1881), in Dr. Carlos J. Finlay and the “Hall of Fame” of New York, trans. by Carlos J. Finlay (Havana: Ministry of Health and Hospital’s Assistance, 1959), 44-45.

21 Later publications by U.S. medical officers tell many stories of the incorporation of

Finlay’s theory. Gorgas, in a statement on yellow fever and the mosquito towards the end of his time in Havana, lauded the adoption of Finlay’s theory yet made no mention of the twenty-year gap between its proposal and its incorporation by sanitary forces. However, in another publication, Gorgas admitted that he originally thought of Finlay as that “crazy Cuban doctor” and ignored the theory altogether.76 American experts such as Reed and Gorgas blamed this lack of acceptance of his theory on many other sources, such as Finlay’s lack of experimental evidence for his theory, as none of his experiments with mosquitoes had successfully controlled the onset of yellow fever.77 However, Dr. , who was in charge of the hunt for yellow fever’s cause, actively prioritized other ideas of how to deal with yellow fever, such as a series of inoculations in Brazil, while ignoring Finlay’s developments on the theory of transmission.78 He only investigated Finlay’s theory years later when yellow fever in Cuba started killing Americans. Sternberg’s initial rejection of Finlay’s theory resulted in years of delayed treatment.79 Finlay felt deterred by this rejection, citing the positive French response to his theory and lambasting Sternberg for the lack of even modest consideration of his theory, yet this did not stop his dedication to the project or prevent him from working with these men again.

The Yellow Fever Commission, comprised of Drs. Walter Reed, James Carroll, Jesse

Lazear, and the Cuban Aristides Agramonte, arrived in Cuba in June of 1900.80 All of these men were medical experts; Agramonte, a Cuban, was an equal member of the Commission, demonstrating the Commission’s willingness to include Cuban doctors in its quest to eliminate

76William C. Gorgas, Description of Sanitary Conditions. Report. From Library of Congress: William C. Gorgas Papers. Accessed January 6, 2017, 3. 77 Gorgas and Hendrick, William Crawford Gorgas, 96. 78 Howard A. Kelly, Walter Reed and Yellow Fever (Baltimore: The Norman, Remington Company, 1923), 119. 79 Kelly, Walter Reed, 120. 80 Ibid., 140.

22 the disease. The Commission initially intended to investigate claims that specific bacteria caused yellow fever. Though they found the bacteria in many yellow fever patients, the Yellow Fever

Commission eventually concluded that these bacteria ere not the causative agent of yellow fever.81 Skeptically, Reed and his team turned towards Finlay’s idea of mosquitoes as the vector for yellow fever in July 1900.

In order to begin the process of conducting experiments to determine whether mosquitoes actually transmitted yellow fever, the Yellow Fever Commission, also known as the Reed Board, needed to acquire the funds to conduct the experiments that could definitively prove the mosquito theory. Luckily for them, Governor-General Wood allocated the funds from the Cuban treasury for the Reed Board to conduct the necessary experiments that mostly benefitted the nonimmune American population.82 To begin the experiments, the Reed Board chose Finlay’s

Stegomyia mosquitoes because he still had specimen and eggs of this type of mosquito. Lazear began testing almost immediately, yet before he did so, the Reed Board came to the conclusion that any individuals who submitted themselves to the experiment would be fully informed of all the risks and able to give free consent. Additionally, the Reed Board determined that as the risk of infection with yellow fever was high, it was their obligation to be the first human subjects.83

Unfortunately, Lazear died as a result of these tests.

Lazear’s death earned him national fame as a martyr of the American conquest to defeat yellow fever and sparked an interest in conclusively proving that being bitten by the Stegomyia mosquito was the only way to transmit the disease.84 The commission established Camp Lazear for Stegomyia experimentation one mile from their main military barracks on November 20,

81 Kelly, Walter Reed, 142-144. 82 Gorgas, Sanitation in Panama, 18-19. 83 Kelly, Walter Reed, 149. 84 Ibid., 303.

23 1900, with strict quarantine rules.85 The first volunteers were all native Spaniards who decided yellow fever was inevitable anyway and they would rather control when they got the disease.86

With a certificate of immunity, a Spaniard could command twice the wages as he had previously, and the additional payment of $250 to every man who came down with the “mild case of yellow fever” financially incentivized many immigrants to volunteer.87 However, Spanish volunteers suddenly began to disappear to be replaced by American soldiers. According to Gorgas, these soldiers had been spreading rumors to the Spanish immigrants that yellow fever would kill them and their bones would be added to a pile in an old lime kiln; the American soldiers saw the mild cases of yellow fever and the significant pay and determined that this was “too good for

Gallegos, and belonged of right to natural-born Americans.”88 The act of paying the immigrants in the first place capitalized on their need for money, yet the American soldiers’ acts reflected the American soldiers’ view of their rightful supremacy over everyone else on the island.

The Reed Board’s first experiments on Americans were conducted on quarantined individuals, who were subjected to a mosquito bite and subsequently developed yellow fever a little more than three days later.89 While demonstrating that the onset of the disease was related to the mosquito bite, the Reed Board still needed to prove that the disease was not miasmatic.

Therefore, the Reed Board designed a house to be divided into two sections with a wire net between them. Both halves were well ventilated, with the only difference between them being the presence of Stegomyia mosquitoes on one side. After both soldiers were quarantined and then placed on each half, only the soldier on the half with mosquitoes became ill with yellow fever,

85 Kelly, Walter Reed, 155. 86 Gorgas, Sanitation in Panama, 25. 87 Ibid., 25-26. 88 Ibid., 30-31. 89 Kelly, Walter Reed, 157.

24 while the soldier on the other side maintained perfect health.90 To demonstrate that only mosquitoes, and not clothing and bedding covered in fomites, could transmit yellow fever, two soldiers slept in clothing and on bedding contaminated by yellow fever patients. Neither of them became ill.91 Finally, the Reed Board had proven correct Finlay’s theory of the mosquito as the vector of yellow fever.

Not all tests were successful, however. Two Spaniards, Antonio Carro and Cumersindo

Campo, died as part of an inoculation test by the U.S. Accounts are mixed in reporting whether or not the deaths were a result of a serum, which supposedly provided immunity to the disease, created by a Brazilian physician, Dr. Caldas. The Indianapolis Star reported that the experiments, conducted in 1901, were not associated with Caldas’ serum and thus could proceed.92

Newspapers lauded the heroism of the Spanish men and the American nurse, Ms. Maas, who had given their lives in support of the great American mission, stating that “six persons have risked life and three have lost it in a new corps of the grand army of peace and civilization…”93 Despite popular opinion, other newspapers spoke out, citing the immorality of using human subjects to understand the spreading of disease. The Cincinnati-based Commercial Tribune attacked the U.S. for its experiments, claiming that the pecuniary reward that had been offered was immoral and that the U.S. had no right to extend its colonial authority over Cuban medicine.94 Additionally, the Americans promptly reexamined whether Caldas could test his serum; at no point did the

U.S. take the blame for the failed inoculations and instead allowed Caldas’ name to be associated with the failure. The Americans knew full well that the reputation of the American medical project in Havana could not be threatened by the loss of the image of a Good Samaritan nation

90 Gorgas, Sanitation in Panama, 32-34. 91 Kelly, Walter Reed, 163-165. 92 “Havard Announcement,” The Indianapolis Journal, August 19, 1901. 93 “A New Form of Warfare That is Worthy of Our Time.” 94 “Victims of Science,” The Cincinnati Commercial Tribune, September 3, 1901.

25 eliminating yellow fever abroad, and instead allowed Caldas to be tarnished and his serum never given a fair chance.

Anti-Mosquito Work in Havana

With the discovery of the Stegomyia as the vector of yellow fever and the understanding that killing the mosquito meant eradicating yellow fever, Gorgas’ focus shifted from general sanitation to eliminating the conditions that allowed for mosquitoes to breed. Las Animas

Hospital served as the American hospital in Havana, but it was by no means the only hospital in

Havana. The three other major hospitals were Dependientes, Covadonga, and Benéfica. These three hospitals were private and belonged to Spanish clubs where Spaniards and Cubans with enough money could pay a yearly fee and gain access to treatment at these facilities that had mortality rates comparable to Las Animas.95 Las Animas Hospital treated all Americans, whether rich and poor, as well as poor Spaniards who could not afford memberships at one of these clubs.

An ambulance from the hospital picked up the yellow fever patients wherever reported, a personal nurse assisted each patient, regardless of nationality, upon arrival, and every effort was made to ensure that that patient had to exert no effort at all while suffering from the disease.

The first orders to begin eliminating mosquitoes took effect on March 27th, 1901 in the area closest to the harbor where many immigrants lived.96 This was just one of twenty equally- sized districts under the oversight of a Cuban inspector from the Sanitary Department who examined each house monthly and filed a report on the conditions found.97 Each day, the inspector would return to the Sanitary Department offices after work and log the receptacles that

95 William C. Gorgas. Notes on the Treatment of Yellow Fever at Las Animas Hospital. Report. From Library of Congress: William C. Gorgas Papers. Accessed January 6, 2017, p. 4. 96 LePrince and Orenstein, Mosquito Control in Panama, 236. 97 Gorgas, Sanitation in Panama, 56.

26 had been found to contain mosquito-breeding spots.98 The Sanitary Department knew at this point that the Stegomyia mosquito bred on pools of standing freshwater, so they were looking for any water receptacles that could be housing mosquito larvae. Other sanitary inspectors would conduct follow-up visits to eliminate these breeding grounds. These inspectors were each in charge of one of eight districts in Havana, and were tasked with emptying any other receptacles and explaining the work to the owner of the house. Each inspector brought two men with him who carried oil to pour over the surfaces of standing water; if the water was not dumped out, the oil had to be applied to suffocate the mosquito larvae.99 By the end of the first month, reports indicated that more than 26,000 water deposits contained mosquito larvae and were cleared by the Sanitary Department.100 In accomplishing this task, the Sanitary Department employees used more than two thousand gallons of oil each month.101 By the end of the campaign, the Sanitary

Department had used over 35,000 gallons of crude petroleum to eradicate mosquitoes.102

The Sanitary Department formed a mosquito response team that was ready at a minute’s notice to respond to any emergency, operating out of a central station in Havana.103 Upon arrival at the scene, the chief of the disinfection department made clear which homes had been afflicted; it was highly likely that the mosquito had not travelled far from its breeding location. First, the home was outfitted with screens over the windows and doors, meaning no mosquitoes could enter or leave the building.104 The building was then fumigated using one of many different types of substances. One substance used was sulphur, which killed all the mosquitoes within a few

98 LePrince and Orenstein, Mosquito Control, 237. 99 LePrince, Joseph A. LePrince to Gorgas. Letter. From Library of Congress: William C. Gorgas Papers. Accessed January 7, 2017, p. 1-2. 100 Yellow Fever Commission, General Directions. Report. From Library of Congress: William C. Gorgas Papers. Accessed January 6, 2017, p. 21. 101 Gorgas, Sanitary Conditions, 9. 102 “An American Triumph,” The Columbus Dispatch, September 2, 1901. 103 Gorgas, William C. Address delivered before the District of Columbia Medical Association. Speech. From Library of Congress: William C. Gorgas Papers. Accessed January 6, 2017, p. 11. 104 Gorgas, Description of Sanitary Conditions, 4.

27 hours.105 However, sulphur tarnished metals and damaged light fabrics, so a different powder, pyrethrum, was used in cases where sulphur would cause damage to the house.106 Pyrethrum was riskier, as it only stunned the mosquitoes, yet the Sanitary Department made sure to follow through and clean up all the stunned mosquitoes on the ground following the use of pyrethrum powder. The Sanitary Department also had to find an alternative arrangement by using tobacco stems for cigar companies, as pyrethrum and sulphur damaged tobacco.107 In searching for alternatives to sulphur, the U.S. found chemicals that would benefit its own economic interests and protect Americans and wealthy Cubans who did not want the anti-mosquito efforts to damage their luxury goods at home, yet were not nearly as effective as pyrethrum.

The Sanitary Department also passed an ordinance forbidding the presence of mosquito larvae on one’s premises and giving the Sanitary Department the ability to impose a fine on an offending household.108 Though the fine was only $10, it displayed American power; the U.S. could impose a fine on any person found guilty, yet revoke the fine at any moment should the situation be remedied.109 In 1901, 2,500 fines were levied against the Cuban population, of which only fifty were collected.110 The Americans were pleased that this made them look favorable, as they seemed to be the ones eliminating the fine, yet they also benefitted from the collection of the fines. The money went straight to the Cuban treasury under the direction of Governor

General Leonard Wood, who then used the money to help fund American anti-mosquito efforts.

Though the U.S. just wanted to eradicate mosquitoes, it simultaneously demonstrated its own greediness both for money and the gratitude of the Cuban population.

105 Gorgas, Sanitation in Panama, 53. 106 Ibid., 54. 107 Ibid., 55. 108 Kelly, Walter Reed, 321. 109 Yellow Fever Commission, General Directions, 21. 110 Gorgas, Sanitation in Panama, 57.

28 Anti-mosquito work was not a task undertaken solely by the American forces and imposed over the Cuban population; instead, the Americans worked closely with Cubans to ensure the successful implementation of the necessary reforms. While Gorgas headed the

Sanitary Department, qualified Cubans filled many other positions. All of the laborers in the streets cleaning up garbage, sweeping, and implementing sanitary policies were Cubans, as were their supervisors and foremen.111 Even those conducting house inspections were Cuban. Gorgas’ chief allies were the Cuban physicians , Juan Guiteras, and Antonio Díaz; of these four men, Carlos Finlay was the president of the commission charged with identifying cases of yellow fever.112 The Sanitary Department acknowledged that the Cuban population, with its abundance of laborers fit for the task and physicians internationally acclaimed as yellow fever experts, was necessary in the fight against yellow fever, and their cooperation was what made the campaign so successful. Cuban physicians knew that the U.S. needed Cuba in more ways than one; not only was the completion of the project in Cuba dependent on the labor of the Cuban population, but in order to defeat yellow fever at home in the southern U.S., the lessons from

Cuba needed to be incorporated at home.113

Rates of yellow fever paled in comparison to the rates of tuberculosis in Havana, yet the

U.S. instead prioritized yellow fever work. In the summer of 1900, yellow fever was the eighth- deadliest disease while tuberculosis was the deadliest, taking 851 lives.114 Though the general death rate went down, the U.S. chose to reform the sanitary conditions with the hope of lowering yellow fever rates, rather than tackling the disease that contributed the most to the overall mortality in the city of Havana. Yellow fever was the main focus of the Sanitary Department, as

111 Espinosa, Epidemic Invasions, 99. 112 Ibid. 113 Ibid., 106-107. 114 “Health of Havana,” The Buffalo Express, February 4, 1901.

29 its eradication benefited U.S. soldiers, trade interests, and the health of the civilians back in the southern United States.

Despite the lack of attention that the U.S. paid to tuberculosis at the beginning of its campaign, the U.S. did in fact attempt to improve the general health of the population. The sanitary efforts that cleaned up the city, while not affecting yellow fever rates, still lowered the death rate from 33.67 per thousand in 1899 to 24.40 per thousand in 1900.115 Prior to the sanitary efforts, Cubans were dying of many diseases.116 Yet, by December 1901, there were significantly fewer deaths within the Cuban, Spanish, and American populations.117 The efforts of American sanitation, in the course of just over a year, lowered the monthly prevalence of many diseases, and resulted in the lowest monthly death rates in each month’s eleven-year history of record- taking.118 Only after the U.S. finished fighting yellow fever in Havana did it shift its focus to tuberculosis treatment.119 In 1902, Gorgas brought in Major C. L. Furbush to lead the Sanitary

Department’s campaign against tuberculosis. He established dispensaries in order to treat

“Pulmonary diseases” where more than 3,000 patients received free medicine.120 The staff also provided physical development sessions to the children and continued exercises to improve health and minimize risks of tuberculosis.121

The Sanitary Department also tried to inform the Cuban citizens as much as possible about the ordinances and the risks posed by disease. The Sanitary Department produced a

115 “Health of Havana,” The Buffalo Express, February 4, 1901. 116 Gorgas, William C. Report of Vital Statistics of Havana for March, 1900. From Library of Congress: William C. Gorgas Papers. Accessed August 19, 2016. 117 Gorgas, William C. Report on Vital Statistics of Havana for December, 1899. From Library of Congress: William C. Gorgas Papers. Accessed August 19, 2016. 118 Gorgas, Vital Statistics December; Gorgas, Vital Statistics March. 119 Gorgas, William C. Gorgas to Baker. Letter. From Library of Congress: William C. Gorgas Papers. Accessed January 9, 2017, 4. 120 T. Q. Praise for Gorgas. Memorandum. From Library of Congress: William C. Gorgas Papers. Accessed January 9, 2017, p. 1. 121 T. Q. Praise, 2.

