WHEN in October, 1898, the late Colonel George E. Waring, of New York City, who had been sent by the Government to investigate the physical condition of Havana, became the victim of the monster he had sought to throttle, he had already written a large portion of his report, and he left copious notes for the completion of it, from which his efficient secretary and assistant, Mr. G. Everett Hill, prepared a full report. From this report the following extracts are made: “The death-rate of the city has always been high. In five years (not consecutive) between 1800 and 1819, with a population less than one-third of the present number of inhabitants, 26,576 people perished from yellow fever alone. In 1832 the cholera killed 10,000. The official reports of the Spanish garrison show that up to January 16, 1896, more than 82 per cent. of the total losses were due to yellow fever. In 1897 the total mortality by disease in the Spanish army in Cuba was 32,534. “At present the death-rate in Havana is enormous. The mortality for the week ending October 6, 1898, was 536—an annual rate of 139.36 per cent. per 1000. Since then owing to the change of season and to the removal of certain contributing causes, it has fallen to 114.4. “The surroundings and customs of domestic life are disgusting almost beyond belief. Sixteen thousand houses, out of a total of less than 20,000, are but one story high, and at least 90 per cent. of the population live in these— “The characteristic feature of the whole establishment—perhaps the only feature which is conspicuous in every house without exception—is the privy-vault, and sometimes a second vault for kitchen waste. These occupy a space practically under and almost in the kitchen. It is very rarely, indeed, that a Cuban privy has a ventilating pipe, so it belches forth its nauseous odours throughout the house and pervades the streets.” “There is no ordinance—at least none in force—requiring a householder to empty his privy vault. He uses it until it threatens to overflow; then he hires a night-scavenger, who comes with a cart, carrying the requisite number of barrels. These are filled through square holes at the top, and discharged through a plugged orifice at the bottom. “The workmen use tub-like ladles with long handles, with which they scoop up the filth. These they carry, dripping as they go, through kitchen, dining-room, reception-room, and hall to the street.” “When the barrels are filled, the cart starts, ostensibly for the prescribed place of disposal; but often, in a dark street, the plugs come out, and, before the waggon has gone very far, the barrels are empty. “Lest the conditions above set forth should fail to do their appointed work of destruction, stimulus for their effectiveness is “The southerly edge of the harbour is bordered by broad marshes, through which flow a number of watercourses, and to which these bring the offscouring of a very poor quarter of the town, and especially the effluent of the slaughtering-pens and of other foul establishments; while a large portion of the flat is used as a dumping-ground for garbage. “This intimate relation of marsh and filth is greatly aggravated by the admixture of fresh and salt water, by occasional floods, and by a daily scorching sun. “The vicinity of such marshes would be deadly in this climate, even to a veritable ‘City of Hygeia.’ Their proximity to this foul, fever-cursed town has always been recognised as disastrous, even by intelligent Habaneros themselves.” The water supply of Havana is very pure and abundant,—more than two hundred gallons per head per day: “This and the winds of the Gulf save the city from being absolutely and unqualifiedly bad; but they are powerless to make it tolerable. It is a veritable plague-spot. “Its own people, largely immune though they are to yellow fever, which has prevailed here without interruption for one hundred and sixty-eight years, fall constant victims under the pernicious malarial and depressing influences to which they are always subjected; and it needs only the immigration of fresh material, which the enterprise of our population is sure to bring here, to create a sacrifice such as we have not yet known; while commerce will carry the terror and the terrible scourge of yellow fever to our shores, until we rise again in a war of humanity, and at all costs wipe out an enemy with which no military valour can cope. YARD OF AMERICAN CLUB, HAVANA. “Can Havana be purified? And if so, will such purification result in the eradication of yellow fever and malaria? Both questions can be answered affirmatively and positively. Havana is no dirtier than many another city has been. In England, in the olden time, the earthen floors were strewn with rushes. When these became sodden with filth beyond all endurance, fresh rushes were thrown over the old ones, and these in turn “The poison of yellow fever is ponderable. It clings to low levels and usually follows the lines of greatest humidity. Like malaria, it is more active—or at least more to be feared—by night than by day. The danger from it in any quarter of an infected locality depends upon the presence primarily of filth, secondarily of dampness; and it increases in direct proportion to the confinement and stagnation of the air. Infected cellars are more dangerous than infected rooms. The holds of ships are notorious hotbeds of the disease. “In Havana the average height of