This was a lecture that i delivered some years ago at a local university for 20th Century America:

In the late 19^th century and early 20^th Century America was standing on the edge of becoming a World Power. War with Spain and American expansion into the Gulf of Mexico and Pacific Ocean was driven by the Roosevelt Corollary to the Monroe Doctrine, a belief in Manifest Destiny, and, in a historical twist of fate, a plasmodium and a flavivirus epidemic. The Malaria and Yellow Fever that stopped the French from building the Panama Canal were in turn stopped by the Americans who finished the projects and controlled the Canal Zone for 70 plus years thereby controlling rapid access between the Atlantic and Pacific Oceans.

President T Roosevelt was an Imperialist to the core. He saw American foreign policy as activist. He viewed the World in two ways. The first was the civilized world. These were industrial and were predominantly white. Then there was the uncivilized world. These produced raw materials and were non-white, Latin, or Slavic. Japan was considered civilized because they were industrial. The civilized world had the right to intervene with the uncivilized nations in order to preserve order and stability.

This attitude can be seen in the Roosevelt Corollary to the Monroe Doctrine. This states that America had the right and the duty to not only oppose European intervention in the American hemisphere (aka the American Lake) but to also intervene when a country proved unable to maintain order and national sovereignty on their own.

This came out of the German, English, and Italian blockade on Venezuela in 1902. Venezuela was having problems paying back international loans so they sent their navies. The US Navy convinced the Europeans to leave. The Corollary was used again and again as justification for action. However, the most creative use of the Roosevelt Corollary was over the Panama Canal.

The geography of Central America combined with the time it takes to sail around South America to get from the Atlantic to the Pacific made an all water canal on the Isthmus of Panama the obvious choice to Charles V, HRE and King of Spain as early as 1534. He ordered a survey of the area so that perhaps a canal could be built so that the Spanish ships could bet from Spain to Peru more rapidly. This would give the Spanish a great tactical and military advantage over the Portuguese.

Other attempts and surveys continued until the French began a serious dig in 1880. The plan was driven by the success of the Suez Canal. The French had control of a strip of land on the Isthmus of Panama. Unfortunately for the French, Panama is a jungle. The Suez canal is in a desert. The Panamanian jungle diseases would stop the French in their tracks.

The French did not have an adequate understanding of disease vectors, nor did they study the geography and hydrology of the area enough to ensure success. Malaria, Yellow Fever, and cave-ins form rain hampered and eventually halted French operations in Panama. The hos[pitals themselves were aiding the diseases. The French had the posts of the be sitting in bowls of water to keep the crawling insects away from the patients. These bowls of water were the perfect breeding ground for the mosquitos that carry Yellow Fever and Malaria. The French abandoned Panama in 1893 leaving 22,000 dead workers, almost all of the deaths were from Malaria and Yellow Fever..

“The basic elements of the life cycle are the same for all Plasmodium sp. transmission begins when a female Anopheles mosquito feeds on a person with malaria and ingests blood containing gametocytes. During the following 1 to 2 wk, gametocytes inside the mosquito reproduce sexually and produce infective sporozoites. When the mosquito feeds on another human, sporozoites are inoculated and quickly reach the liver and infect hepatocytes. The parasites mature into tissue schizonts within hepatocytes. Each schizont produces 10,000 to 30,000 merozoites, which are released into the bloodstream 1 to 3 wk later when the hepatocyte ruptures. Each merozoite can invade an RBC and there transform into a trophozoite. Trophozoites grow and develop into erythrocyte schizonts; schizonts produce further merozoites, which 48 to 72 h later rupture the RBC and are released in plasma. These merozoites then rapidly invade new RBCs, repeating the cycle. Some trophozoites develop into gametocytes, which are ingested by an Anopheles mosquito. They undergo sexual union in the gut of the mosquito, develop into oocysts, and release infective sporozoites, which migrate to the salivary glands. Manifestations common to all forms of malaria include fever and rigor—the malarial paroxysm, anemia, jaundice, splenomegaly, epatomegaly The malarial paroxysm coincides with release of merozoites from ruptured RBCs. The classic paroxysm starts with malaise, abrupt chills and fever rising to 39 to 41° C, rapid and thready pulse, polyuria, headache, myalgia, and nausea. After 2 to 6 h, fever falls, and profuse sweating occurs for 2 to 3 h, followed by extreme fatigue. Fever is often hectic at the start of infection. In established infections, malarial paroxysms typically occur about every 2 to 3 days depending on the species; intervals are not rigid. Splenomegaly usually becomes palpable by the end of the first week of clinical disease but may not occur with P. falciparum. The enlarged spleen is soft and prone to traumatic rupture. Splenomegaly may decrease with recurrent attacks of malaria as functional immunity develops. After many bouts, the spleen may become fibrotic and firm or, in some patients, becomes massively enlarged (tropical splenomegaly). Hepatomegaly usually accompanies splenomegaly”¹.