30 publication called “Circular de información para los medicos, relativa á la prevención de tuberculosis en la Ciudad de la Habana,” in which it outlined the relevant information for the public about how it could prevent tuberculosis.122 Though tuberculosis primarily affected the

Spanish immigrant and Cuban populations, the Sanitary Department went out of its way to create a publication that all could read. Additionally, any documents relating to the implementation of a fine or a closure of an apartment for fumigation were printed bilingually so that the entire population would be aware of all policies.123 Though the U.S. had assumed the leadership of

Cuba and implemented reforms without the population’s consent, the U.S. still attempted to be inclusive by keeping the Cuban and Spanish population well informed while simultaneously protecting the health of the population, yet still only doing so following the campaign against diseases that most impacted Americans.

The Platt Amendment

In order to maintain American domination in Cuba, the U.S. codified its guidelines for future involvement through the Platt Amendment, which was a list of provisions to be added to the Cuban constitution. It was divided into seven sections and recognized Cuban independence while calling for provisions such as Cuba’s inability to enter treaties without American consent, the right of American intervention should Cuba’s independence be threatened, and the right of

122 Sanitary Department. Circular de Información Para Los Médicos, Relativa á La Prevención de Tuberculosis en La Ciudad de La Habana. Circular. From Library of Congress: William C. Gorgas Papers. Accessed January 7, 2017. 123 Sanitary Department. Fine Notification. Letter. From Library of Congress: William C. Gorgas Papers. Accessed January 7, 2017; Sanitary Department. Closure Notification. Notice. From Library of Congress: William C. Gorgas Papers. Accessed January 7, 2017.

31 the American government to take Cuban land for military bases.124 However, the fifth provision of the document read:

“That the government of Cuba will execute, and as far as necessary extend, the plans already devised or other plans to be mutually agreed upon, for the sanitation of the cities of the island, to the end that a recurrence of epidemic and infectious diseases may be prevented, thereby assuring protection to the people and commerce of Cuba, as well as to the southern ports of the United States and 125 the people residing therein.”

The American government was concerned about the spread of yellow fever and malaria to the southern U.S., and was therefore willing to push this specific component of the amendment through. The U.S. valued the elimination of disease so strongly that it was willing to eliminate

Cuba’s right to self-sovereignty over the issue of yellow fever propagation.

The Cuban population did not unanimously support the new measure. Newspapers stated that the sanitary provisions presented by the Platt Amendment were welcome and created no objection.126 One newspaper specifically reported that the Cubans understood the magnitude of the sanitary work had has been done and why the U.S. needed to further monitor conditions that may lead to yellow fever on the island.127 The U.S. did not trust the Cubans to adequately enforce the necessary sanitary reforms to keep Havana and its other cities clean, as American senators voting on the amendment argued.128 The Cubans at the Constitutional Convention were split as well, with many recognizing the underlying mistrust from the American government and thus refusing to include the provision, or any American provision, in the new constitution.129 A back-and-forth between the Cuban Constitutional Convention and the liaisons of the American government ensued. Finally, the U.S. gave Cuba an ultimatum refusing to withdraw troops and

124 United States. Congress. The Platt Amendment. Washington: 1901. Accessed via https://www.ourdocuments.gov/doc.php?doc=55&page=transcript 125 Ibid. 126 “Cuban Sanitation,” The New York Mail and Express, May 14, 1901. 127 “American Sanitary Supervision,” March 22, 1901. 128 Espinosa, Epidemic Invasions, 79. 129 Ibid.

32 recognize Cuban independence unless Cuba adopted the Platt Amendment as initially proposed.130

The U.S. did not fully value true Cuban independence, or the right to self-determination, and valued the health of American lives in the south more than the right of Cubans to determine their own way of life. The Republican representative Townsend Scudder of New York, when discussing the sanitation clause, said, “The Cubans will do well also to accept [the sanitation clause], for if they do not voluntarily agree to them they will be required involuntarily to conform to them. This Republic is done with nonsense.”131 The American government gave no leeway; Cuba either had to adopt the measure or face American occupation. This forcible incorporation of an American sanitary law in Cuba was a clear indication that the U.S. valued

American lives more than Cuban lives. This amendment highlighted how the true purpose of the

American occupation of Cuba as one meant to benefit the lives of the Americans and value their lives as more important.

Conclusion

The beginning of American involvement in the Cuban war of independence with Spain had everything to do with protecting American interests. Not only did the U.S. rely on Cuban trade for its exports, such as tobacco and sugar, but many yellow fever epidemics in the U.S. had also been traced back to Havana and ships leaving the city. Consequently, the U.S. intervened in order to effectively control the disease at its source, rather than to treat diseases such as tuberculosis killing Cubans at higher rates than yellow fever. In making this determination about which diseases to treat, the Sanitary Department chose to focus on diseases that protected the

130 Espinosa, Epidemic Invasions. 83. 131 Congressional Record, 56th Cong., 2nd Sess., 1901, 34: 3371, accessed from Espinosa, Epidemic Invasions, 78.

33 nonimmune population rather than the people of Havana, who were oftentimes subject to diseases such as tuberculosis that were not as much of a concern to the American population.

The process of ridding Havana of disease began with the sanitation of the streets, yet this had no bearing on rates of yellow fever.

The Yellow Fever Commission, headed by Walter Reed, arrived in Cuba and set out to prove the assertion that the Cuban physician Carlos Finlay originally proposed twenty years prior that the Stegomyia mosquito was responsible for the transmission of yellow fever. Through a series of experiments, the Commission proved that the mosquito was the vector and tasked

William Gorgas of the Sanitary Department with eliminating the disease. Gorgas, with the help of his predominantly Cuban team of physicians and with an almost entirely Cuban labor force assisting him, implemented reforms, including fines, monthly water checks, and house-to-house inspections in newly-formed districts. This work, however, reinforced the notion of American superiority over the Cuban population, as it directly benefitted the Americans on the island and back in the U.S. rather than the Cuban population. The Platt Amendment in the new Cuban constitution, which mandated the American standards of cleanliness in sanitary efforts conducted by Cuban authorities, was also a clear sign of American colonialism. If anything, the Platt

Amendment displayed a fundamental lack of trust in the Cuban people, as it demonstrated that the U.S. not only felt that Cuba was incapable of handling its own public health ventures, but also that the lives of Americans were more important than the lives of the Cubans.

Meanwhile, though the efforts of the U.S. certainly demonstrated the perception that

Cubans were not as deserving of humanity as Americans and the paternalistic approach the U.S. took in dealing with Cuba, the Sanitary Department did go out of its way to explain projects to the Cuban population and revoke fines when deemed unnecessary. Though these acts did not

34 minimize the significance of the colonial efforts of the U.S., these acts set the U.S. apart from other colonial powers that made no effort to relate to the colonized population.

Not all agreed with this assessment, however. Some people in the U.S. felt that the U.S. was unfairly ruling over the Cuban population. In 1901, the Portsmouth (N.H.) Times claimed that the U.S. was no better than the Spanish for the indefinite occupation of Cuba, and that

“every day of the continuance of American domination in the island adds to the sum of our national disgrace, no matter how much it may conduce to the health or even the prosperity of the people.”132 As the paper points out, the American occupation of Cuba should not be described as anything other than colonial. Yet, the partnership between the Cuban laborers and physicians, as well as the late attention to health issues affecting the Cuban population, demonstrates how this

American brand of colonialism in Cuba exposed a relationship where the occupying power relied on the cooperation of the colonized population. As the U.S. turned its attention to the canal project in Panama, it took the lessons learned from sanitation in Cuba and took a harsher approach to dealing with the native and immigrant population.

132 “Criticism,” The Portsmouth (N.H.) Times, January 19, 1901.

35 Chapter 2 - Turning the White Man’s Grave into the White Man’s Paradise: Racism, Colonialism, and the American Canal Project in Panama

In 1905, U.S. President faced a difficult decision - he had two qualified men ready to assume the leadership of the Panama Canal Zone sanitation project, yet only one position available. One man, Theodore Shonts, believed that the only way to eliminate malaria and yellow fever, which were killing thousands of workers every year, was through sanitation and cleaning projects.133 The other man, William Crawford Gorgas, had already successfully defeated the diseases in Havana and believed that the best course of action was to attack the mosquito breeding grounds and destroy what he knew to be the vector of both diseases. While Gorgas had the science and experimental results to back up his beliefs, many people still doubted his conclusions and urged Roosevelt to endorse the much safer bet of

Shonts. In the end, Roosevelt took the advice of Dr. Alexander Lambert, who made his own opinion on the matter clear: “If you back up Gorgas and his ideas and let him pursue his campaign against the mosquitoes, you will get your canal.”134 As a result, the U.S. completed the canal, marking the beginning of the United States’ economic dominance on the global stage by giving it ownership rights of one of the most traveled commercial routes.

Both malaria and yellow fever had been wreaking havoc on Canal Zone workers and forces for a long time. In order to successfully complete this project, these two diseases needed to be eliminated. Gorgas viewed malaria as the more significant problem, saying, “If we can control malaria, I feel very little anxiety about other diseases. If we do not control malaria our

133 McCullough, Path Between the Seas, 467. 134 Gorgas and Hendrick, William Crawford Gorgas, 201.

36 mortality is going to be heavy.”135 Yellow fever, meanwhile, was “one of those diseases which almost never assail the same person a second time. Even a slight attack… protects the sufferer from a second visitation.”136 As yellow fever was a constant presence in Panama and not endemic in the U.S., American workers, like in Cuba, stood to suffer the heaviest toll from this disease.

Gorgas, in leading the charge against disease, sought to assemble a team and allocate resources so that the diseases would be decimated and the Canal Zone rendered safe for

American occupation. This was not the first attempt at establishing a canal; a group called the

French Compagnie Nouvelle du Canal de Panama maintained the rights to construct a canal in the Republic of Panama on behalf of the French government up until 1904. However, once

Panama declared its independence from Colombia in 1903, it signed a treaty giving the U.S. the

Canal Zone for its “use, occupation and control.”137 Thousands of French workers lost their lives, warning the U.S. about the danger to its workers in this region.138 The French left behind aging and decrepit buildings, abandoned as the French escaped the menace of both yellow fever and malaria.139

The Isthmian Canal Commission (I.C.C.), an American governmental organization tasked with the completion of the Panama Canal, took responsibility for the purging and elimination of yellow fever and malaria from the Canal Zone. This work was done without any input from

Panamanian or other non-American officials, meaning the I.C.C. was responsible for the

135 McCullough, Path Between the Seas, 419. 136 Gorgas and Hendrick, William Crawford Gorgas, 72. 137 United States and Panama. Convention for the Construction of a Ship Canal (Hay-Bunau-Varilla Treaty), November 18, 1903. Quoted in Olive Senior, Dying to Better Themselves (Kingston, The University of the West Indies Press, 2014), 105. 138 Gorgas, Sanitation in Panama, 138. 139 LePrince and Orenstein, Mosquito Control in Panama, 18.

37 imposition of American customs, values, and traditions in the Canal Zone.140 In a clear case of

American colonialism, this campaign to eliminate yellow fever and malaria was, in the words of

Gorgas himself, a “conquest of the tropics for the white man.”141 The process of eliminating disease in Panama favored the white American population on the Panamanian isthmus; American officials and medical workers sought to reinforce the idea of white people as the superior race through medical treatment and efforts to control mosquito-borne illnesses aimed at protecting predominantly the white population of Americans.

The laborers in the Canal Zone, primarily from Barbados, Jamaica, and Panama, arrived in order to work on the American canal project, yet faced racially motivated mistreatment and unequal access to health care in their communities and in the hospitals.142 The American colonial force, under the control of the I.C.C., used spatial segregation, access to medical care, and resource allocation, and attempted to devalue both the West Indian and native lives relative to the white American lives present on this isthmus as part of a large American colonial project. By reinforcing whiteness as superior, the I.C.C.’s forces intended to create a clear dichotomy between the classes of people in the Canal Zone, which would solidify American power and lead to the successful completion of the first passageway connecting the Atlantic and Pacific oceans.

At no point was this purely an economic project, however; the treatment of the workers and their families, both in labor and in medical treatment options, demonstrates that this project was simultaneously about the reinforcement of a colonial system over the entire non-white population. The documents the I.C.C. produced, including expense reports, photographs, and memoranda, give insight into how the I.C.C. approached this task with this goal in mind. These

140 Senior, Dying, 106. 141 Gorgas, William Crawford. “The Conquest of the Tropics for the White Race.” Boston Medical and Surgical Journal 160 (1909): 765-767. 142 Senior, Dying, 111.

38 resources, in conjunction with secondary resources, shed light on the treatment of non-white laborers both on the ground and in hospitals, however no scholarly literature has looked exclusively at the treatment of these laborers for yellow fever and malaria as an American exercise in colonialism and imperialism. But, as these sources reveal, the American entomological project in Panama to eliminate mosquitoes and mosquito-borne illnesses reflected

American racism and prejudice in aiming to primarily help the white population. What was originally intended to be an economic project beneficial for the U.S. ended up serving as an exercise in American colonialism that denigrated entire populations in the Canal Zone.

The Origins of the Canal Project

Construction of a canal originally began in 1881 by Compagnie Universelle du Canal

Interocéanique, a French organization that had purchased the right to build in that location.143

The company developed the Canal Zone into a region that permitted debauchery and immorality, never allowing the project to flourish. When the company failed in 1889, they sold the rights to the canal to Compagnie Nouvelle du Canal de Panama, which similarly failed and sold the rights to the land to the U.S.144 By the time the U.S. took over, the Canal Zone had a new name: the

White Man’s Grave.145

The two main mosquito-borne illnesses devastating populations in the Panama Canal

Zone were yellow fever and malaria. Yellow fever, as described in the previous chapter, was discovered to be a mosquito-borne illness that attacked populations where the disease was endemic at a young age, conveying a mild case of the disease that gave protective immunity

143 Senior, Dying, 63. 144 Ibid., 71-73. 145 Thomas W. Martin, Dr. William Crawford Gorgas of Alabama and the Panama Canal (New York: Newcomen Society of England, American Branch, 1947), 18.

39 against future infections. Cases only spiked with the influx of a foreign colonial power, as demonstrated in Figure 1.146 The graph shows that following the arrival of the French in 1881 until 1883, the nonimmune French population climbed while the number of yellow fever deaths hover around the low thirties. However, as the nonimmune population began climbing higher and higher, so did the number of yellow fever deaths per year, until eventually, the population growth halted, yellow fever deaths rose higher, the population began declining, and eventually the number of yellow fever deaths began declining with it.147 The graph clearly indicates Figure 1 that while yellow fever certainly caused death, it Graph demonstrating how yellow fever infections and deaths relates to the nonimmune was by no means as large problem for the native population population as it was the foreign population. The native Panamanian population had used mosquito bars, which kept mosquitoes out of buildings, as a “protection against their annoyance.”148 This observation, written in a 1916 book, recognized that the immune

Panamanian population could not get yellow fever, yet they may have feared another disease: malaria.

Malaria, on the other hand, had a completely different history and disease pattern that caused problems in the Panama Canal Zone even without the presence of a nonimmune population. In 1898, Sir Ronald Ross, a British doctor, discovered that mosquitoes were the vectors for avian malaria, and a year later a team of Italian scientists had proven that the

Anopheles mosquitoes were the vector for human malaria, meaning the elimination of the disease

146 Gorgas and Hendrick, William Crawford Gorgas, 148. 147 LePrince and Orenstein, Mosquito Control in Panama, 264. 148 Ibid..

40 depended on the eradication of the Anopheles mosquito.149 The Anopheles mosquito bred in small puddles of water, including animal hoof prints, and did not care about the quality of the water.150 Additionally, because the Anopheles had a wide range, it was difficult to pinpoint the origin of the mosquitoes.151 Gorgas recognized the necessity of destroying malaria as quickly as possible, noting about his work to eradicate disease: “This experience has impressed on me the fact that malaria in the tropics is by far the most important disease to which tropical populations are subject, either military or civil.”152

Once malaria was in the bloodstream, it was there to stay; many laborers had weekly malarial attacks, and one town in the Panama Canal Zone had 80% of its residents infected with malaria. Gorgas himself had inspected a Culebra work camp, finding almost all of the children to have chronic malaria, and almost every adult reported symptoms of malaria in the previous six months.153 The Americans certainly suffered from malaria, but this was a disease that did not target one specific population; in 1906, 186 people in the Panama Canal Zone died of malaria, most of whom were West Indians.154 The work that the I.C.C. forced on the laborers exposed them to conditions that the Anopheles mosquito loved, such as being in high grass, swamps, and brush. The Americans saw the devastating side effects the native and West Indian populations experienced, and saw the danger to which they were exposing their own citizens. Gorgas wrote,

“The condition is very much the same as if these four or five hundred natives had smallpox, and our Marines had never been vaccinated.”155 The United States therefore saw the laborers not as a

149 Francis EG Cox, “History of the discovery of the malaria parasites and their vectors,” Parasites and Vectors 3 (2010), 1. 150 Fitzgibbon, Cuba and the United States, 43. 151 Ibid., 44. 152 William Crawford Gorgas. Malaria in the Tropics. Article. From Library of Congress: William C. Gorgas Papers. Accessed January 6, 2017, p. 1. 153 McCullough, Path Between the Seas, 420. 154 Ibid., 502. 155 Ibid., 420.

