Science, Politics, and Public Health in the Building of the Panama Canal

Abstract

Public health officials rely on science to understand the needs of the public and how to best protect the public’s health. At the same time, politics and plays an essential role in determining what resources will be devoted to public health. Unfortunately, public health officials often focus exclusively on the scientific and medical aspects of their work, ignoring the practical political and legal concerns necessary to achieve their goals.

This relationship between science and politics can be seen especially clearly in the United States’ effort to build the Panama Canal - and the struggle with malaria and yellow fever that accompanied effort. Public health and sanitation officials assigned to the project, led by Dr. William Crawford Gorgas, understood the science behind these diseases, and they understood at a practical level what needed to be done to prevent the spread of the diseases.

Unfortunately, for the first year of American presence in Panama, little progress was made. Public health officials were unable to get the resources they needed to prevent these diseases from spreading.

This article examines why, in spite of public health officials’ understanding of the science behind yellow fever and malaria, they were unable to bring about the necessary changes to fight the diseases. These reasons include (1) the fact that many of the engineering and political officials on whom the public health workers relied failed to understand the scientific basis of their work, (2) the low priority that public health and sanitation were given in the institutional structure of the enterprise, (3) the unwieldy bureaucratic structure of the enterprise, and (4) a lack of political ability on the part of public health officials.

After approximately one year of failure, Dr. Gorgas and his team were finally able to get the support that they needed to carry out their projects. Some of the changes that led to this success include (1) a general reorganization of the canal-building enterprise, making it more efficient and less bureaucratic, and (2) increased advocacy for public health to leaders who were in a position to make changes.

Today, as then, public health is often given low priority. Understanding the factors that led to the initial failure and to the eventual success of public health officials in Panama can help current officials to better use to tools of government to work toward their goals.