20
the work of abolishing and screening cisterns which followed the
introduction of the water-supply, but at the time of my visit many
favourable breeding places for the species still remained, and one
cannot but regard with anxiety the cessation of the special mea-
sures. As a rule the houses in the better parts of the city are-
carefully screened, but this is not the rule in the areas where an
epidemic is most likely to occur, and at the hotel where I stayed
the manner of screening was not such as would have prevented,
the entry of mosquitoes.
Quarantine arrangements are supervised by the Federal Government and
the rules forthe treatment of ships are, in general, similar to those adopted in
the Canal zone, but all ships from suspected ports are fumigated throughout
before being permitted to proceed up the river, and in the case of infected ships
the period of detention after fumigation is seven days instead of six. The quaran-
tine station at which all ships proceeding to New Orleans must stop is situated
at the mouth of the Mississippi, 90 miles below the port. The following sketch
indicates the arrangement and uses of the different buildings. The station is on
an uninhabited area of land, and is free from mosquitoes, but for greater safety all
the buildings are thoroughly screened. The station is provided with a disinfecting
apparatus on a tug as well as with the movable apparatus on shore.
Guayaquil.—Yellow fever has been endemic in some of the seaports of
Ecuador for many years and the danger of its spread from that country is a cons-
tant source of anxiety to the officials of the Panama Canal zone. Heavy expenses
incurred during the political troubles in which the country is frequently involved
have strained its financial resources, and adequate sanitary public works are
almost non-existent. The available records of the occurrence of yellow fever refer
only to Guayaquil (which is the principal seaport) and neighbouring places along
the railway, and they are not, 1 think, sufficiently accurate to be given in detail..
They shew, however, that the disease has been endemic for a long time and that,
while cases occur as a rule in every month of the year, the disease is most preva-
lent during the rainy months from December to April. Any unusual immigration
of non-immunes at once causes a rise in the number of cases, and in Guayaquil
this occurred markedly in December 1911 and January 1912 when revolutionary
troubles brought many non-immune soldiers into the district. The troubles were
such that no record was kept during that period, but during February there were
recorded 98 new cases and 43 deaths and during March 96 new cases and 36
deaths. Cases and deaths were also recorded in those months at Duran, Tagu-
achi, Milagro, Naranjito, Huigra and Naranjal.
The distribution of the disease in Guayaquil during the last three years is
shown on the accompanying map. The city is situated on low-lying land bet-
ween the river Guayas and an arm of the sea or salt water creek known as the
Estero Salado, and considerable areas in its neighbourhood are covered with
brackish water. The climate is equable, the daily average temperature being
about 76° F. with a range between 72° in the morning, 80° at mid-day and 79°i
n the evening. In 1910 the highest monthly temperatures were in February and
"March when the average figures 'were 72° in the morning, 84° at mid-day and
81° in the evening. As a rule no rain falls from the beginning of May until the
end of November, but the remaining months are very wet. The population-
numbers about 80,000, and is housed for the most part in water-logged situations
among ponds, marches, stagnant water-courses and open ditches.
The houses of the poorer classes are usually constructed of split bamboos
and are raised on piles. A few main streets near the water-front are laid with
large smooth stones, but in many places the stones have become loose and worn
away so that large pools and ruts full of water are numerous : the remaining
roads, being entirely " unmade," are grass grown and deep with mud ; and down
the middle of them there are surface ditches full of stagnant water. A portion
of the city is provided with a water-supply and sewerage system, but the
water is turned on for only a few hours each day, and during that time the
inhabitants collect as much as they can in cisterns, barrels, large water-jars and
Other receptacles,