41 population in need of help, but as a population that served as a liability to its own troops; were the I.C.C. to successfully build the canal, the native and West Indian populations would need to be treated or the entire American workforce would be susceptible to a disease. In valuing the

American life and health as more important than the health of the native and West Indian population, the U.S. reaffirmed its commitment to the advancement of the white man’s goals and

American values, while implicitly indicating that a white American’s health was more important than the health of the entire Panamanian and West Indian populations. Any work fighting malaria, a disease that affected all populations because very few could have resistance or immunity, would therefore impact an entire population. The I.C.C. could effectively favor the health of the Americans by controlling the distribution of anti-malarial resources.

The French companies in control of the Canal Zone in the late years of the 19th century lost thousands of men immediately following their arrival on the isthmus. Two out of every three

Frenchmen died after arriving in Panama due to yellow fever, and for every eighty men who survived six months in Panama, twenty died.156 American engineers calculated that more than

20,000 Frenchmen died during the attempted completion of the Canal project, leaving only 700 employees of the Compagnie Nouvelle when the rights to the land were eventually sold to the

U.S.157 These employees were not Frenchmen, however; instead, they were mostly Jamaicans.

The French running the project realized they had to abandon the idea of using white French workers due to the high death rates and “were forced to resort to the use of unskilled and inefficient black labor,” a sweeping characterization that degraded an entire population.158

The French contempt for black labor and the notion of superiority and skillfulness of white labor carried into the American approach to work in the Canal Zone. When U.S. work on

156 Senior, Dying, 71. 157 Ibid., 71-73. 158 Martin, Dr. William C Gorgas, 18.

42 the Panama Canal began in 1904, the Americans sought white American labor, as many believed that the West Indian black population, the source of the labor towards the end of the French project, was “a quarter as good as northern white labor.”159 However, Gorgas’ inability to put together the funds to adequately compensate white American laborers in light of the high levels of sickness led to the I.C.C. turning to West Indian, specifically Jamaican and Barbadian, labor.

The 150,000 employees who came to Panama were enticed by the opportunity to make money almost immediately, due to scant opportunities for labor in their native countries.160 The I.C.C., recruited from a population who they did not need to pay as much, and thus concerned itself primarily with the loss of American lives rather than the loss of life in general in the Panama

Canal Zone.

Simultaneously, the I.C.C. forces used denigrating phrases to refer to labor from the West

Indies, stating that “the negro alone could perform manual labor…” which stands in stark contrast to the desire for white labor.161 This notion of black labor stemmed from the legacy of slavery in the U.S., which persisted in the post-Civil War relegation of many black Americans to manual labor in the American south. “The negro” was considered the only person able to perform the tough and grueling labor that focused only on strength and the ability to work rather than the French “skilled” labor. The U.S., even before the workers arrived, had created a social and societal hierarchy that relegated the West Indies laborers to the bottom of the pack. The relationship between the concept that black labor was not as talented as white American labor and the concept that black people were suited for manual labor indicates that Gorgas and the

I.C.C. believed black labor was not ideal, as prevalent racial stereotypes in the U.S. presented

159 Isthmian Canal Commission. Report of the Isthmian Canal Commission. Washington DC: Government Printing Office, 1905. P. 9-11, accessed from Conniff, Black Labor, 25. 160 Michael L. Conniff, Black Labor on a White Canal (Pittsburgh: University of Pittsburgh Press, 1985), 25. 161 Isthmian Canal Commission. Report of the Isthmian Canal Commission. Washington DC: Government Printing Office, 1904. P. 114.

43 black citizens as inherently inferior to white Americans, yet a natural position for the inferior race. In lumping black Americans and black Jamaicans and Barbadians together, the U.S. equated race and ability to work, making judgments about capabilities solely on the color of one’s skin.

“Otherness” and Differentiation Between White and Non-White Workers

The I.C.C. differentiated between American workers and both West Indies and

Indigenous workers through the labor treatment of each group; the Jim Crow laws of the U.S. carried over into the Panama Canal Zone as a mode of subjugation of the non-white laborers.

The I.C.C. purposefully recruited white foremen from the Southern states, “as they were supposedly experienced in dealing with Negroes,” enabling the application of Jim Crow laws from the southern U.S. in Panama.162 Many northerners also came to work in Panama, many of whom incorporated the southern style of direction in order to maintain a colonizer-colonized relationship. The bigoted behavior was evidenced in the observation of Harry Franck, an

American traveller, who noted, “any northerner can say ‘nigger’ as glibly as a Carolinian, and growl if one of them steps on his shadow.”163 The I.C.C. incorporated the racial dynamics of the southern U.S. into day-to-day life in the Canal Zone, resulting in a racialized and colonial dynamic between the white and non-white populations both on the job and in living conditions.

These racial dynamics both influenced and were emblematic of how the I.C.C. treated the non-American workers as second-class citizens. This treatment was evident from the classification system, denoted by the terms “gold” and “silver.” Gold, the most valuable metal,

162 John Biesanz and Mavis Biesanz, The People of Panama (New York: Columbia University Press, 1955), 56, accessed from Senior, Dying, 168. 163 John Biesanz, “Cultural and Economic Factors in Panamanian Race Relations,” American Sociological Review 14 (1949): 23, accessed from Conniff, Black Labor, 35.

44 referred to the skilled labor, which additionally meant the white American working population, while silver referred to the unskilled West Indian and native populations that outnumbered the gold workers by four or five to one.164 This division was further demonstrated by the paying of the non-white laborers in Panamanian silver and the white Americans in actual gold.165 The silver, used as the standard currency in Panama, helped to reinforce to the workers that they were no different from the rest of the native population in the Canal Zone, and also subjects of the

American colonizing mission. While payment in gold reinforced the value of white American labor, payment in silver demonstrated that the laboring and native populations were inferior to the gold population. The creation of this system only helped classify the workers, devaluing the labor of those deemed inferior by I.C.C. forces and echoing the Jim Crow sentiment of white supremacy on the isthmus.

In addition to the classification system that separated workers based on the perceived labor value of their race, the I.C.C. paid vastly different sums to the different laboring classes.

The gold workers averaged approximately $750 a year in benefits and were paid on a monthly basis regardless of the amount of work that they did.166 Many I.C.C. inspectors were paid upwards of $125 gold each month while taking vacations of between six weeks and three months.167 The pay for vacation time displays a sense of trust that was placed in the gold workers, and the average pay of $175 per month for gold workers showed how well compensated white Americans were in the Canal Zone.

164 Isthmian Canal Commission. Statements of Cost. Report. From Library of Congress: William C. Gorgas Papers. Accessed August 20, 2016. 165 McCullough, Path Between the Seas, 472. 166 Personnel for Transfer. Report. From Library of Congress: William C. Gorgas Papers. Accessed August 20, 2016. 167 Inspectors. Report. From Library of Congress: William C. Gorgas Papers. Accessed August 20, 2016.

45 While this relatively luxurious life existed for the gold roll employees, the silver roll employees were lucky to take home $30 per month.168 However, this $30 per month was much more fluid, as silver workers were paid approximately $.20 per hour rather than in a lump monthly sum. This payment scheme inherently created a disparity in what was allowed in work practices, as the hourly basis of silver work meant that each hour was both valued and monitored for silver workers. The I.C.C. spent less money overall on the silver workers by using lower wages and estimating costs using these lower wages, but simultaneously displayed a lack of trust in these workers. An hourly rate implied that the I.C.C. did not want to cover any non-work hours, and lent no leniency to the work life of the silver workers. Instead, there was the constant pressure of being on the clock, of finishing work in order to earn as much money as possible as wages were not pre-determined.

Non-White Labor Conditions

In order to build the canal and to combat the mosquito-borne illnesses that were affecting the canal’s construction simultaneously, the I.C.C. started working to create a force that would eliminate the mosquitoes. The dynamic between the worker and the boss, or foreman, produced

“great animosity,” as the foremen recruited were often from the South and experienced in discrimination tactics with their non-white employees to reinforce authority over their workers.169 The foremen did not have as grueling work, either. It was the black labor force, of between twenty-five thousand and thirty thousand people, who were “doing the heaviest, most difficult physical labor.”170 The Jamaicans “were ordered to wade into the knee-deep mud and

168 Personnel for Transfer. Report. From Library of Congress: William C. Gorgas Papers. Accessed August 20, 2016. 169 Senior, Dying, 168. 170 Conniff, Black Labor, 26.

46 bring the lumber in on their heads. In water up to their chests they struggled ashore… a vast army of Negroes slowly plodding back and forth across the mud flats.”171 This dirty job was considered too degrading for the white American workers. In fact, the I.C.C. expected that the black population would be working, as stated in its annual report: “the Negro alone could perform manual labour; the white man must supervise and direct.”172 The white population had historically only valued black bodies for labor, using the racist justification that they were less than human and thus capable of more labor. It was degrading for a white man to work, as that meant that he was animalistic and not capable of what was viewed as skilled labor. Instead, the consignment of black men to these jobs seemed logical, as the idea of black people as animals was prevalent and part of the racist discourse that dominated Jim Crow society both in the U.S. and on the isthmus.

The U.S. used two main methods in order to control the mosquito population - grass cutting and pesticides. In a letter from Gorgas to Major Carroll A. Devol, the Chief

Quartermaster in Culebra, Gorgas acknowledged that the topographical changes that resulted from the construction of the canal inherently created more breeding grounds for the Anopheles mosquito.173 Gorgas then acknowledged there were significantly higher malarial rates where the grass cutting was neglected, as tall vegetation provided ample breeding space for the mosquitoes.174 The I.C.C’s sanitary forces also heavily invested in oiling, or the process of spreading oil over pools of water to reduce possible mosquito breeding grounds. Over a two-year period, the U.S. spent $15,874.36 to coat water surfaces with oil.175 However, the West Indian

171 Edwin Slosson and Gardner Richardson, “Life on the Canal Zone”, Independent, 22 March 1906. 172 Canal Commission. Report, 114. 173 Gorgas, William C. Gorgas to Devol. Letter. From Library of Congress: William C. Gorgas Papers. Accessed August 20, 2016, p. 4. 174 Ibid., p. 6. 175 Isthmian Canal Commission. Statement Showing Cost of Different Kinds of Work Done by the Sanitary Service of the Canal Zone. Report. From Library of Congress: William C. Gorgas Papers. Accessed August 20, 2016, p. 1.

47 and native laborers, who had no protective clothing, were the ones responsible for spreading the sixty-five thousands gallons of crude oil each month.

While most of this work seemed logical in order to kill mosquitoes, it fell to the West Indian and native laborers to actually spray pesticides, burn the vegetation, and carry out much of the physical labor in high temperatures and in heavy clothing. Pictures depict black laborers, armed with nothing more than long pants, spraying Figure Two larvacide from a “knapsack sprayer” over large Application of larvacide and controlled grass burning techniques areas, simultaneously burning large portions of the brush away to eliminate any nearby mosquito breeding ground (Figure Two).176 The West

Indian and native populations were expected to do much of the grueling and dangerous work; the use of oil and larvacide, as well as being around fire and flammable chemicals, put the silver laborers in significantly more danger than the gold overseer population. The white Americans did not want to risk their own white population doing this dangerous work, so they hired the

West Indian and native laborers to do it for them. By deliberately putting the West Indian and native populations in danger, American leadership labeled West Indian and native labor as inferior to white American labor, enabling the subjugation of an entire race on the isthmus.

176 Application of Larvacide and Burning Grass. Photograph. From Library of Congress: William C. Gorgas Papers. Accessed August 19, 2016.

48 The white population was rarely in

harm’s way at all, as many of the white

overseers never actually got involved in

the work that was going on. In one

particular photograph, a white man on

horseback approaches five black laborers

in a field (Figure Three).177 The laborers

Figure Three are all spraying chemicals while the white A white man on horseback directs non-white laborers man directs their efforts in one particular

direction. The clothes also indicate a major difference, in that the laborers’ pants are dirty and

covered in black spots everywhere, the shirts are too big, and the shoes do not come up very

high. The white man on the horse, from what is visible, has shiny boots and a perfect collar on a

shirt that seems to fit well. The white overseer is safely out of danger on his horse as he watches

the West Indian and native laborers work diligently.

The overseer also had the added benefit of having a sympathetic Canal Zone court

system. Laborers were strongly discouraged from filing suits against their bosses and overseers,

as any worker who brought their boss to the courts would be fired immediately.178 Black laborers

reported consistent verbal abuse, threats, and intimidation from their bosses to carry out tasks

and to avoid making official complaints.179 However, this was a significantly greater cost to pay

than the white bosses had to bear for actual violence against their employees. The Colón Starlet,

an American newspaper in the Canal Zone, reported cases ranging from striking an employee to

177 Nelson, E. N., Waging War on the Mosquito in Panama. Photograph. From Library of Congress: William C. Gorgas Papers. Accessed August 19, 2016. 178 Senior, Dying, 169. 179 Ibid.

49 assault and battery, all of which resulted in fines between ten and twenty-five dollars.180 With this semblance of disciplinary action and no other punishment, the American officials implicitly condoned violence against a laborer, but not towards an overseer. Police were actively involved in this dynamic as well; white policemen were called “Grade A” and comprised only one-fifth of the police force in 1907.181 The West Indian policemen were not allowed to arrest white overseers and instead had to file a report with the police chief.182 The I.C.C., while endorsing the efficacy of the West Indian force, did nothing to intervene with the leniency shown towards the

white overseers.

This power dynamic was not

unique to just the overseers either; Gorgas,

while carrying out an inspection, posed for

a photo in front of barracks with other

members of his team (Figure Four).183

Meanwhile, a group of non-white laborers

worked hard in the background, wearing Figure Four Dr. Gorgas and other officials conduct inspections clothes much more suitable for working while laborers work in background than the suits Gorgas and his colleagues are wearing. Though the work being conducted was important, there was a clear racial dynamic at play; the Americans had clearly established themselves as superior to the black laborers. The

Americans did not have to conduct the physical labor themselves, and literally looked down from horseback or from off to the side as those who do have to conduct the labor exposed themselves

180 Senior, Dying, 169. 181 Ibid., 171. 182 Ibid. 183 Colonel Gorgas and Major Noble. Photograph. From Library of Congress: William C. Gorgas Papers. Accessed August 19, 2016.

50 to dangerous and exhausting conditions. The white population had divided the workers, leaving the black population to work in the dangerous and undesirable jobs in the field while the

American population worked indoors in offices and engineering positions.184 The Americans managed to create a system in which white American labor, done oftentimes with very little threat to the white people themselves, was valued far above the grueling and dangerous labor done by the West Indian and native laborers.

Population Protection on the Isthmus

The American canal project in Panama relied upon the ability of the U.S. to ensure the health and safety of its employees. One way to do so was to protect against mosquitoes carrying yellow fever and malaria. However, once again the U.S. prioritized the protection of white

Americans over the non-white laboring population, specifically by ensuring that the gold workers had better accommodations that were more suited for fighting mosquitoes.185 The gold workers were given access to “free housing, furniture, light, water, fuel, ice and garbage disposal service.”186 These spaces set aside for the gold workers were also segregated from the native population, precisely to protect the gold workers from exposure to malaria and yellow fever. 187

The I.C.C. acknowledged the greater value of gold workers’ lives by constructing the gold homes far away from the native and West Indian homes, as well as the initiatives for frequent repairs, inspections, and check-ins on the gold workers’ homes and the homes nearby that posed a threat to the gold workers’ safety.188

184 Gorgas and Hendrick, William Crawford Gorgas 169. 185 Senior, Dying, 151. 186 Ibid., 228. 187 James Stevens Simmons, Malaria in Panama (Baltimore: The Johns Hopkins Press, 1939), 97. 188 LePrince and Orenstein, Mosquito Control in Panama, 306.

51 The bare minimum requirement for the gold homes was the implementation of wire

screens to keep out mosquitoes. All new houses constructed, which were subsequently given to

the white American workers, were planned specifically to have a minimum number of doors and

windows so mosquitoes would have a smaller chance of gaining entry into a house.189 While this

home construction service was available to the gold population, it was not offered to the silver

population, who often lived in far worse conditions. Additionally, the mosquito bars, which were

designed to protect people from mosquitoes while they were sleeping, were frequently broken,

and the sanitary department only offered free repair for the gold workers.190 The gold homes

were also incredibly luxurious; each bungalow housed one or two families, were fully screened,

and had well-kept lawns that eliminated

the possibility of a mosquito breeding

ground nearby.191 The gold homes also

came with verandas that were completely

screened, allowing for a hint of luxury in

the midst of death and dying among other

populations on the isthmus.192

Figure Five A postcard depicting Judge Owen’s home in Ancon

189 Gorgas, Sanitation in Panama, 196. 190 LePrince and Orenstein, Mosquito Control in Panama, 296. 191 Senior, Dying, 228. 192 McCullough, Path Between the Seas, 479.

52 One such example of the gold homes’ luxury comes in the depiction of Judge Owens’ home, which was incredibly large, completely screened, and surrounded only by similar-style buildings (Figure Five).193 Owens’ home sat on a hill, visible to everyone in the surrounding area, and had a large veranda with multiple doors, Figure Six suggesting that he, and other Americans like him, Gold workers’ living quarters in the Panama Canal Zone were above the worry for mosquito-borne illness. When afforded the ability to be physically above the disease, gold employees took the opportunity, cementing the view that the lives of white Americans were elevated in importance.