“Yellow fever is a mosquito-borne flavivirus infection endemic in tropical South America and sub-Saharan Africa. Symptoms may include sudden onset of fever, relative bradycardia, headache, and, if severe, jaundice, hemorrhage, and multiple organ failure. Diagnosis is with viral culture and serologic tests. Treatment is supportive. Prevention involves vaccination and mosquito control. Infection ranges from asymptomatic (in 5 to 50% of cases) to a hemorrhagic fever with 50% mortality. Incubation lasts 3 to 6 days. Onset is sudden, with fever of 39 to 40° C, chills, headache, dizziness, and myalgias. The pulse is usually rapid initially but, by the 2nd day, becomes slow for the degree of fever (Faget’s sign). The face is flushed, and the eyes are injected. Nausea, vomiting, constipation, severe prostration, restlessness, and irritability are common. Mild disease may resolve after 1 to 3 days. However, in moderate or severe cases, the fever falls suddenly 2 to 5 days after onset, and a remission of several hours or days ensues. The fever recurs, but the pulse remains slow. Jaundice, extreme albuminuria, and epigastric tenderness with hematemesis often occur together after 5 days of illness. There may be oliguria, petechiae, mucosal hemorrhages, confusion, and apathy. Disease may last > 1 wk with rapid recovery and no sequelae. In the most severe form (called malignant yellow fever), delirium, intractable hiccups, seizures, coma, and multiple organ failure may occur terminally. During recovery, bacterial super-infections, particularly pneumonia, can occur².”

In 1898, 5 years after the French quit Panama, with the United States and Spain on the brink of war, the Oregon — the U.S. Navy’s first true battleship — took 67 days to rush back from San Francisco to the Caribbean. That event stuck in the mind of Theodore Roosevelt. When William McKinley’s assassination made TR president in 1901, he vowed to build a canal — not for commerce, like the French, but to ensure that U.S. naval power could dominate two oceans. He favored Nicaragua at first but abruptly changed his mind to Colombian-owned Panama when the French made it known they were willing to unload their partly dug ditch at a bargain price of $40 million. A skeptical Congress was eventually swayed with a high-powered lobbying campaign by France’s former chief engineer Philippe Bunau-Varilla, who’d made it his mission to see the project completed. At the last moment, Colombia nearly threw a wrench in the deal by insisting that the United States pay for the right to dig on Colombian soil, but the White House and the Panama Canal lobby were not to be stopped. The Columbian diplomats in Washington under great pressure agreed to a $10 million dollar payment and an annual rent of $250,000. The Columbian Senate refused to ratify this agreement. They wanted $20 million plus. However, at the time the isthmus was part of Columbia. What the Columbians did not realize was that they were on the uncivilized list and the Roosevelt Corollary would soon be visited upon their country.

“We were dealing with a government of irresponsible bandits,” Roosevelt stormed. “I was prepared to . . . at once occupy the Isthmus anyhow, and proceed to dig the canal. But I deemed it likely that there would be a revolution in Panama soon.”

Teddy was right. The chief engineer of the New Panama Canal Company, Philippe Bunau-Varilla organized a local revolt in November 1903. Roosevelt immediately sent the battleship Nashville and a detachment of marines to Panama to support the new government. 1 Person and one donkey were killed in the ‘prevention’. The new, independent nation of Panama quickly gave the United States the go-ahead. The rebels gladly accepted Roosevelt’s $10 million offer, and they gave the United States complete control of a ten-mile wide canal zone. The Americans, however, could only use a portion of what the French had excavated. Over 48,000,000 cubic yards of earth moved through French back-breaking labor was useless as the Americans began to dig.