the ground floor of a house above the soil is but six or seven inches; and this space is unventilated. The earth is not only damp, but is sodden with putrefying organic matter. The houses are closely built, without adequate space for ventilation between them. In the poorer quarters the population is crowded, a whole family often occupying a single room. The emanations from the cesspool and garbage-vault pervade, as has been stated, the kitchen and the sleeping-and living-rooms, even of houses of the better class. The standard of personal cleanliness is, necessarily, very low. These conditions, for which the citizens are responsible, are sufficient in themselves to transform the most healthy locality into a fever-nest. In the case of Havana, they are accumulated by climatic conditions favourable to, but in no case accountable for, the propagation of disease. No amount of rainfall, no high average of humidity, and no degree of temperature will cause In the notes which Colonel Waring brought with him from Cuba, the following improvements are specified as absolutely necessary for the sanitary redemption of Havana: (1) The immediate organisation of a Department of Public Cleaning,” under the full control of a single Commissioner experienced in the conduct of such work,” who should have authority to act as occasion may require. The chief function of the Department would be the maintenance of a “constant state of cleanliness” in all the streets and places of public business or resort, including the abattoirs and markets. “It should also control the disposal of all wastes, except sewage—by cremation and otherwise.” (2) The construction of a system of sewers “to receive the liquid wastes of all houses of the main city.” The topography of the city divides it naturally into several districts. Each of these should be served by a distinct sewerage system, which should discharge directly into the harbour or the Gulf, as the case may be. “ Before such discharge, the effluent should be effectively clarified by one of the various well known methods; so that it would carry only its dissolved impurities.” The dilution would be immediate and more than sufficient; for the daily movement of sea water into and out of the harbour is about six thousand times as great as would be the day’s discharge of clarified sewage from the harbour slope of the city. (3) The clearing out and filling with clean earth of all the cesspools and garbage-vaults, and the supplying to each house of a suitable water-closet connected with the public sewer system. The closets furnished should be practically automatic in operation, and not liable to damage from ignorance or carelessness. They should be made so that no foreign substance able to cause an obstruction in the house drain or the sewer could pass out of sight. If more elaborate plumbing be desired, this may be put in by the householder, (4) The paving, or repaving, of all the streets with the best quality of asphaltum. Some form of artificial paving of the streets of cities is indispensable. Mr. Edwin Chadwick says that between the two divisions of a town population, similarly situated in general condition, one part inhabiting streets which are unpaved and another inhabiting streets that are paved, a difference of health is observed. He cites instances showing the sanitary benefit resulting from paving. Laying aside all considerations of comfort and economy, which in themselves are sufficient to warrant its construction, asphaltum is the best paving material from a hygienic standpoint. Being a monolithic sheet it is impervious alike to the rise of exhalations from the earth and the soakage of liquids into the earth. It is easily cleaned; and, as it can be cleaned without sprinkling, it can be cleaned dry. At intervals it can be thoroughly washed with a hose, and all surplus water removed immediately with a squeegee. The absence of dust and the minimising of noise are hygienic benefits of secondary degree. (5) The erection of a new abattoir, adequate to all the needs of the population, and furnished with modern appliances for the inoffensive utilisation of the entire animal, so that no refuse remains to be got rid of. (6) The construction of “a suitable and sufficient incinerating furnace, for the complete and inoffensive destruction of garbage and other refuse,” including dead animals, street sweepings, mattresses, discarded clothing, rags, excelsior, paper, and similar substances, which might serve as vehicles of contagion. The experiments made by Colonel (7) The reclamation and drainage of all the marshes, or at least of those bordering on the harbour on the south and west. “This reclamation to be made after the ‘Polder’ method of Holland—by diking out the harbour and the watercourses and removing the water by pumping.” (8) The establishment of a “power-plant sufficient for this pumping, for pumping sewage where necessary, and for propelling the machinery of the abattoir.” In concluding his paper, Mr. Hill says: “It may seem strange that no reference has been made to the dredging of the harbour—so urgently advocated by some advisers—or to any improvement of it, save such as would be effected by the withholding of solid organic matters from the abattoir, sewage, and dumping grounds, and by the construction of the dikes at its southern end. As has been said, the tidal flow is more than sufficient to effect the purification of