The American quarters were also incredibly clean and viewed as a paradise, in strong contrast to what was happening in the rest of the country. Adjourning the long roads winding through the gold encampments was a perfectly manicured lawn with palm trees every few feet (Figure

Six).194 Every gold home was spaced out to give room to each bungalow, and was elevated off the ground by cinder blocks to protect against the filth of being on the ground. The white people, standing on the path in this particular photograph, are having a conversation, not having to concern themselves with the possibility of mosquitoes. These conditions also were afforded to guests at the Tivoli Hotel, a picturesque tourist destination for Americans and Europeans.195

However, the Americans made the conscious decision to only line the publicly visible ditches

193 Residence of Judge Owen on Ancon Hill, Panama. Photograph. From Library of Congress: William C. Gorgas Papers. Accessed August 19, 2016. 194 American Quarters in Panama. Photograph. From Library of Congress: William C. Gorgas Papers. Accessed August 19, 2016. 195 Tivoli Hotel from Ancon, Canal Zone, Panama. Photograph. From Library of Congress: William C. Gorgas Papers. Accessed August 19, 2016.

53 with concrete so as to create a favorable impression towards guests. The U.S. deliberately funded tourism ventures instead of allocating funds towards much needed sanitation projects throughout the isthmus. This helped to demonstrate that between tourism and safety on the isthmus, the U.S. predominantly cared not about eradicating mosquito-borne disease, but in protecting only the visiting white population from these two diseases.

While the gold workers benefited from conditions that helped eliminate mosquito-borne illness, the native and West Indian laboring populations continued to suffer from the purposeful neglect of the American sanitary crews. Many of the homes designed to house the West Indian and native laboring populations were denied the same amenities as the gold workers’ homes, including the wire screening that was crucial to keeping out the mosquitoes. As a result, mosquito-borne illness remained a problem in Panama for a much longer time than necessary.196

The silver workers were housed next to the “native section” in each city, and the homes generally did not meet any of the workers’ needs, housing up to 80 people in a large room with open planks to the outside on the top for ventilation.197 The fact that they were screened was irrelevant; the American engineers had already admitted that more openings into the barracks created higher chances of mosquito infiltration, demonstrating that the U.S. was more than willing to go to any length to protect the gold workers while providing inadequate facilities for the silver workers.

Homes of the West Indian and native population, as many photographs demonstrate, were covered in filth, designed as multi-family and multi-story homes.198 Unfortunately, the lack of sewage disposal systems and subsequent outdoor puddles of filth created another sanitary

196 McCullough, Path Between the Seas, 585. 197 Senior, Dying, 229-230. 198 Ibid., 249.

54 problem, while the gold workers had free plumbing as part of their bungalow.199 The I.C.C. also subjected the native population to poor sanitary conditions and miniscule protections against the deadly mosquitoes, such as leaving mosquito traps either located centrally in a village or placing a single trap in a home.200 There was no protective screening applied to the native homes, creating an opportunity for mosquitoes to enter. The native Panamanian homes were in poor condition, housing large families and containing few amenities.201 These homes were clustered in groups that were a far cry from any of the facilities created by the American and European forces, with thatched roofs made of vegetation on top of shacks.202

The U.S. did not attempt to amend these conditions either, either. The U.S. passed public health laws meant to protect the people from mosquito-borne illness, but forced the laws upon the people with no input or warning to the native population in a display of paternalism. The sanitary forces subsequently arrested anyone, particularly natives, who did not obey the strict laws set forth by the Americans.203 The I.C.C. viewed the natives as propagating mosquito-borne illness amongst the white Americans rather than as another group suffering from disease.

Nov. Dec. 1907 Jan. 1908 Feb. 1908 Mar. Jul. 1908 Total

1907 1908

Garbage $3,344.90 $3,360.66 $3,671.80 $3,240.90 $3,601.65 $4,357.50 $21,577.45

- I.C.C.

Garbage $1,213.75 $1,139.47 $1,339.12 $2,186.19 $1,065.18 $1,362.65 $8,305.96

- Native

199 McCullough, Path Between the Seas, 406. 200 Mosquito Traps. Photograph. From Library of Congress: William C. Gorgas Papers. Accessed August 19, 2016. 201 A Native Home in the Canal Zone. Photograph. From Library of Congress: William C. Gorgas Papers. Accessed August 19, 2016. 202 Saboga. Photograph. From Library of Congress: William C. Gorgas Papers. Accessed August 19, 2016. 203 Jos, Guadeloupéens, accessed from Senior, Dying, 151.

55 Consistently, the U.S. consciously chose to focus its efforts on protecting the gold laborers and the I.C.C. employees over the native population.

As the above graph demonstrates, the U.S. was spending about a third of the total spent on the I.C.C. homes on the native homes each month (Figure 7).204 In the preparation of nightsoil, or human excrement, and the cleaning of different closets, this discrepancy in amount spent on the native population versus the amount spent on the I.C.C. employees held true as well, indicating a pattern of U.S. funding in favor of the gold employees and white workers and against the native population.

The I.C.C. only allocated $4,303.43 to clean native villages over these six months, while policing received $3,438.23 and the cumulative ditching costs ran at $43,952.83.205 Policing, or making sure that all natives and black laborers were adhering to the Americans’ laws, was almost as important as the safety and well being of the native population; while ditching was important, it was done primarily around the gold laborers’ zones and to impress tourists. Therefore, native homes were relatively ignored compared to the quarters of gold employees and tourists. It was clear through the groundwork and tasks carried out by the sanitary department that protecting the

West Indian and native populations was not a major priority, as demonstrated by their horrible living conditions and the lack of funding for basic sanitary measures within their communities.

Racism and Colonialism in Healthcare

The I.C.C. gave Gorgas only a few months to eradicate yellow fever, so eliminating the

Stegomyia mosquito quickly became a top priority..206 The order came directly from the U.S.

204 Isthmian Canal Commission. Statement Showing Cost of Different Kinds of Work Done by the Sanitary Service of the Canal Zone. Report. From Library of Congress: William C. Gorgas Papers. Accessed August 20, 2016. 205 Ibid. 206 Senior, Dying, 147.

56 government, and demonstrated that while malaria affected both the white foreigners as well as the native and West Indian populations indiscriminately, it was easier (due to the breeding conditions of the Stegomyia mosquito) and more beneficial to the white population arriving to treat the disease that was more deadly to them as soon as they arrived.207 While the two diseases may have differed in populations targeted and best modes of eradication, the basic steps to eliminate the disease were similar, and the Americans chose to eradicate the disease most likely to cause white people and foreigners to become ill.

In order to start fighting these diseases, Gorgas tackled the disease in a similar way as he had in Cuba; he divided into 11 districts and assigned inspectors to enter each region and carefully monitor the yellow fever rates while simultaneously disposing of any unsanitary water containers.208 While such action helped to eliminate the yellow fever epidemic, it also denied the fact that Panama City was not actually in the Canal Zone, meaning Gorgas was infringing on the sovereignty of the Panamanian Republic to accomplish goals favorable for the

U.S.209 The U.S. saw itself as having a greater right to sovereignty than Panama, and thus had the right to go into Panama City and implement policies that would directly benefit the susceptible white Americans.

The white laborers and the native and West Indian laborers had two very different standards applied to them while they were on the job. The white laborers got thirty paid sick days, meaning that the black population that already received lesser pay would have to forgo treatment for their illness to earn money.210 Additionally, because the I.C.C. forces closed the

207 Gorgas and Hendrick, William Crawford Gorgas, 224. 208 McCullough, Path Between the Seas, 448. 209 Isthmian Canal Commission. Map of Panama Canal Zone. Map. From Library of Congress: William C. Gorgas Papers. Accessed August 20, 2016. 210 Gorgas, Sanitation in Panama, 247.

57 barracks and homes during the day, the West Indian laboring population was forced to take refuge from illness in the bushes, which only enabled more exposure to unsanitary conditions.211

Treatment was available free-of-charge to all people in the hospitals. However, the employees of the I.C.C. did not have equal access to these hospitals. The I.C.C. chose to concentrate its resources at the base hospitals in Ancon and Colon, on the Pacific and Atlantic

Oceans respectively, with district hospitals in between.212 This favored the American I.C.C. forces that were often clustered around bases and located in the major cities. The West Indian and native populations also faced a disadvantage in home visits, since all employees were charged one dollar a day for a home visit, a price disproportionately large for a person earning much less than their American counterparts.213 However, the I.C.C. allocated physicians to visit hotels and boarding houses daily in Panama City and Colon to check the nonimmune white population for yellow fever.214 The I.C.C. also concentrated its physicians around the Tivoli

Hotel, a prominent tourist destination in Ancon, to make sure that guests were protected from yellow fever, a disease that only affected the white population outside of the native and West

Indian populations, ignoring the universal disease of malaria.215

In fact, some of the only home care provided came in the form of medical experimentation on the West Indian and native laborers. Gorgas and the I.C.C. incentivized the

“negro” employees to sleep in a special tent at night to test for the presence of Anopheles mosquitoes that had been marked the previous day.216 While the job was not exclusively for the silver laborers, the participants were paid at the same rate as laborers during the day, meaning

211 Senior, Dying, 161. 212 Gorgas, Sanitation in Panama, 209. 213 Ibid., 212. 214 LePrince and Orenstein, Mosquito Control in Panama, 285-286. 215 Gorgas, Sanitation in Panama, 235. 216 Ibid., 204.

58 that the wages were well below the gold payroll while being a luxury for those silver workers.

The I.C.C. also purposely removed the mosquito bar that kept the mosquitoes out.217 This compensation system, in addition to the purposeful exposure of silver workers to malaria- carrying Anopheles mosquitoes, promoted and incentivized medical experimentation on non- white bodies, and demonstrated the I.C.C.’s inherent lack of value for West Indian and native lives.

The families of employees were treated in a separate category altogether, as they did not receive the same free healthcare that the employees did. The families of employees that earned more than $50/month were charged one dollar per day spent in the hospital, while the families of employees who earned less than $50/month were charged thirty cents per day spent in the hospital.218 However, this numerical figure does not account for the revenue lost as a result of unpaid sick leave for the silver employees. The rate paid by the gold workers of one dollar a day was equivalent to the rate charged silver employees to receive care in their house, but it was significantly greater a charge proportionally, as the silver workers were regularly paid so much less. Moreover, these discounted rates applied solely to the employees of the I.C.C. Any native

Panamanian who wished to receive treatment for malaria, or any other disease, was forced to pay two dollars a day for treatment.219 This price scheme clearly indicates that the I.C.C. exploited the health of the silver workers for American profit and saw it as inferior to the health needs of the gold workers on the isthmus.

At the hospital itself, the doctors treating the patients with the mosquito-borne illness were nonimmunes, meaning predominantly white Americans.220 The I.C.C. required these

217 Gorgas, Sanitation in Panama, 203. 218 Ibid., 247. 219 Ibid. 220 Gorgas, Sanitation in Panama, 230.

59 doctors to have graduated from medical schools in good standing and have passed a civil service exam, meaning they were accredited in the U.S. as competent physicians.221 The process of receiving treatment, therefore, reinforced white superiority on the isthmus; white American doctors, certified by the white colonial population, had claimed they had superior medical knowledge than the Panamanians, and thus thought they were more qualified to deal with malaria and yellow fever. The white Americans generated a power dynamic that forced the silver laborers and the native population to become dependent upon the white physicians for medical care, and charged exorbitant fees for care that unfairly targeted the non-white isthmus population.

The white population was also directly responsible for the transmission of disease in the hospitals. Instead of grouping patients by disease, which would have allowed the hospital staff to provide specific accommodations, the hospital grouped patients by nationality.222 The I.C.C. felt nationality was more important than illness, and they would rather the gold employees and silver employees were separate than obtain the proper medical care. Race concerns overshadowed disease management, which minimizes the notion that eradication of malaria and yellow fever was the goal of the sanitation project. Instead, the Americans were focused on the canal, and neglected the silver workers and native population in the process. As American Harry Franck noticed as well, the accommodations for the gold and silver populations in the hospitals were very different; the white wards were overlooking the sea, while the wards for the “black” were located behind the white wards and had access to only “second-hand breezes.”223 Aside from the lack of circulation that invariably resulted from the lack of fresh air, the psychological effect of

221 Gorgas, Sanitation in Panama, 213. 222 Simmons, Malaria, 95. 223 Harry A. Franck, Zone Policeman 88 (New York: The Century Company, 1913), 49, accessed from Senior, Dying, 163.

60 knowing other patients had access to fresh air and better resources must have affected some medical outcomes. Showing priority to the gold workers demonstrated that the I.C.C. was more concerned with the health of their white American patients.

Conclusion

J. R. McNeill, in his book Mosquito Empires, claims that in our new world of medicine,

“the richer and better organized societies and states could safeguard their populations’ health at home and… even abroad. This capacity tended to make these societies richer and more powerful still.”224 He also describes how this has become at the expense of the poorer nations and populations, and that the wealthier nations have established a positive feedback loop that continues to widen the difference between these two societies. However, as this chapter has demonstrated, the divide between these two different types of states goes back many years further. McNeill acknowledges the differences between the societies and discusses medicine in the context of race and colonialism, yet does not extend his claim back to the beginning o the

20th century. To understand that the project in Panama was a project of power and colonialism on full display is to incorporate McNeill’s theory further back than he intended. The U.S., in building a canal, sought to simultaneously complete a large economic project and create a racial gap between the white Americans and the non-white laborers from Panama and the West Indies.

The I.C.C. sanitary forces created an environment that was particularly hostile towards the non-white population in Panama, which had a significant impact on the health of the West

Indian and native populations. Malaria was a problem that affected everyone; in 1906, 186 people in the Canal Zone died of malaria, 174 of which were West Indians.225 In 1907 and 1908,

224 McNeill, Mosquito Empires, 313. 225 McCullough, Path Between the Seas, 502.

61 despite medical advancements made by the U.S. and clear treatment techniques that had been established, the death rate of white American employees was 2.06 per thousand, while the death rate of non-white workers was 8.23, about four times as high.226 Prevention and treatment of mosquito-borne illnesses were only some of the agents of American colonialism in Panama, yet may have had the most impact on the health of the population.

The I.C.C. only utilized the sanitary department to achieve the construction of the canal, as the prevention of illness saved one dollar for every day spent working on the canal.227

Between 1904 and 1914, this saved thousands of dollars, indicating that the financial benefit drove the I.C.C. to pursue these health measures. While medical professionals such as Gorgas did express concern for the health and safety of the population on the isthmus, promoting health was just a means to accomplish the end goal of constructing a canal. However, even in the measures taken to eradicate mosquito-borne illness, the white population was favored while the native and West Indian populations were regarded as secondary concerns. One nurse returning from the Canal Zone claimed that yellow fever was responsible for the deaths of “well set-up, clean boys with good principles.”228 What she neglected to mention was that the treatment for yellow fever, a disease that rarely affected any adults in Panama, only existed in order to protect the white foreigners living in Panama. While yellow fever was deadly, so too was malaria, which affected everyone regardless of prior exposure. However, the concentration on yellow fever helps disprove the idea that the white Americans genuinely cared about the health of the non- white population, or malaria treatments would have taken higher priority. Instead, the I.C.C. focused on using medicine and mosquito-borne illness prevention to devalue the lives of native

226 Isthmian Canal Commission. Report of the Isthmian Canal Commission. Washington DC: Government Printing Office, 1914. P. 381-301, accessed from McCullough, Path Between the Seas, 582. 227 Gorgas, Sanitation in Panama, 280-281. 228 N.Y. Tribune, July 6, 1905, accessed from McCullough, Path Between the Seas, 451.

62 and West Indian populations; the health of the native and West Indian population was a secondary concern that reflected racism and colonialism from the I.C.C.

63 Chapter 3 - The Menace at Home: Yellow Fever and the Incorporation of Colonial Public Health Efforts in 1905 New Orleans

The visit had been planned relatively recently, yet its symbolism could not have been clearer to the people of New Orleans. For months, the city had been ravaged by yellow fever, a disease that infected almost 3,500 people in New Orleans alone and 9,321 across the state of

Louisiana.229 Almost 1,000 people had died, and the city was still recovering both financially and emotionally from the trauma of a major epidemic sweeping through the streets. Now, in October of 1905, the disease was mostly gone and life was beginning to return to normal. Faith in the city’s ability to protect its citizens from the ravages of disease was still low, meaning that the planned appearance by President Theodore Roosevelt in New Orleans would reinvigorate and inspire the entire population.

Planning had been underway for weeks to make President Roosevelt feel welcome in

New Orleans and to show the city’s population that they no longer had anything to fear. Upon

President Roosevelt’s arrival at 3:00 PM on October 24th, there was a military reception and a parade that greeted him at the Presidential train. The night would progress in a grand manor, with speeches and receptions at the local hotels, before President Roosevelt headed to the river early the next morning to board a large ocean-liner and depart the city.230 The New Orleans government formed a special committee to handle everything and anything during Roosevelt’s visit, making sure that he stayed safe and his image conveyed the resiliency of the city in the face of disease. Roosevelt, in a speech that stirred the hearts and minds of the citizens of New

Orleans, emotionally declared that he would have been fighting against yellow fever in New

229 Jo Ann Carrigan, The Saffron Scourge (Lafayette: The Center for Louisiana Studies, 1994), 194. 230 “Reception of President Roosevelt in New Orleans,” New Orleans Daily Picayune, September 7, 1905.