At first it was to be built in the lowlands in Nicaragua, this would cost $109 million. This would have prevented the need for a lock system but would require a much longer channel. The French had attempted to dig through Panama some years earlier but yellow fever and malaria proved too much for the laborers, the French sold the holdings for $40 million. To fix that situation, TR sent down Dr. William Gorgas to drain the swamps thereby getting rid of the mosquitoes; the mosquitoes Aedes aegypti and Anopheles are the carriers of yellow fever and malaria respectively.

In 1900, U.S. Army tropical disease expert Walter Reed proved what previous scientists had suspected — that the fever was transmitted not by poor sanitation or contact with infected people, but by certain species of female mosquitoes. The following year, in fever-ridden Havana, a Reed protégé named Col. William C. Gorgas staged a successful campaign to eradicate the mosquitoes; yellow fever disappeared.

Gorgas was assigned to Panama but ran into stiff resistance at first from budget-conscious bureaucrats — who thought, incredibly, that he wanted tons of old newspapers, which he needed to seal windows for fumigating, as reading material for fever patients. Finally, in April 1905, after the fever outbreak had killed 47 workers, Gorgas got the go-ahead and funding he needed. Over the next few months, he installed $90,000 worth of wire screens on windows and sent teams of health workers on a door-to-door search for mosquitoes and their eggs. They fumigated houses — several times if necessary — and enforced a ban on the old Panamanian custom of keeping water indoors in uncovered containers. They traced the movements of victims to determine where they’d been infected. By December, yellow fever had vanished from the Canal Zone And Malaria, as well as other tropical diseases, were greatly reduced.

The American canal builders started out almost as badly as the French: the first wave of laborers had to drive railroad spikes with axes because they hadn’t been given sledgehammers. The Roosevelt administration appointed the illustrious John Findley Wallace as head engineer. This former president of the American Society of Civil Engineers was accustomed to building low-stress projects in urban areas, and he left after just a year to take a job in the private sector.

His successor, John Stevens, lacked a college degree, but he was a rough-hewn outdoorsman who’d extended the Great Northern Railroad through the Rockies, using a mountain pass he himself had discovered. Stevens stopped digging and spent two years methodically building the infrastructure needed to stage the massive project — everything from sewers for Panama’s two cities to a bakery to supply his workers with bread. By early 1907, when Stevens was ready to resume digging, the effort was so well-organized that before long the workers were excavating 500,000 cubic yards of soil a month; more than double the French’s best performance. Stevens astutely realized that a sea-level canal would be too difficult, and convinced Roosevelt to opt for a canal with locks instead.

In 1907, chief engineer Stevens, tough as he was, began to crack under the pressure; he wrote a stinging letter to President Roosevelt accusing bureaucrats and politicians of stabbing him in the back and complaining that, “to me, the canal is only a big ditch.” Roosevelt quickly replaced him with Army officer Col. George W. Goethals, who led the project through its most arduous stages, including the excavation of the mountainous Culebra Cut. During this stage of excavation workers had to brave massive landslides that sometimes set work back for months at a time.

Even so, Goethals took the efficient system that Stevens had built and pushed it to ever-astonishing levels of performance. From 1907 to 1914, Goethals’ work force excavated nearly 215,000,000 cubic yards of earth, nearly three times what the French had accomplished. Goethals also supervised the construction of the locks advocated by Stevens, the biggest and most technologically advanced devices of their kind ever built. In Aug

August 1914, a cement boat, the Cristobal, made the first actual passage from the Atlantic to the Pacific, with Philippe Bunau-Varilla onboard. Two weeks later, on August 15, a ship named Ancon sailed on the first official interocean transit through the Panama Canal. Estimated height of earth excavated if it were piled: one city block wide by 19 miles high

“The canal,” Roosevelt said, “was by far the most important action I took in foreign affairs during the time I was President. When nobody could or would exercise efficient authority, I exercised it.”

Roosevelt was true to his word. He said he would no accept a third term, he would probably have not one the nomination because of the way he completely alienated the Conservatives in his party. So, in true TR form he went to Africa to go big game hunting.

As explained above, the path of history can be changed by the smallest of organisms. Had the French been able to control the Yellow Fever and Malaria mosquito vectors, they would have had control over the Panama Canal. The United States would not have had the opportunity to expand as rapidly as they did without the Canal. Eventually, the situation between the US, France, and Panama would have probably come to violence over use and control of the Canal. For instance, a Vichy or German controlled Canal during WW2 would have been totally unacceptable; invasion would be necessary. In this case, tropical disease guides the hand of history.