the clarified sewage, which Colonel Waring proposed to empty into the harbour. So long as solid wastes are withheld, its surplus oxidizing power will gradually destroy the accumulation of putrescible material. “To dredge the harbour now would be dangerous work; for it would stir up and expose to the air vast quantities of putrid filth. Later, if Colonel Waring’s recommendations should be carried out, it would mean only the removal of innocuous mud. Navigation is not yet impeded by the deposits; and the rate at which the harbour is silting up—one-third of one per cent. per year—makes it evident that a delay of even ten years would not be injurious to commerce. Long before this time has elapsed the harbour should be clean. “Havana can be freed from her curse. The price of her freedom is about $10,000,000. Can the United States afford to redeem her? For once humanity, patriotism, and self-interest should be unanimous, and their answer should be, Yes!” General Greene, U.S.A., has submitted an extended report on the city’s condition. General Greene notes that For three hundred years or more house drainage has been discharged into cesspools, varying in size from three to ten feet in diameter, and from four to eight feet deep, closed at the top with a stone. While rules for taking proper care of these cesspools are plenty, enforcement of them is so neglected that some of them have not been cleaned in five years. They are not cemented inside and they drain off into the soil and rock, infecting everything in reach. The paved streets (surface) are cleaned by contract, by methods prevailing in this country twenty-five years ago, and the work is fairly well done. The cleanings are carried eight miles from the city, where they are dumped and left on the ground, and the condition there is fearful. During the blockade the authorities ordered the cleanings to be dumped into the marsh near the Christina Street station, and here in the wet soil they remain, a dangerous menace to health. The thousands of reconcentrados and soldiers in the city used the unpaved streets as open privies, and when the Americans went into the city they found these streets There is but one slaughter-house in the city and it is owned by the municipality. It is mortgaged, like other city properties, to the Spanish Bank. From three hundred to four hundred cattle are killed daily, and the offal, which might easily be saved, and is, in American slaughter-houses, is dumped into Chavez Creek, where it is left to rot in the sun. The construction of a new building in a different locality has been long discussed, but opposition has been made to it, and nothing has been done. In the meantime the dumping continues in Chavez Creek. The military hospitals have not yet been examined. Of the nine city hospitals, asylums, and homes examined by Surgeon Davis, three were in fairly good condition, two in bad condition, and four are most deplorable. Some of the houses are overcrowded and the inmates half starved. These hospitals can be put in good condition very soon. The two principal markets, the Colon and the Tacon, are owned by the city and mortgaged to the Spanish Bank. Their sanitary condition is bad as it can be, but it can be remedied easily and quickly. An elaborate code of Health Regulations, a volume of fifty pages, exists, but it is seldom or never referred to or its provisions carried out. Dairies prevail in many parts of the city, where twenty to thirty cows are kept in stalls in the same house where human beings live; livery stables are located in the most thickly settled parts of the city; dead dogs, cats, and other animals are left in the open streets for weeks; slops, filth, and night soil are thrown out of the windows and doors on the streets in the poorer localities and no kind of regard is paid to health regulations of any kind. The condition of the harbour is gone into at length, one new fact being noted, to wit: that the water is so foul that the bottom cannot be seen two feet below the surface, while Both General Greene and Surgeon Davis are of the opinion that the harbour is not such a menace to health as are the cesspools, slaughter-house, and general filth of the city, and that it should come last in the cleaning process. In recapitulation, General Greene says: “From the foregoing it is apparent that the first steps toward sanitation are the improvement of the slaughter-house, the cleaning of cesspools, the inauguration of a proper system of street cleaning, and the devising and rigid enforcement of health regulations. I have therefore advised that immediately on taking possession of the city government a board be appointed, consisting of three army surgeons and two civilians—one from New York and one from Chicago—of long experience on the Health Boards in those cities; that this board study the sanitary conditions of the city and draw up a new code of sanitary regulations, including the management of the hospitals; and that this code be rigidly enforced by the new city police, assisted by such number of sanitary inspectors as may prove to be necessary. In this manner I believe that the sanitary conditions can be improved and the death-rate enormously reduced before the next rainy season sets in. The death-rate in October last was at the rate of 133 per 1000 per annum; in December it had been reduced to 106, and with only two deaths per week from yellow fever. “In order