64 Orleans alongside the population had he been asked, for their fight was gallant and successful.231

The fact that the President could stay in New Orleans and have nothing to fear spoke volumes; the people of New Orleans had triumphed over the disease.

This was not just a victory for the people of New Orleans, as many claimed, but it was also a victory for science. The outbreak of yellow fever in New Orleans was the first major U.S. epidemic of the disease following the outbreaks among the American and immigrant populations in Cuba and Panama, two regions in which the U.S. had utilized a vast range of resources in order to stamp out this disease. Malarial fever, common in New Orleans and another focus of the

American campaigns in Panama and Cuba, did not have as concentrated a focus in New Orleans, as the constancy of that disease made it seem less severe and more of a fact of life while appearing less spectacularly deadly.232 However, the focus on yellow fever in the initial two experiments abroad allowed the U.S. to apply what was learned in a manner that safeguarded

American interests, and then use that knowledge to construct a mosquito eradication campaign in the U.S. The American scientific community called the victory over the mosquito a victory for science; historian George Augustin, who was present in New Orleans at the time of the 1905 campaign, said that the epidemic was a “grand victory which science… has achieved against a disease which is foreign to this country, and which we sincerely hope, has been forever ostracized from our shores.”233

The city’s public health officials, who understood the implications of the new scientific developments in Havana, realized the importance of incorporating science into the campaign to eliminate yellow fever.234 Newspapers, in assisting with the incorporation of science into the

231 Carrigan, Saffron Scourge, 195. 232 “Affidavits Under the Screening Laws,” New Orleans Daily Picyaune, August 15, 1905, 5. 233 Carrigan, Saffron Scourge, 196. 234 “The Mayor’s Proclamation and Public and Private Protection,” New Orleans Daily Picayune, July 25, 1905.

65 anti-mosquito campaign, published information about mosquitoes and the work done previously in Havana and Panama to help establish the mosquito as the only vector of yellow fever and to promote the current campaign in New Orleans.235 Every previous campaign had been focused on treatment; for the first time, the doctors and scientists could instead redirect public energy towards prevention in addition to the standard treatments.

However, the application of new yellow fever knowledge did not come without a cost to the population. Like what happened in Cuba and Panama, the effort exerted treating yellow fever and eradicating the mosquito focused primarily on the white American male population. In this chapter, I will focus on the eradication campaign conducted by the New Orleans public health officials, which included each individual ward organization, and how it prioritized the health and work of the white American male population. The prioritization of the white American males, however, meant that certain groups were marginalized. These groups - women, black people, and Italian immigrants - were purposefully left out of the Board of Health’s campaign against the mosquito, leaving them to organize themselves and protect themselves from the menace of yellow fever. Women organized in their own community organizations after being left out of the main ward organizations established by the white men. These organizations mobilized members to create their own campaign aimed at eliminating mosquitoes.236 While much of the population wanted to trivialize the role women played, women persisted and ended up playing a crucial role in eradicating mosquitoes as part of the “domestic science” movement. Meanwhile, the black community was expected to fall in line behind the predominantly white ward organizations and serve in whatever way they were asked.237 Within New Orleans and the entire United States, the black population was viewed as inherently inferior to the white population, and this attitude

235 “Mosquito Theory and Its Triumph,” New Orleans Daily Picayune, August 21, 1905. 236 “Clean Up Clubs Still Forming,” New Orleans Daily Picayune, July 28, 1905, 7. 237 “Inspection, Fumigation and Widest Education,” New Orleans Daily Picayune, August 17, 1905.

66 applied to the approach towards mosquito work as well.238 Finally, the Italian immigrant population faced significant discrimination, particularly when they were scapegoated as the cause of the yellow fever outbreak. The initial cases of yellow fever were traced back to the

Italian section of the city, causing the population to turn on the Italian community and the government to impose unfair regulations.239 The xenophobic attitude exhibited by the New

Orleans population may help explain the reticence of the Italian community to go public with cases of yellow fever, and justify the fear of medical professionals. The treatment of these three groups represented the incorporation of American styles of colonialism abroad into New

Orleans. Native and foreign laboring populations had been treated as colonial subjects in Havana and Panama, under the control of the ruling American imperialist government, and that mindset was applied in New Orleans to reinforce the power dynamic of white American males over other populations. In accordance with this application of colonial lessons, the black population,

Italians, and women were forced to organize themselves to have control of their own yellow fever campaigns rather than remaining subject to the dominant ward organizations and public health officials.

Disease in New Orleans

While the 1905 yellow fever outbreak in New Orleans was certainly large, it was hardly the first scare to hit both the South and New Orleans. The French established New Orleans in

1718, and yellow fever started attacking residents en masse shortly thereafter.240 In 1796, the epidemic broke throughout the city, attacking hundreds of new immigrants between July and

238 “Two Negroes Lynched by a Mob at Hattiesburg,” New Orleans Daily Picayune, August 5, 1905, 11. 239 “Sanitation and Isolation Plans,” New Orleans Daily Picayune, July 7, 1905. 240 Carrigan, Saffron Scourge, 20.

67 November.241 People fled New Orleans, retreating further north or even nearby to the opposite shores of Lake Pontchartrain or Mississippi.242 The residents of New Orleans, living in the city known as the “Necropolis of the South,” had to become accustomed to the disease. After

Louisiana became a U.S. territory, successive outbreaks in 1804, 1809, 1811, 1817, and 1819 in

New Orleans struck fear into society.243 As the disease continued to wreak havoc on the population, a pattern emerged - yellow fever was omnipresent each summer, but every ten years there were two or three severe outbreaks that resulted both in high infection rates and high mortality rates.244 Yellow fever, by the time the epidemic of 1905 arrived, was both common and feared, a way of life that resulted in high casualties.

The voracity of the 1905 outbreak caught the city by surprise. A pronouncement of yellow fever meant the initiation of extensive public health measures and a pervading sense of fear, meaning that city officials were hesitant to make any official declarations. However, Dr.

Joseph H. White, a member of the U.S. Public Health and Marine Hospital Service, following the autopsies of some of the dead, officially announced that yellow fever was back in New Orleans on July 22nd.245 In the immediate aftermath of this announcement, hundreds of cases appeared, all of who were either sick or dying and seemed to have hid the disease without ever alerting the proper health services. The 1905 outbreak was the first to hit New Orleans following the success of the yellow fever campaign in Cuba and the initiation of the sanitation project in the Panama

Canal Zone. Consequently, this was also the first chance the city had to incorporate new anti- mosquito measures and yellow fever treatment techniques.

241 Carrigan, Saffron Scourge,22-25. 242 Ibid., 27. 243 Ibid., 29; Ibid., 31. 244 Ibid., 41. 245 Benjamin H. Trask, Fearful Ravages (Lafayette: Center for Louisiana Studies, 2005), 108.

68 The presence of yellow fever in New Orleans tied it together with the projects in Cuba and Panama. Cuba and Panama were inherently colonial locations, as they were under the control of a U.S. government imposing its will on the population. This colonial characterization, as

Natalie Ring discusses in “Mapping Regional and Imperial Geographies,” originates from the idea that certain areas exist outside in the realm of “radical otherness from the temperate world.”246 The U.S. South was not originally part of this classification, as it was part of the U.S. and thus incapable of being foreign; however, as travelers reached “tropical” lands outside of the

U.S., they noticed that diseases present in these foreign countries were similar to those in the southern United States. As the American imperial project grew in places such as Cuba and

Panama, a clear hypocrisy arose in the fact that Americans were advocating for reforming the tropics abroad while having their own “tropics” back in the South. As the U.S. went abroad in order to help reform areas that were “exotic alien spaces,” the South came to be viewed as

“alluring and perilous, exotic yet familiarly American.”247 A region of the U.S. had in essence become a foreign land due to the presence of diseases like yellow fever.

Tropical lands were considered to be home to people who were in a “state of mind and physical constitution that undermined the propensity to engage in efficient labor, engendered backwardness and disease, and contributed to the degeneration of the white race.”248 As long as the tropics were not safe for white men, these regions could only cause harm to their race. If this was true abroad, then it was certainly true back in the South, where public health officials remarked that the “animal-like” conditions in which many southerners lived were indicative of the degeneration of the white race in the South.249 As diseases from the tropics permeated

246 Ring, “Imperial Geographies,” 298. 247 Ibid., 301; Ibid., 299. 248 Ibid., 297. 249 Ibid., 304.

69 through the rural, poor, and white communities, race and disease became further intertwined.250

The white southerners had “fall[en] below the level of their race,” no better than those living in the Caribbean or other traditionally “tropical” locations. As long as yellow fever was spreading in the South as it was in other “tropical” regions, white racial superiority was at stake.

The city of New Orleans was aware of the problem of disease, as epidemic after epidemic reduced the city’s population each year. However, the success of American colonial projects in

Cuba and Panama gave hope to the diseased city; the campaigns demonstrated that the use of colonial tactics, in favoring the white American population over other populations as part of yellow fever prevention and treatment, could solidify the position of the white male as the superior being in the American South, and that white racial superiority could be reaffirmed through the conquering of a disease that had long been viewed as “tropical.” To eliminate a

“tropical” disease was to set the city apart from other “tropical” cities, marking the rise of New

Orleans from within the depths of death and disease into a world in which the city had defied its climate and prescribed notion of “tropicality” to become a beacon of the white race. This victory would also symbolize American superiority, and give the U.S. a moral justification for colonizing other tropical locations unable to eradicate yellow fever. All actions taken during the campaign in New Orleans were therefore aimed at this goal of resurrecting the city and incorporating the U.S. government’s colonial agendas from Cuba and Panama into the anti- mosquito campaign back in New Orleans.

The Campaign Against Yellow Fever

Within hours of the proclamation of yellow fever’s presence in New Orleans, the campaign to eliminate mosquitoes and treat the population began. Beginning July 24th under the

250 Ring, “Imperial Geographies,” 307.

70 guidance of Reverend Doctor Beverley Warner, a New Orleans rector who cared deeply about the progress of his city and who had also previously dealt with yellow fever outbreaks in New

Orleans, the Citizens Volunteer Ward Organization started a campaign against yellow fever and the mosquito. Warner advocated tactics such as placing screens on windows and doors, dumping water out of cisterns or covering them with screens, spreading a thin layer of oil on top of standing pools of water, and fumigating the rooms in which people had come down with yellow fever.251 The central organization under the Board of Health helped kick start the initial anti- mosquito campaign, but the formation of the ward organizations helped to decentralize the campaign and place anti-mosquito work in the hands of each ward rather than one large organization.

A government ordinance was passed on August 3rd in the middle of the epidemic, establishing the regulations for dealing with mosquitoes.252 The ordinance firstly required, within

48 hours of its passing, the proper care of cisterns, which had to have a coating of oil on top and be screened in such a way that no mosquitoes would be able to live in the water. The ordinance created specific requirements for different containers of water, and standing ponds were filled with fish that fed on mosquitoes and mosquito larvae. While it gave power to the Board of

Health of New Orleans to amend any situation they saw fit, such as by forcibly covering or oiling any standing water deemed a threat, the ordinance simultaneously placed the burden on the property holders in the city; should property holders fail to comply with these requirements, they were subject to a punishment of a fine of up to $25 and/or thirty days of imprisonment.253 This regulation meant that each citizen of New Orleans was required to play a part in the eradication of the disease, generating an element of individual responsibility for mosquito eradication. Once

251 “Sanitation and Isolation Plans.” 252 “Mosquito Law is in Full Force Now,” New Orleans Daily Picayune, August 3, 1905. 253 “Mosquito Measure Passes Unanimously,” New Orleans Daily Picayune, August 2, 1905.

71 passed on August 3rd, the ordinance was distributed far and wide; over 10,000 copies were distributed across New Orleans, targeting each ward with the goal of reaching as many people as possible.254 By reaching each ward’s leadership, the information was spread even further, and local organizing could be coordinated at a level still close to the ground yet far removed from the central leadership of the Board of Health. Each ward was responsible for the cleaning up of its areas, electing its own leadership, and carrying out the actual mosquito eradication, as well as sanitary tasks, within the district.255 Though eventually consolidated under Warner, the wards were on their own at the beginning of the campaign. The wards began their own work, reporting recent updates to the newspaper and asking for as much assistance, whether through financial means or manual labor, as possible from the citizens.256 When the New Orleans Board of Health appointed Warner to lead the campaign and serve as a central figure for volunteers, the citizens were only expected to submit reports to him and carry on their anti-mosquito work while reporting any cases of yellow fever.257 Warner encouraged the formation of executive councils within each ward to combat yellow fever, while also giving an iota of centralization to all the ongoing volunteer projects.

Throughout the campaign, New Orleans benefited from the knowledge acquired about yellow fever from previous American anti-yellow fever and anti-malaria campaigns in Panama and Cuba. The Board of Health in New Orleans, despite the deliberate reporting of American methods in Cuba and the beginning reports of American work in Cuba, chose to assign more responsibility to the ward organizations. In Cuba and Panama, governmental organizations oversaw the implementation of public health measures and sanitary projects, while in New

254 “City and Suburban,” New Orleans Daily Picayune, August 4, 1905. 255 “Clean Up Clubs Forming in Every City Section,” New Orleans Daily Picayune, July 27, 1905, 5. 256 “Clean Up Clubs Still Forming,” 7. 257 “Sanitary Work is Pushed Rapidly,” New Orleans Daily Picayune, July 29, 1905.

72 Orleans the government delegated the task to the ward organizations; this was still similar to the districting in Havana and Panama City that allowed those in charge to keep a close eye on happenings on the ground. The decentralization in New Orleans put more power in the hands of the wards, indicating a greater sense of trust in a population that was white and male (the leaders of the ward organization) rather than a foreign colonial population. However, this decentralization also gave greater maneuverability to the population, as the individual ward organizations were the ones crafting their own campaigns. While the government certainly thought that the population was more trustworthy and able to direct its own efforts, the lack of central organization also meant that the government would not intervene to help groups that were left out of the locally organized anti-mosquito effort.

The New Orleans Daily Picayune as well as doctors present on the scene of earlier yellow fever outbreaks were some of the main sources of information regarding prior epidemics.

Colonel Valery Havard, the chief surgeon in Governor General Leonard Wood’s administration, was the first to explain the work in Cuba to the physicians of the South. Havard, as the chief surgeon, had access to all of the medical cases in Cuba through his time, allowing him a window into all of the techniques that were used to eradicate the mosquito while simultaneously maintaining the American subjugation of the Cuban people. As Gorgas indicated in a 1902 letter,

Havard created a pamphlet on the disease and eradication to be distributed to physicians in the

Gulf States; in all, 4,500 pamphlets were distributed throughout the South.258 Gorgas said, “I was more anxious to effect the Gulf States than any other, and consequently have not had any

Spanish copies printed.” He went on, “my total allowance is $1000.00, ans [sic] as I want to make it a series, with 4 or 5 papers besides yours, I could not afford more than $200.00 on any

258 Gorgas, William C. Gorgas to Havard. Letter. From Library of Congress: William C. Gorgas Papers. Accessed January 9, 2017.

73 one paper.”259 Gorgas seems to be suggesting that this pamphlet, generated by Dr. Havard for the purpose of yellow fever eradication, was one of many distributed to Gulf State physicians; the promulgation of this pamphlet suggests the adoption of many features of the Cuban campaign in

New Orleans and throughout the southern U.S. Thus, the complex American system of colonial rule over the Cuban population would be implemented in New Orleans, equating Havana and

New Orleans as tropical cities in need of colonial medicine.

This pamphlet was one of many communications between Cuba and the south, as Gorgas demonstrated with his 1902 letter to a Fort Morgan, Alabama physician, Frederic E. Jenkins.

Gorgas opened by telling the doctor that he had mailed him pamphlets describing the methods of work in Havana, and continued to go into detailed descriptions about the sanitary work completed and how to mitigate any risks in the home.260 This letter, in response to one of the many Gorgas received, exemplified how work that started abroad made its way into the southern

U.S. directly from the people who worked there.

Juan Guiteras, one of the Havana physicians who worked with Gorgas to combat yellow fever, played a unique role in the treatment and eradication of yellow fever in 1905 New Orleans, as he traveled from Cuba to the city in order to assist in any way that he could. The first mention of Guiteras in the New Orleans Daily Picayune came in discussion of the detention camps for quarantine.261 As mentioned previously, American doctors established camps outside of Havana to keep the Americans protected from yellow fever there. Guiteras directly coordinated the establishment of these camps outside of New Orleans with White, demonstrating how experts from the Havana campaign had a distinct impact on the approach to the New Orleans campaign.

259 Gorgas, William C. Gorgas to Havard. Letter. From Library of Congress: William C. Gorgas Papers. Accessed January 9, 2017. 260 Gorgas, William C. Gorgas to Jenkins. Letter. From Library of Congress: William C. Gorgas Papers. Accessed January 9, 2017, p. 1. 261 “The Mosquito Campaign,” New Orleans Daily Picayune, July 25, 1905, p. 4.

74 Guiteras, in working on the ground, served as the resident expert on yellow fever, and could thus assist and guide New Orleans based on his own experiences with the disease in Cuba. As he worked with the individual citizens, he imparted his knowledge and first-hand experience, meaning that individual citizens learned directly from the source how to incorporate techniques he used in Havana into everyday life in New Orleans.

Guiteras helped institute the use of fumigation to rid a building of mosquitoes.

Advertisements in the New Orleans Daily Picayune called for a “Fumigation Day,” a day on which each citizen of New Orleans would fumigate their home to rid it of mosquitoes. The newspaper printed instructions developed by White on how to successfully fumigate the home, which Guiteras publicly endorsed. Guiteras’ name had been used in the newspaper to represent the success of the Havana campaign, and he lent his name to endorse fumigation techniques and materials developed in Cuba for use in New Orleans. Different gases had been used for different classes of people in Cuba; sulphur, while effective, damaged metals in the house, whereas pyrethrum was less effective at killing mosquitoes (stunning them instead) but did not affect metals and was thus used in wealthier homes to protect metal goods. Both of these gases were available for use in New Orleans, an idea clearly taken from Havana where the two gases had first been developed, yet only sulphur was widely available to the masses for free.262 Sulphur in

Havana had been the fumigation agent of the poor native Havana resident; in the U.S., due to its availability, it served a similar role.263 Pyrethrum, meanwhile, remained an option only for those who could afford it.

Guiteras further promoted the work he had done with mosquito eradication by speaking to different community groups. In an address to the fourth ward, Guiteras spoke of the work

262 “Sunday, Fumigation Day,” New Orleans Daily Picayune, August 17, 1905. 263 “The Deadly Mosquito Advance Agent of Yellow Fever,” New Orleans Daily Picayune, August 4, 1905.

75 conducted in Havana and the daily demonstrations that only the mosquito transmitted yellow fever.264 Guiteras also took the time to speak to the Jewish community of New Orleans, spreading a similar message about yellow fever.265 As wards began to regularly bring in speakers such as Guiteras to packed lectures, the gospel of science and previous mosquito campaigns began to spread and more and more people heard how the successful work abroad could be applied back in New Orleans.266 Even when he did not speak, he acted as an observer in many areas, helping each ward attempt to eradicate the disease.267 Guiteras spread the work of the yellow fever doctors in Cuba, who, as previously demonstrated, favored the health of the white

Americans in Cuba over the lives of the native Cuban population. While Guiteras’ own conception of medicine was not inherently colonial, he was spreading the work of a government agency that implemented colonial reforms in Havana. By the time Guiteras moved on to the yellow fever epidemic in Pensacola, Florida, he was praising the success of the anti-mosquito work in New Orleans.268

The newspaper also helped to spread knowledge about all the work in both Cuba and

Panama. The Daily Picayune, in the midst of the yellow fever epidemic in 1905, published a detailed history of all the work that established the mosquito as the vector of yellow fever as part of an attempt to not only convince the public that the mosquito was the only vector, but also to lend legitimacy to the current mosquito eradication programs in New Orleans.269 The article detailed the deadliness of the infected Stegomyia and outlined the history of both the Stegomyia and the Anopheles, the malaria vector. The work in Cuba was therefore readily accessible to

264 “General Fumigation Programme for Sunday,” 7. 265 “Millions of Stegomyia Mosquitoes Killed Sunday,” New Orleans Daily Picayune, July 21, 1905. 266 “Saturday and Sunday the Fumigation Days,” New Orleans Daily Picayune, August 25, 1905. 267 “Low Death Record Good Indication,” New Orleans Daily Picayune, August 17, 1905. 268 “Dr. Juan Guiteras Points to New Orleans as a Model,” New Orleans Daily Picayune, September 4, 1905. 269 “Mosquito Theory and Its Triumph.”

76 everyone reading the newspaper in New Orleans, making the decentralized campaign possible; even without a government organization directly supervising every move, any citizen could recreate the conditions of the successful anti-mosquito campaign on a smaller scale within their ward. The public was knowledgeable and informed about the racialized public health project abroad, generating a perception of the Havana project as standard and a model for New Orleans.

While the work of Havana was entirely in the past, the outbreak of yellow fever in New

Orleans coincided with the second year of American occupation of the Panama Canal Zone, meaning the city of New Orleans and American forces in Panama were fighting similar battles against mosquitoes at the same time. The newspaper would often print updates regarding the progress made in the Canal Zone and the heroic efforts of physicians such as Gorgas, which demonstrated that the knowledge of how yellow fever was spread could be successfully applied in both foreign and domestic lands.270 The detailed description of each aspect of the work, the superiority of the Americans in Panama, and the American success generated a pride in

American nationalism and demonstrated the success of the colonial project abroad. The easily visible articles detailing the success in the Canal Zone allowed a transferal of the unsympathetic attitudes towards the native and laboring population into an already racially divided U.S. south.

Respected physicians who had visited the canal also brought back valuable information, as Dr. R. H. von Ezdorf did. As he stated, “places for mosquitoes to breed are ample. The extermination of mosquitoes will be very difficult… but it is contemplated.”271 New Orleans was able to stamp out yellow fever and mosquitoes much quicker than Panama was, allowing for a comparison between the two cities. In the southern U.S., almost everyone was susceptible to yellow fever, resulting in a universal call to arms against the mosquito. Meanwhile, in Panama,

270 “Sanitating Panama,” New Orleans Daily Picayune, July 25, 1905. 271 “Dr. R. H. Von Ezdorf Comes From the Isthmus Here,” New Orleans Daily Picayune, August 25, 1905.

77 the colonized population felt that the crusade against the mosquito and yellow fever, a disease that did not affect many people except when foreigners were present, was directed towards a nonimmune colonizing population. In New Orleans, the nonimmune population was the majority, meaning the campaign had to cover all facets of life and be complete in its eradication.

The campaign in New Orleans was therefore a makeover of the entire city and its practices, while the campaign in the Canal Zone was able to neglect any care for a portion of the population that was already immune without ill effects on the white American population.

New Orleans, at the onset of yellow fever in 1905, had its peak population of 325,000 people, with 60,000 houses and 70,000 cisterns. As White reported, the yellow fever campaign of 1905 involved 300,000 house-to-house inspections, 55,151 room disinfections, and 60,000 used gallons of oil. Over 4,000 people were involved in this work, with a cost of $290,000 to the city, state, and federal governments, a figure that did not include hundreds of ward volunteers.272

The last case of yellow fever in New Orleans, culminating a period of the deadly yellow fever outbreak between summer and fall 1905, occurred on November 5th; however, a relatively low number of deaths at 452 made it the least deadly outbreak in more than fifty years.273 The 1905 statistics in conjunction with the statistics of the previous epidemics indicate that the overall mortality rate dropped in 1905. This major yellow fever epidemic, the last of its kind in New

Orleans, showed how the involvement of citizens could shape the course of yellow fever. The citizens took lessons directly from the other American colonial mosquito campaigns in Cuba and

Panama and incorporated them into the New Orleans campaign.

Treatment of the Black Population

272 Kelly, Walter Reed, 218. 273 Ibid., 222.

78 The Jim Crow-era racial attitudes present throughout the South did not bypass New

Orleans; in this city and in the state of Louisiana, race relations were tense and hostile.

Lynchings were frequent, and the black population was frequently blamed for crimes they either did not commit or charged with insufficient evidence; mob justice oftentimes replaced justice in the courts, a result of animosity towards what was viewed as the inferior black race.274 Medicine, too, was an area in which black patients were scapegoated for causing the yellow fever outbreak.

When a black man came down with yellow fever, the Daily Picayune was quick to publish this fact, implying that there was nothing to fear; in one specific incident involving a black child, the newspaper publicized the fact that “It is a very mild case and is a negro.”275 Both of these facts together imply that neither warrants a cause for alarm, suggesting the public should be consoled that the person with the illness is black. The same thing happened when describing the infractions against the ordinance that had been passed aimed at eliminating mosquitoes; three people were brought before the judge for violating this new ordinance, yet the only two who had their race mentioned were the black women who had not properly cleaned their yard.276 The press tried to create an enemy, someone who could be held responsible for the failure of anti- mosquito work and someone who could be demonized for failing to comply with official ordinances. These actions fall in line with the colonial nature of the project, as the superiority of the white race in New Orleans had to be maintained and another group blamed for the degradation of the white race.

The scapegoating of the black population demonstrated that the white population and the

Board of Health was more focused on blaming the black population for not cooperating rather than helping alleviate the black population’s suffering. As Keith Wailoo argues in Dying in the

274 “Current Comment in Mississippi,” New Orleans Daily Picayune, September 3, 1905. 275 “Saturday’s Showing the Best in Weeks,” New Orleans Daily Picayune, September 3, 1905. 276 “Women Starving in a Detention Camp,” New Orleans Daily Picayune, August 11, 1905.

79 City of the Blues, black people were seen as a “naturally diseased people,” a “social menace whose superstitions, ignorance, and carefree demeanor stood as a stubborn affront to modern notions of hygiene and advancing scientific understanding.”277 As he points out, white health professionals oftentimes viewed their fight not against the disease, but against “physical, mental, and moral inferiority, against ignorance and superstition, against poverty and filth.”278 These were all the signs of the tropics represented in one race; the white population was therefore quick to fight back and scapegoat those who had caused the city to fall to its “tropical” nature.

The black population was subject to the same mosquito regulations as the white population, yet did not have the same opportunities to be involved in ward work. The same standards for mosquito work applied as in Cuba - mosquito proofing was a required aspect of the campaign, and fumigation was only required once a case of yellow fever was reported. Each ward in New Orleans began its own clean up process that oversaw these regulations, but as these were held at the homes of individuals in the ward, oftentimes the black population was excluded altogether.279 Therefore, all-black organizations began to form, a direct result of the white public health officials urging the black community to organize into its own organization. In order to get the organization started, the newspaper reported, “colored ministers and leading colored men have called a mass meeting… and addresses will be made by prominent white men.”280 The

“prominent white men” took control of the meetings, impressing the goals of the campaign onto the black population. When the white men, such as Warner, Secretary of the Progressive Union

Henry Mayo, and General Superintendent of the Fourth Ward Dave Heller addressed the crowd, they made it clear that the point of their meeting was to “enlist the aid of the colored men of the

277 Keith Wailoo, Dying in the City of the Blues (Chapel Hill: University of North Carolina Press, 2001), 56. 278 Wailoo, Dying, 56. 279 “Clean Up Clubs,” New Orleans Daily Picayune, July 26, 1905. 280 “Clean Up Clubs Still Forming,” 7.

80 city in the fight against the mosquito…”281 They continued on to state that the black sanitary organization could have control of subsidiary organizations within each ward. This meant that the black community was expected to form their own organization separate from the white community, but did not have control of anti-mosquito work on the scale of the white population.

When representatives of the newly formed “colored” ward organizations arrived to meet with Warner, he advised them that despite their willingness to work for the central sanitary committee, they were to report directly to their respective ward organizations for assignment and assistance, and all reports made would be sent through the predominantly white central ward organization.282 Despite Warner’s praise for their work ethic, the black population was not trusted to have their own ward organization as the white population was; instead, they were responsible for reporting their work to the white ward organizations, a clear sign of inferiority and lack of endorsement from the Board of Health. Within a day of their inceptions, the “colored organizations” were following orders, reporting directly to the explicitly white ward organizations, subjugated both in social status and in work status in the fight to eliminate mosquitoes.283 The Colored Sanitary Association, the central organizing group for all the organizations in each ward, managed no money and recognized itself as an auxiliary organization to the white organization; despite its own value, it recognized its subordination to the white organization and its lack of authority in the fight against the mosquito.284 The black population was encouraged to believe that their “interests are with the white people,” who are acting in the best interests of the white and black populations.285 As Professor J. L. Jones, a black member of

281 “Colored Men Organize for Sanitation’s Sake,” New Orleans Daily Picayune, July 29, 1905. 282 “Magnificent Work by Clean Up Clubs,” New Orleans Daily Picayune, July 30, 1905. 283 “Some Wards Worked on the Sabbath,” New Orleans Daily Picayune, July 31, 1905. 284 “Colored People to Aid Sanitation,” New Orleans Daily Picayune, August 5, 1905. 285 “Inspection, Fumigation and Widest Education.”

81 the Central Sanitary Association, stated, “We must believe [the mosquito theory] and help [the white people].”286

The black population got to work, offering as much help as they could to benefit both their own population as well as the city. The Colored Sanitary Association constantly reaffirmed its commitment to continue its work conducting mass meetings for the black population of New

Orleans while simultaneously conducting educational talks about the mosquito and transmission of yellow fever.287 Despite the adversity faced from the lack of independence in conducting anti- mosquito work, the black population kept offering their help. J.C. Eddington, Superintendent of the Eighth Ward of the Colored Sanitary Association, offered to assist in any way without remuneration, yet was told that his services were not needed.288 These acts may have acted as deterrents for the black population, yet time and time again the black community demonstrated its resolve and willingness to work against the mosquito and help the white ward organizations that never wanted the black population’s help.

From the perspective of the white ward organizations, the Colored Sanitary Association would not be of much use, as the members were part of an ill population suffering from both physical illness and the aforementioned overall inferiority; they would contribute diseased bodies to the campaign, which posed a threat to the white ward workers. In the context of the “tropical” society, black people were seen as the reason for disease and the reason for the degeneration of society as a whole. As Wailoo states, “the disease rate was high among blacks” because “’the

Negro’ was little more than an ‘ignorant’ child,” implying that the black population was unable to help itself because it did not have the knowledge or ability to deal with disease.289

286 “Inspection, Fumigation and Widest Education.” 287 “Affidavits Under the Screening Laws,” 5. 288 “General Fumigation Programme for Sunday,” 7. 289 Wailoo, Dying, 65.

82 Wailoo argues of his time studying sickle cell anemia in Memphis, “Memphians emphasized the dangers posed by blacks in their town, much more than the dangers posed to black citizens.”290 This notion applied in New Orleans as well, a fellow southern city; where the black population existed in the presence of disease, existing racial stereotypes at the time allowed the white ward workers to blame the disease on the black population and focus on the menace posed by the black population rather than on the ways in which the disease affected their lives. The white residents of New Orleans were focused on relegating the black population to the

“otherness” of populations in tropics zones, rather than addressing the health needs of the black population.

Treatment of the Italian Population

The Daily Picayune, as well as the population at large in New Orleans, characterized the

Italian immigrant population in New Orleans as both infected with yellow fever and full of malice. At the beginning of the epidemic, White announced that he had traced the yellow fever infection back to both the Italian quarter of the city as well as mostly Italian patients.291 When each parish in Louisiana and regions of Mississippi began introducing quarantine measures, many barred the entry of people from the “infected” district, which implied people from the

Italian quarter.292 Other districts implemented policies aimed at keeping out “suspicious characters and Italians,” viewed as a threat to public health, yet did not go as far as to institute an actual quarantine; rather, they spoke to employers and specifically asked them not to employ any

Italians.293 These orders, whether physical quarantines or policies aimed at specifically excluding

290 Wailoo, Dying, 61. 291 “Sanitation and Isolation Plans.” 292 “Quarantine Lines Still Tighter Drawn,” New Orleans Daily Picayune, July 27, 1905. 293 “Complications in Quarantine Craze,” New Orleans Daily Picayune, July 26, 1905.

83 Italians from certain regions, were meant to target a population seen as the propagators of disease rather than people who actually had the disease.

Depictions of the Italians painted them in a negative and unfavorable light. In light of their illness and their inability to rid the disease from within their own community, Dr. Kohnke claimed that the Italians “had no concern for the welfare of the whole population,” and were

“secretive and suspicious.”294 Many other leading health authorities, such as those represented at the Cotton Exchange Conference, reflected this hostile attitude. At this meeting, representatives from two health boards, unions, hospitals, and medical and education societies called Italians with the fever unwilling to receive modern medicine and “obstreperous, refractory and uncontrollable.”295 These words were from leading yellow fever experts and city health officials, meaning bias at this levels meant it may seep through into all facets of life. In St. Bernard Parish, when law officials showed up at the home of some Sicilians who were “mean-tempered and refractory by nature,” the Italians turned them away out of fear.296 The paper quoted an Italian as saying, “Me shoots you, too, if you coma ina my house.”297 The inclusion of the Italian accent serves no practical purpose, and seems to be included solely to generate an image of the Italian as foreign and not American so as to stir up fervor against him.

Conditions were dire within the Italian community. As Kohnke correctly pointed out, most of the cases came from the Italian quarter of the city, but not for any reason directly attributed to that population.298 The Italian quarter had had some unreported cases, yet in the conditions in which the Italians lived, it was easy to miss the illness. Living in “close and crowded tenements,” according to Kohnke, led to the inability to regulate the barrels in which

294 “Inspection, Fumigation and Widest Education.” 295 “Government Asked to Complete Campaign,” New Orleans Daily Picayune, August 5, 1905. 296 “St. Bernard Officers Have Clash with Italians,” New Orleans Daily Picayune, July 29, 1905. 297 “St. Bernard Officers Have Clash with Italians.” 298 “The Record Shows Encouraging Signs,” New Orleans Daily Picayune, July 31, 1905.