completely to stamp out yellow fever it will be necessary to destroy a limited number of the worst infected houses occupied by the poorest classes, to construct a system of sewers, and lay new pavements. This will involve a very large expenditure of money, and it is not at present clear how the city can raise this money. It is probable, however, that a feasible financial scheme could be devised after thorough study, and in the meantime a commission of engineers should be appointed to study the problem, and either acquire the existing surveys by purchase, at a fair valuation, or else make new surveys, and a definite report covering the whole ground, so that the matter may be intelligently considered.” EXTRACTS FROM REPORT OF THE HAVANA YELLOW FEVER COMMISSION, 1879TEMPERATURE“This is conceded to be a climatic element of greatest importance, and the ‘annual mean’ to be the chief factor. Throughout the West Indies the mean annual temperature, near the sea, is from 78 degrees to 80, the mean daily range is only about 6 degrees, and the extreme annual range does not usually exceed 20 degrees. At Havana the mean annual temperature varies in different years from 77 degrees to 79; the mean temperature of the hottest months, July and August, varies from 82 to 85 degrees; and of the coldest months, December and January, from 70 to 76 degrees. The minimum temperature is very rarely as low as 50 degrees, and the maximum as rarely exceeds 100 degrees; in fact, the thermometer, in the shade, seldom rises above 94 degrees. There are no records nor any tradition of frost having ever occurred except on December 24 and 25, 1856. It is alleged that even in the sparsely inhabited mountains in the east of Cuba, where the Tarquino peak reaches an altitude of about 8000 feet, frost rarely occurs, and snow never.” RAINFALL“During the sixteen years, 1859-74, the average number of rainy days at Havana was 113; the minimum number, 97 days, occurred in 1869, and the maximum number, 141 days, occurred in 1862. The average amount of rain for the sixteen years was 49 inches, the minimum was 42.5 in 1861, and the maximum was 70 inches in 1867. The maximum amount of rain falling in any one season is from May to September, inclusive, but especially during August and September. The rain then descends with such rapidity that it runs off in torrents; but, as is seen, the usual belief that the annual rainfall is excessive is erroneous. The annual mean relative humidity varies in different years from about 73 to 74.5, and that of the different months of the year from 66 to 79; the minimum, occurring in any day of the year, may be as low as 34, and the maximum as high as 96. Evaporation is extremely rapid. ANNUAL DEATHS IN HAVANA, 1870-79
“Spanish army losses to January 16, 1896:
“Total mortality of Spanish army in Cuba in 1897 (from Public Health Report, U. S. Marine Hospital Service, April 29, 1898):
“The above table ... clearly proves that ‘the actual sanitary condition of the principal ports of Cuba’ is very unfavourable, since, in recent years, their death-rates have ranged “The portion of the city in worst repute is the fifth district, and especially Jesus Maria, one of its wards. This is, to considerable extent, reclaimed swamp lands, filled in largely with street refuse and garbage. It fronts the bottom of the harbour. Its rough, unpaved streets are in many places almost impassable in wet weather, even to pedestrians. Great mud-holes, covered with green slime, and fit only for the abode of hogs, are numerous. The houses, as well as the streets, have an uncared-for, filthy, and disgusting appearance; and the sickly, anÆmic residents look as dirty and cheerless as the streets and houses. “The Punta or Colon wards in the third district—at least the portions which immediately front the sea—have a reputation almost as bad as the Jesus Maria ward. The foundation rocks were, during the last century, excavated to build fortifications, and these excavations were filled up with street refuse and garbage; hence this ward is, like Jesus Maria, to some extent, reclaimed land. These portions are alleged to be very unhealthful, while houses only six or eight blocks distant are not so; comparatively light rains flood the banquettes and run into the houses. The streets are wider and the houses better than in Jesus Maria. Some consider the location of the latter, at the bottom of the harbour, a chief cause for its unhealthfulness, but the unhealthy portion of the city now referred to fronts the sea. THE PRADO AND INDIAN STATUE, HAVANA. “The Pueblo Nuevo ward, still farther to the west, also fronts the sea, and is built on a slope which attains an altitude of nearly seventy feet. Notwithstanding these advantages, it is very badly “The three suburban wards, Jesus del Monte, the Cerro, and Vedado, enjoy the best reputation for salubrity, and also for their freedom from yellow fever. Intelligent residents are readily found, who will assert with great assurance that no one is ever attacked in these wards except those who have been elsewhere infected. The summit of Jesus del Monte has an altitude of 67 meters, or 220 feet, the highest point in Havana, or its immediate vicinity. However, there are few, if any, houses about the summit; the average level of the ward is only 80 feet, and more inhabitants live below than above this level. The natural drainage is excellent, the houses in the elevated