84 the Italians stored their water.299 As Alan Kraut points out in Silent Travelers, Italians were often frightened and confused in this new land displaced from the rest of their family.300 They tried to recreate their communities from home by living in tightly concentrated neighborhoods, which pushed non-Italians away from these enclosed communities; the presence of illness within this nationality “made a dramatic impact upon the imagination of a public already shaken by the virulence of the epidemic…” 301 “Italian” therefore became synonymous with diseased, as communities throughout the U.S. witnessed the Italian community come down with diseases from yellow fever to polio in their close confines.

The establishment of an isolation hospital with an Italian physician at the helm helped to tackle the yellow fever problem, as patients were more willing to seek treatment and the staff particularly sought out Italian patients.302 Yet Italians still died senselessly; one Italian died of yellow fever in a ditch in St. Rose, Louisiana, just outside of New Orleans, showing the squalor in which the Italians suffered and the lack of access to basic healthcare supplies.303 The large

Italian community was demoralized by such large mortality rates, yet to have their deaths trivialized in the newspaper that qualified its reports of death by indicating that the victims were likely Italian and implying that the deaths were therefore slightly less significant.304

The most common response from the citizens of Louisiana and surrounding areas was to blame the Italians and to suggest that they were unwelcome. In a letter to the Daily Picayune, H.

L. Zander, a citizen of New Orleans, suggested that the Italians were the hosts of the disease and that it was their fault for getting sick.305 No one thought to ask why it was that the Italians were

299 “Inspection, Fumigation and Widest Education.” 300 Alan M. Kraut, Silent Travelers (New York: BasicBooks, 1994), 108. 301 Kraut, Silent Travelers, 109. 302 “Cooperation and Better System,” New Orleans Daily Picayune, August 1, 1905. 303 “Forty-Four Cases and Seven Deaths,” New Orleans Daily Picayune, August 25, 1905. 304 “No Great Spread of Mosquito Fever,” New Orleans Daily Picayune, August 1, 1905. 305 “City on the Right Track at Last,” New Orleans Daily Picayune, August 4, 1905.

85 getting sick instead of calling for extreme measures, such as a travel ban during the months of

June and August if they were to live with the other Italians in the current conditions.306 There has long been a strong relationship between medicine and anti-immigrant fervor, promoted largely by groups of nativists intent on preserving American customs and values, as Alan Kraut argues.307 Immigrants in the U.S. were judged based on appearance, and those who looked well and American were given approval, deemed fit to be neighbors and integrated into the American lifestyle.308 Disease therefore came to represent the immigrant population, as marginalization due to disease heaped onto the marginalization due to outsider status moved immigrants further from mainstream American status.309 For many nativists, sure of American superiority and the inherent inferiority of foreign populations, in order to have better health in the U.S. one needed to relinquish previous traditions and customs and assimilate into the American lifestyle.

The white American community was more nervous about the possibility of yellow fever trapped within the Italian community spreading to the non-Italian population. While some help was being provided to the Italian community, the article headlined “Fever Spreading Among

Non-Italians” demonstrates that the focus of the work was containing the disease to the specific

Italian quarter of the city.310 Therefore, the movement of Italians outside of their quarter was particularly troubling for many of the New Orleans and Louisiana residents; a large panic broke out when a significant number of Italians started moving from the infected area to Milneberg.311

When Warner was asked about the Italian immigration to Milneberg, he clearly recognized it as a complication, yet advocated the treatment of the Italian community in their quarter rather than

306 “Italian Immigrants,” New Orleans Daily Picayune, August 5, 1905. 307 Kraut, Silent Travelers, 2. 308 Ibid., 6. 309 Ibid., 3. 310 Non-Italian Fever “Fever Spreading Among Non-Italians,” New Orleans Daily Picayune, August 11, 1905. 311 “Cooperation and Better System.”

86 the forcible eviction of the new families.312 In St. James Parish, residents began calling the police as soon as an Italian family arrived, at which point the police would formally watch the family throughout the duration of their stay.313

While this particular strategy focused on the management of the Italian population once they arrived in a new place, the simple solution was to institute a quarantine that would prevent the Italians from showing up at all. Towards the beginning of the yellow fever scare at the end of

July, several towns both in Louisiana and surrounding states began implementing quarantines; while each town had different requirements for who was allowed to enter, a common theme was that residents of New Orleans were not allowed to enter the town and any freight cars had to be fumigated prior to arrival.314 Almost every day, new restrictions were printed in the Daily

Picayune, detailing what action each parish was taking. Italian rail passengers already in transit when the bans were announced were forced to stay overnight in train cars when towns denied them entry, and were eventually forced back to New Orleans.315

Despite all these negative components of the fight against Italians, some people did genuinely try to help the Italian immigrants recover from yellow fever, both from outside the

Italian community and from within the community. The organization in charge of helping the

Italian population, under the direction of a physician named Dr. Richardson and an investigator named Dr. Gessner, had thus far been trying to help the Italians, yet the most successful component of their campaign was the implementation of mosquito bars in the homes of Italians.

312 “Magnificent Work by Clean Up Clubs.” 313 “District Work to Include Everything,” New Orleans Daily Picayune, August 14, 1905. 314 “Complications in Quarantine Craze.” 315 “Quarantine Bars Put Up By Towns,” New Orleans Daily Picayune, July 28, 1905.

87 These were distributed free of charge, and given with the sole purpose of stopping the spread of yellow fever in that region of the city.316

The Italians also tried to organize within their own community to eradicate mosquitoes and thus yellow fever. A number of prominent Italians all gathered together to organize a fight against the mosquito so that they would stop getting yellow fever.317 They took matters into their own hands, as the ward organizations began to form and they were left out of the primary planning components, and set out to prevent the spread of the disease.318 The Italians were more than willing to contain the disease plaguing their own component of the population, working within their community when the ward organizations actively distanced themselves from interacting with the Italian population. Even when blamed for endangering the entire city, the

Italians continued to organize, motivated by the desire to prove that they were better than the image that the white Americans and newspapers had painted of them.319

Two Italian organizations, the League of Italian Societies and the Italian Relief Executive

Committee, both worked to assist the Italian populations struggling with disease. The League of

Italian Societies was especially helpful in translating health documents into Italian so the population could understand what was going on. The League also had its own well-funded treasury that went towards the implementation of anti-mosquito measures, in addition to their advocacy work attempting to spread the words of the city’s Board of Health.320 This work was invaluable in reaching many members of the Italian community that would not have otherwise had access to information regarding yellow fever. The Relief Committee went around the Italian quarter looking for cases of yellow fever, and when one was found it was reported. The

316 “Analysis of Figures Shows Improvement,” New Orleans Daily Picayune, August 3, 1905. 317 “Italian Colony Leaders at Work,” New Orleans Daily Picayune, July 28, 1905. 318 “Sanitary Work is Pushed Rapidly.” 319 “Fight Organized, Results Showing,” New Orleans Daily Picayune, July 27, 1905. 320 “Italian Colony Leaders at Work.”

88 Committee then provided assistance in any way possible, including providing physicians to tend to cases and providing monetary relief to businesses that were forced to shut down on account of yellow fever.321 The Italian Relief Committee was also able to open “a free kitchen for the distribution of rations and meals to any destitute individuals and families”322 Though the Italians distrusted authority, they were able to organize themselves to combat yellow fever with only some assistance from the central ward organizations. However, the Italians could not be blamed for their distrust of American public health; Kraut points out that Southern Italy, where most of the immigrants were from, was largely impoverished and run by individual families, representing a lifestyle where government played no role and any intervention from those outside of a family unit was viewed with contempt and hostility.323 The public health measures in the U.S. were therefore unwanted and unwarranted intrusions into daily life that were a far cry from the lifestyle they enjoyed back in Italy, manifesting the sense of distrust back home into similar sentiments towards American public health officials.

Italians had a distrust of hospitals as well, as prolonged periods of time concealing disease turned hospitals into the place to as a last resort, and many never returned.324 Charitable institutions were the worst place to go, as “nothing of worth was received in acts of altruism.”325

It was therefore hard for the Italian population to volunteer the information that they were ill; to do so was in violation of tradition, and going to the hospital was an affront to their culture.

Unfortunately, no one in New Orleans tried to understand Italian cultural beliefs, and everyone was content to impose the American lifestyle and assimilation on the immigrants out of their comfort zone. New Orleans felt that if Italians could not abandon their “otherness,” as Ring

321 “Italian Colony Supplies Plan for Convalescents,” New Orleans Daily Picayune, August 5, 1905. 322 “Italian Relief,” New Orleans Daily Picayune, August 11, 1905. 323 Kraut, Silent Travelers, 112. 324 Ibid., 118. 325 Ibid., 119.

89 describes, they were not Americans, and thus not part of the superior race worthy of yellow fever protections. The colonial nature of medicine, in establishing the worth of American lives over

Italian lives, was ever present in the Italian community.

The Mobilization of Women

Women played an incredibly important role in the implementation of the colonial campaign, yet did so in a way that reflected their acknowledged reliance on the black and Italian populations. Women were not given enough credit for their work to eradicate yellow fever in the newspaper; one of the main features of the newspaper was a column called “Woman’s World and Work,” a section of the newspaper where women could read all about issues that applied specifically to women in 1905 New Orleans. Only in the first edition following the announcement of yellow fever, on July 26, 1905, did women hear about the value of sanitation and the value of following all of the ordinances.326 They were advised “to procure copies of Dr.

Kohnke’s pamphlet… and distribute them among their friends and neighbors as a means of educating them in the very simple way of ridding our city of the stegomyia… which is now admitted by scientists and medical experts to be the cause of the spread of yellow fever.”327 This incredibly valuable information was listed first among all the things in the column, suggesting that it was of the utmost importance and specifically targeted towards all women who could help.

However, in few successive issues was the problem of yellow fever even mentioned. Just a few days later, women were being told through the same column how to dress beautifully and were told of some of the best recipes.328 Other large columns, meant to draw the eye, focused on proper attire and what was fashionable - a dichotomy persisted separating the work from the

326 “Woman’s World and Work,” New Orleans Daily Picayune, July 26, 1905. 327 “Woman’s World and Work.” 328 “Woman’s World and Work,” New Orleans Daily Picayune, July 29, 1905.

90 appearance women were expected to maintain.329 The columns may have had a negative impact on health as well; one particular column advises women to not report or even discuss when they feel under the weather, for doing so would “cast a shadow of gloom over other people” and the column implies the woman’s job is to keep a positive attitude rather than positively contribute to the yellow fever campaign.330 These matters, trivial compared to the growing epidemic in New

Orleans, may have served as a distraction and subtly encouraged women to busy themselves with matters of house-keeping rather than anti-mosquito work, leaving the more important matters to the men. Column after column, however, suggested that women should be worrying only about trivial matters, not about the mosquito or yellow fever problems.

An interesting dichotomy emerged in the publication of side-by-side articles in the

August 2nd Daily Picayune. On one half of the page, women were advised in the daily “Woman’s

World and Work” column how to dress fashionably for the summer weather and how to remove marks from a mahogany countertop.331 Immediately next to it, however, in a tiny section of the article detailing the work being done to help the population overcome yellow fever, was information about an educational session hosted by the Department of Home and Education of the Women’s League.332 These two paragraphs did not stand out as much to women, and were not featured prominently, indicating that this should not be the primary focus of women. Instead, women were expected to occupy themselves with issues pertaining to beauty and homemaking.

Despite the focus on other matters in the newspaper, many women took leading roles in the fight against yellow fever and mosquitoes. One women’s club, the Kingsley House Women’s

Club, started canvassing and going door-to-door, making way for the systematic campaign

329 “Fetching Fashion Features for New Orleans,” New Orleans Daily Picayune, July 30, 1905, 5. 330 “Woman’s World and Work,” New Orleans Daily Picayune, August 1, 1905. 331 “Woman’s World and Work,” New Orleans Daily Picayune, July 28, 1905. 332 “Rain Makes Work for the Volunteers,” New Orleans Daily Picayune, August 2, 1905.

91 against mosquitoes.333 Later, when fumigation occurred in city-wide campaigns, women helped by making sulphur available for as many people as possible as well as going house to house in order to help citizens fumigate.334 For the most part however, women’s organizations were kept separate from the main ward organizations, and instead asked women to focus on the education campaign instead. This work, while not physical labor, was intimately tied to the on-the-ground work in order to “disseminate information among the women regarding the mosquito extermination as a prevention of the fever.”335 The goal of this was to simultaneously provide enough information so that the women would be able to lead their own educational campaigns, which would then translate to actual work done by their husbands and sons.

The ERA club, or Equal Rights Association, also became involved with the goal of integrating women into the most important work being done, which was educational instruction.336 Though Warner acknowledged the work and approved it, he did not actively seek the help of women early on in the epidemic. The ERA club began planning their efforts to help

New Orleans, and released a statement reading: “That the ERA Club feels that everything possible is being done by the proper authorities to stamp out the fever, and offers its services to said authorities to assist them in any way possible, and stands ready to hold parlor meetings in every ward to fully explain the necessity for exterminating the only means of transmitting the fever, namely, the mosquito.”337 The ERA club was echoed by the Business Women’s League, who also offered any assistance, yet Warner only asked them to “show their sympathy” and not take on any extra roles outside of the missionary work regarding cisterns and oiling.338 Warner

333 “Clean Up Clubs Still Forming,” 7. 334 “Patriotic Women Will Aid Fumigation Cause,” New Orleans Daily Picayune, August 30, 1905; “Fumigation Now the Vital Duty,” New Orleans Daily Picayune, August 30, 1905. 335 “Magnificent Work by Clean Up Clubs.” 336 “Sanitary Work is Pushed Rapidly.” 337 “Cooperation and Better System.” 338 Ibid.

92 seemed to be placating the women rather than capitalizing on a well-managed organization, accepting help without making the most of an opportunity to involve people dedicated to the anti-mosquito work.

Women, as the architects of the educational campaign against yellow fever, joined what

Nancy Tomes, in The Gospel of Germs, calls the domestic science movement. This movement centered on the role of the woman in the campaign, stating that the home was the site of preventing infectious diseases and was founded by women, led by women, and directed at women.339 While still relegating women to a role in the house, this movement capitalized on the

“natural” instincts of women to be in the home to make them better citizens, while simultaneously motivating them to serve as an educational tool for less-educated women.340

However, as Tomes points out, women were still taught that their primary role was not to learn about the diseases plaguing society; instead, they should learn proper hygiene for the sake of good housekeeping.341 Women in New Orleans were active members of this movement, running a campaign that encouraged education, kept the home safe, and was run by, for, and directed at women.

While effectively fighting against yellow fever, women simultaneously broke the mold of the domestic science movement, which encouraged a more passive approach that focused mostly on women’s roles in the home. Women in New Orleans, conversely, actively organized an educational campaign not just for other women in the context of housekeeping, but also for the

Italian and black communities in order to help each population fight yellow fever collectively.

The Women’s League, which sponsored a series of talks, hosted one specifically for the Italian community. The speaker, the respected Dr. Formento, addressed the Italians directly and helped

339 Nancy Tomes, The Gospel of Germs (Cambridge: Harvard University Press, 1998), 136. 340 Tomes, Gospel,137-138. 341 Ibid., 142.

93 convey the importance of both properly reporting cases of yellow fever and of following city ordinances regarding cisterns and oiling.342 The Women’s League, instead of demonizing the

Italian immigrant community, reached out to them to provide educational materials so that everyone could fight mosquitoes together; this was much more than what ward organizations and health officers did on their own.

Women also played a crucial role in reaching out to the black community so that they would be able to assist in fighting mosquitoes any way possible. The Women’s League partnered with Kohnke to provide a series of lectures, many of which, approximately every other day at the least, were deliberately held in “colored” churches to maximize exposure for the black community.343 The women’s league continued to reach out to black churches to schedule meetings, and advertisements in the Daily Picayune indicate that the Women’s League pretty much commandeered the scheduling of Warner and Kohnke’s illustrated lecture series.344

Women controlled the distribution of information, yet all the credit for the speeches went to the male doctors heading the health committees rather than the people coordinating the lectures.

Women continued to arrange for large meeting, setting the record for “the largest meeting of the negroes of the city which has been held since the campaign of the mosquito education began…”345 In seeking out both white and black officials who could give speeches, the Women’s

League made sure that not only was all of the right information being conveyed, but it did not appear as though the government was giving mandates to what they considered an inferior population that had already had to organize their own ward organizations. Kohnke, in this scenario, came out to discuss how the black population and white population were equal,

342 “Affidavits Under the Screening Laws,” 5. 343 “Woman’s League,” New Orleans Daily Picayune, August 20, 1905. 344 “Millions of Stegomyia Mosquitoes Killed Sunday.” 345 “Cistern Screening Made Effective,” New Orleans Daily Picayune, August 23, 1905.

94 especially in mortality due to yellow fever. This message of equality, regardless of whether it was supported by personal experience, resonated with the black community and inspired efforts to fight mosquitoes. Despite this positive work, women were part of the colonial campaign; they promoted the implementation of the reforms from Cuba and Panama in everyday life, but reached out to the black and Italian minority populations in New Orleans, encouraging all of them in a respectful way to fight yellow fever together. Women, almost like the Americans in

Cuba, realized that yellow fever could not be defeated without the cooperation of each population faction within the city, and thus did everything in their power to cooperate with and educate the black population and the Italians.

Conclusion

Yellow fever had long been prevalent in New Orleans, yet the development of new mosquito eradication techniques and disease management techniques in Cuba and Panama caused New Orleans to utilize them as well. The incorporation of these colonial campaigns back in the U.S. South recognized the tie between the South’s tropicality and the tropicality of both

Cuba and Panama. Therefore, like in both of these locations, in order to successfully regenerate

American superiority and white superiority, these colonial tactics had to be incorporated into the campaign against yellow fever back in New Orleans. Anti-mosquito efforts, such as government ordinances, oiling, screening, and fumigation efforts, reflected what had worked abroad and what public health officials determined could work back in the U.S. However, women, black people, and Italian immigrants all had different responses to their exclusion.

The black community in New Orleans had to form their own ward organizations that worked directly under the white ward organizations. Though they offered to help anti-mosquito

95 efforts multiple times, they were turned away and told to wait while the more competent ward organizations helped throughout the city and racialized language present in everyday life devalued their work. black people were seen as incompetent and a cause of disease and filth rather than as another population affected by disease, evidence that their lives were deemed as less valuable than the lives of the white population. Italians living in New Orleans were presented as filthy and incapable of managing the disease on their own; thus, other citizens in

New Orleans and many Louisiana parishes saw them as responsible for the outbreak and subjected them quarantine measures across the state. Their refusal to assimilate immediately cast them as outsiders, unworthy of protection and members of an inferior group not inherently

American.

Finally, women, though not forced to form separate ward organizations, had to organize to keep the households clean and do work that no other group would do in a reflection of the domestic science movement. Different women’s leagues reached out to the black and Italian communities to coordinate lectures and talks aimed at education and motivated their husbands to join ward organizations. These women did more to help the other minority communities than most of the members of the ward organization did. While they still worked with of the white

American male campaign, women realized that the success of the campaign relied on cooperation with minority groups and spearheaded the effort to work with the black and Italian communities. By the end of the 1905 epidemic, it was clear that the colonialist movements of

Panama and Cuba had become entrenched in the New Orleans campaign against yellow fever.

96 Conclusion

The U.S. rose to the height of power in the early 1900s, joining the ranks of the elite world powers that held colonies in various regions of the world. As Figure 8 shows, American territory stretched from the Eastern Caribbean all the way to the Philippines on the other side of the Pacific Ocean.346 Like the European powers that held significant chunks of territory on the

African continent and throughout southern Asia, the U.S. relied upon its colonies to supply economic and political success both on the domestic and international levels.347 The establishment of these colonies demonstrated that the U.S. was ready to grow far larger than it had previously, yet the U.S. needed to figure out how to run a colonial empire. In the end, the U.S. ended up applying the lessons learned from its colonial ventures back in Map showing many countries’ territorial possessions in 1910 the U.S., creating a colonial system of medicine in New Orleans.

Cuba, which had been under Spanish control, except for a brief period of time during which the British were in charge, since the sixteenth century, was the site of the first Caribbean health project. The Americans also had a clear vested interest in Cuban economics, as over one million tons of goods, specifically sugar cane and tobacco, came to the U.S. from Havana each year.348 In order to successfully control these industries, the U.S. needed to keep a grip on the island and the only way to do that was to control the population. Eliminating yellow fever in

Cuba also meant the safeguarding of the southern American coast, a gargantuan feat should it be

346 “Expansion and Empire, 1867-1914,” LearnNC, accessed April 7, 2017, http://www.learnnc.org/lp/editions/nchist-newsouth/5488. 347 “Expansion and Empire.” 348 Hill, Cuba and Porto Rico, 87.

97 accomplished.349 When sanitation proved ineffective in managing the disease, the U.S. turned toward the Cuban population for help, and conclusively proved that Cuban physician Carlos

Finlay’s theory that the Stegomyia mosquito was the sole vector of yellow fever.350 The implementation of reforms in Havana had heavy Cuban influence, as a majority of the laborers, as well as their supervisors, were native Cubans.351 This did not diminish the fact that the U.S.

Sanitary Department, in control of the yellow fever eradication efforts in Havana, actively prioritized the Americans’ health over the Cubans’ health, and mandated the inclusion of the

Platt Amendment to the Cuban constitution to protect American sanitary interests.352 While the

Sanitary Department ensured positive relations with the Cuban population, the U.S. very clearly acted in the interests of and prioritized the lives of the American population over the Cuban population.

While the project Cuba demonstrated how the Americans relied on support from the

Cuban population to maintain its colonialist, the process of building the canal in Panama did not reflect such reliance or a respect for the native and laboring populations. When the U.S. arrived in Panama in 1904, it immediately began importing laborers from the West Indies, specifically

Jamaica and Barbados, to perform manual labor deemed low enough for “the Negro.”353 By prioritizing American lives, the U.S. demonstrated that it was not concerned with the human cost of the project, but rather the economic cost and the ability to reinforce the disparities present in the U.S. through the perpetuation of Jim Crow era standards and policies.354 The U.S. spent significantly lower sums of money trying to protect both the native and West Indian populations,

349 Gorgas and Hendrick, William Crawford Gorgas, 70. 350 Gorgas, Sanitation in Panama, 32-34. 351 Espinosa, Epidemic Invasions, 99. 352 Espinosa, Epidemic Invasions. 83. 353 Isthmian Canal Commission. Report of the Isthmian Canal Commission. Washington DC: Government Printing Office, 1904. P. 114. 354 Personnel for Transfer. Report. From Library of Congress: William C. Gorgas Papers. Accessed August 20, 2016.

98 leaving them prone to yellow fever and malaria infections that persisted far too long.355 In healthcare settings too, the U.S. once more favored its own population over the lives of the native and black workers, actively providing better healthcare to the white Americans.356 In these conditions, white Americans were able to see that their lives truly mattered to the U.S. government, while the native Panamanians and West Indian workers saw that theirs did not.

These projects abroad proved to be a test run for the U.S. in implementing colonial medicine, because when the city of New Orleans had an outbreak of yellow fever in 1905, the

U.S. implemented many of the reforms and carried over many techniques from their two previous colonial health ventures. The South, according to Natalie Ring, was its own foreign land within the U.S., a land that seemed distant from the rest of the country.357 The tropical pathology, due to diseases that frequently appeared in other tropical countries also appearing in the South, connected it with the lands of other colonial locations and thus designated the South as a region in need of “imperial solutions.”358 It is therefore necessary to examine the public health campaign against yellow fever in New Orleans through a colonial lens. The U.S. implemented its own colonial health regimen in New Orleans; tactics from Panama and Cuba were incorporated into New Orleans’ response to the disease. Pamphlets designed by the Chief

Surgeon in Havana circulated throughout the southern United States, allowing physicians to learn directly from the source about mosquito eradication techniques and how to deal with yellow fever effectively.359 Guiteras, one of the Cuban physicians who played an instrumental role in the treatment of yellow fever in Havana, came to New Orleans to assist with the ongoing

355 Isthmian Canal Commission. Statement Showing Cost of Different Kinds of Work Done by the Sanitary Service of the Canal Zone. Report. From Library of Congress: William C. Gorgas Papers. Accessed August 20, 2016. 356 Harry A. Franck, Zone Policeman 88 (New York: The Century Company, 1913), 49, accessed from Senior, Dying, 163. 357 Ring, “Imperial Geographies,” 299. 358 Ring, “Imperial Geographies,” 298-300. 359 Gorgas, William C. Gorgas to Havard. Letter. From Library of Congress: William C. Gorgas Papers. Accessed January 9, 2017, 4.

99 yellow fever epidemic, playing a key role in helping coordinate relief efforts and city-wide plans.360 New Orleans utilized Havanese mosquito eradication techniques, such as fumigating, oiling, and screening, while the newspapers spread information about what was happening in both Cuba and Panama so the city stayed knowledgeable about the eradication efforts abroad.361

Minority groups in particular were affected by the imposition of colonial public health measures. The black population, though entirely willing to help the ward organizations fight yellow fever, was told to report directly to the predominantly-white ward organizations, serving in a subservient manner that delegitimized the black contribution to mosquito eradication.362 The black population was not given the chance to assist as equal members of the ward organizations, and had to organize their own Colored Sanitary Association to address their health needs.363

They were seen as a menace to public health rather than as another population victimized by disease, and reforms were targeted at keeping the inherent filth of black people away. The health of the black population was neglected, indicating Americans prioritized the lives of white

Americans over black Americans.

The Italian population, particularly affected by yellow fever, was demonized in the press and reviled by public health officials such as Kohnke for not helping eradication efforts.364 The

Italians had a severe distrust of medicine, due to what were likely years of discrimination by authorities, and the rest of the population was scared of the Italians and reported on their movements within the city and all of Louisiana, leading Italians to have to coordinate their own campaign.365 As Kraut notes in Silent Travelers, the Italian hesitance to relinquish their traditions

360 “The Mosquito Campaign,” p. 4. 361 “Mosquito Theory and Its Triumph.” 362 “Magnificent Work by Clean Up Clubs.” 363 “Affidavits Under the Screening Laws,” 5. 364 “Inspection, Fumigation and Widest Education.” 365 “Cooperation and Better System.”

100 and customs and assimilate into American culture made them distant and unknown, a fear to the population and not worthy of protection.366 As outsiders, they were deemed not worthy of

American protections in a clear statement that their lives were not as important as American lives.

Women ended up helping both of these communities as part of the “domestic science” movement, which prioritized their role in educational campaigns and making the home mosquito-free.367 The Women’s League partnered with Kohnke to provide a series of lectures, many of which, approximately every other day at the least, were deliberately held in “colored” churches to maximize exposure for the black community.368 They also hosted talks specifically for the Italian community to focus on active reporting and following yellow fever ordinances.369

Women became the primary vehicle for working with the minority groups on behalf of the colonial campaign, with a benevolence that recognized the importance minority groups played in eliminating the mosquito.

It is impossible to examine New Orleans outside the context of colonial medicine; with the ties through the media and through direct influence, New Orleans was intimately related to both health projects abroad. To examine New Orleans as directly tied to Panama and Cuba is to understand how similar these projects were. Colonialism is fundamentally based in the exercise of power of an occupying population over an already established one, and, in the case of disease, of the valuation of the colonizing population’s health as more valuable than that of the colonized population. The treatment of the minority populations in New Orleans reaffirmed that like in

Cuba and Panama, the government primarily cared about the protection of white American lives,

366 Kraut, Silent Travelers, 3. 367 “General Fumigation Programme for Sunday,” 7. 368 “Woman’s League.” 369 “Affidavits Under the Screening Laws,” 5.

101 while minority populations, which in New Orleans were the black and Italian communities, were inferior and subject to the control of the white population.

Implications

There has been a significant amount of secondary literature examining the implications of

American colonial work in both Cuba and Panama, as both nations have not forgotten the presence of the American colonial projects. The U.S. only gave the Panama Canal back to

Panama on December 31, 1999, ending almost a century of occupation.370 The Los Angeles

Times highlighted the long-standing American colonialism, also claiming “it left influences that have determined the demographics, economy, and social structure of Panama.”371 Only in the last

17 years has Panama started to make revenue off a canal that has cut its land in two since 1914, and the presence of American colonialism started to wane ever so slightly. In Cuba, the anti-

American sentiment that has been present and affected politics and governance began with

American occupation of the island. In a speech to the United Nations in 1960, Cuban leader Fidel

Castro, whose brother Raul is now the President of Cuba, traced American intervention back to its occupation of the island at the turn of the twentieth century and the imposition of the Platt

Amendment.372 Castro proclaimed that Cuba was now ruled by the people, a clear message that the overbearing colonial rule by the U.S. had left its mark on the country and had led it to where it was at that point in time.373 While the U.S. and Cuba have come a long way from the

370 Juanita Darling, “Panama Canal handover ends decades of U.S. presence that began with break from Colombia,” Los Angeles Times, January 1, 2000, accessed April 7, 2017, http://www.latimes.com/world/mexico-americas/la-fg- panama-canal-hand-over-20160622-snap-story.html 371 Darling, “Panama Canal handover.” 372 “Dr. Fidel Castro Denounces Imperialism and Colonialism at United Nations” (speech, United Nations, September 26, 1960), lanic, http://lanic.utexas.edu/project/castro/db/1960/19600926.html. 373 Ibid.

102 relationship the two had in the early 1960s, the strain and ramifications of the colonial administration and health projects are still felt to this day.

There is no significant body of work examining the effects of American sanitary control in New Orleans following 1905. Craig Colten, a professor at Louisiana State University, wrote in

“Basin Street Blues: drainage and environmental equity in New Orleans, 1890-1930” about the impact of Jim Crow policies on New Orleans in its fight against sewage and disease, specifically focusing on lingering health disparities between different racial groups.374 Colten’s literature, while informative, entirely ignores the yellow fever epidemic; though it may have been out of the scope of what he set out to write, he failed to even mention the last major outbreak of this mosquito-borne illness, a major component of healthcare in the timeframe of his article. Other histories of New Orleans, while recognizing the importance of the 1905 yellow fever epidemic, have traditionally sorted this epidemic into a previous era, grouping all of yellow fever together and limiting the discussion of the impacts of this anti-mosquito campaign on healthcare in the city today.375 Any future research could look at the ties to New Orleans throughout the twentieth century, and the implications of a campaign entrenched in colonialism on both access to healthcare in New Orleans and socioeconomic differences today.

But what about the lasting effects of the 1905 yellow fever campaign throughout the

South? Guiteras, who went on to work in Pensacola, Florida to help them with a different, albeit significantly smaller, yellow fever epidemic after New Orleans, designated New Orleans as the model for future yellow fever work in the U.S.376 It is therefore logical to assume that the work conducted in New Orleans was applied to other health projects as well, especially if Guiteras was

374 Colten, Craig E., “Basin Street blues: drainage and environmental equity in New Orleans, 1890-1930,” Journal of Historical Geography 2 (2002): 245. 375 Carrigan, Saffron Scourge, 1. 376 “Dr. Juan Guiteras Points to New Orleans as a Model.”

103 bringing his advice to other southern cities. Yet the Pensacola epidemic has not been studied extensively; when I first started planning this “An American Colonialism,” I considered studying

Pensacola, yet the lack of secondary literature on the city made any significant research difficult.

Unfortunately, extending the application of yellow fever work throughout the rest of the South would have been too extensive, but looking at other small epidemics of yellow fever throughout the South, and persistent malaria outbreaks, would help elucidate the scope of colonial influence on mosquito-borne illness.

Moving toward present day, a colonial mindset could help guide our examination of recent health campaigns. The world is much different today than it was in 1905 - for example, the creation of major international organizations holding the countries of the world together is a post-1905 notion, while international health programs are relatively new as well. Therefore, it is often these groups, rather than individual powerful nations, that coordinate global health relief programs and provide the basic health resources for under-developed countries. The World

Health Organization (WHO) is one of several organizations leading the fight against Zika, a mosquito-borne illness present in North America, South America, and Oceania that shares striking similarities with yellow fever, such as the regions infected and the mosquito that carries the disease. In developing its Strategic Response Plan, the WHO made sure to note that it would partner with federal, state, and local governments while simultaneously empowering the civilian population to both support equal access to health care and implement mosquito control measures.377 International public health organizations now focus on the health of the population on the ground, trying to protect all people regardless of nationality. Now, the focus is, as it should have always been, the health and well being of each individual life.

377 World Health Organization, Zika Strategic Response Plan. 1. Geneva: World Health Organization, 2016. http://www.who.int/emergencies/zika-virus/response/en/

104 Could this mindset as individual countries coordinate responses? In a 2016 opinion article, Michael Gerson and Raj Shah argue that the U.S. needs to play a more active role in Zika prevention, justifying this intervention by claiming that Zika could bring “unnecessary tragedy to thousands of families and justified fear to American shores.”378 This new yet all-too-familiar mindset is dangerous, and we risk repeating the mistakes our own public health officials from the early 1900s. As soon as we begin intervening in international health problems out of fear for

American lives rather than humanitarian purposes, we risk letting our own interests and our own biases influence our mode of response. We must always keep in mind our past colonial campaigns that had immeasurable effects on the lives of the colonized populations; should we forget, we risk instigating new campaigns with mistakes of old.

378 Michael Gerson and Raj Shah, “This is how the U.S. must lead the fight against Zika,” The Washington Post, July 17, 2016, accessed April 7, 2017, https://www.washingtonpost.com/opinions/global-opinions/this-is-how-the- us-must-lead-the-fight-against-zika/2016/07/17/d2ef5314-485a-11e6-bdb9- 701687974517_story.html?utm_term=.91006d4bba99.

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