portion occupy more ground and are better ventilated than in Havana.” GEOLOGICAL FORMATION“The surface soil of Havana consists for the most part of a thin layer of red, yellow, or black earths. At varying depths beneath this, often not exceeding one or two feet, lie the solid rocks. These foundation rocks are (especially in the northern and more modern portion of the city, towards the coast of the sea and not of the harbour) quarternary and especially tertiary formation so permeable that liquids emptied into excavations are absorbed and disappear. In the southern and greater portion of the city, these rocks are of cretaceous formation, and so much less permeable that sinks and other excavations readily fill to overflowing. About twenty thousand persons or one-tenth of the population, live on land reclaimed from the sea, in large measure, by dumping on garbage and street refuse. Much of this reclaimed land was formerly mangrove swamps, and Havana still lies adjacent to these breeders of malarial poison. There are few if any towns in Cuba which are not subjected to malarial effluvia from mangrove or other swamps, and many of these suffer to greater extent than Havana.” Messrs. Ariza and Herrera reported a population of 3000 on the reclaimed parts of the first district, 5000 on parts of the third and fourth, 5000 on part of the fifth, and 600 on part of the sixth district. THE CLEANSING OF THE HARBOUR“The sanitarian cannot hesitate to advocate, for general reasons if not especially for yellow fever, the cleansing of the harbour, the cessation of daily additions to it of large masses of filth, and the replenishment of it by constant currents of pure water. To accomplish the last, it has been much insisted on, in the United States, as well as in Cuba, that canals should be dug. Out of Cuba it ought to be better understood that Havana is by no means deficient in highly educated, skilful, practical engineers, who are fully alive to the sanitary interests of the city, and to the merits of this especial subject. Among these, Colonel Albear stands pre-eminent, and in September, 1879, he delivered before the Academy of Sciences an extremely able address on this subject, which is so full of instruction, on other local conditions also of interest to the sanitarian, that this address has been translated and is presented, as a most interesting part of this report. Colonel Albear seems to have conclusively demonstrated the impracticability of these proposed canals; and my own conviction is that if practicable they could not possibly place the small harbour of Havana in as favourable sanitary conditions as are by nature the large harbour of Matanzas and of Cienfuegos, where yellow fever none the less prevails.” DRAINAGE“In Cuban cities, generally, good drainage is not found except in such comparatively inextensive parts where nature required little or no assistance. Even in Havana, the oldest and wealthiest city, the visitor is often astounded, especially in the rainy season, by impassable mud-holes, and green, slimy, stagnant pools in the streets and in the backyards. This condition was found even in the Pueblo Nuevo ward, which is located so admirably for good drainage that little labour would be required to make it perfect. “Messrs. Ariza and Herrera reported: ‘Havana has no sewers save in a few principal streets. These sewers have been built at interrupted intervals, without reference to any general plan for drainage. They are seldom cleaned and are generally obstructed in part or wholly with sediment or filth from the streets, and exhale offensive odours. As the sewers are few in number, the greater THE PAVING OF STREETS“Less than one-third of the population live on paved streets, and these are well paved and kept as clean, it is believed cleaner, than is usual in the United States. The remainder live on unpaved streets, which for the most part are very filthy. Many of these, even in old and densely populated parts of the city, are no better than rough country roads, full of rocks, crevices, mud-holes, and other irregularities, so that vehicles traverse them with difficulty at all times, and in the rainy season they are sometimes impassable for two months. Rough, muddy, or both, these streets serve admirably as permanent receptacles for much decomposing animal and vegetable matter. Finally, not less, probably more, than one-half of the population of Havana live on streets which are constantly in an extremely insanitary condition, but these streets, though so numerous, are not in the beaten track of the pleasure tourist, in which capacity the writer, in 1856, spent ten days in Havana without witnessing many of the evils now testified to with emphasis.” DENSITY OF POPULATION“Of the various evils recounted in connection with the subject of houses, there are two which deserve special attention. Many facts, besides those associated with the holds of vessels, justify the belief that the growth of the poison of yellow fever is specially “The Registry Office in Havana reports that there are upwards of eighteen thousand fincas in this registry district, which comprises the village of Marianao in addition to the city of Havana. “A finca is a piece of land, with definite boundaries or limits whether large or small, and whether it has buildings on it or not. “Of the eighteen thousand fincas in the district about fourteen thousand have houses upon them, and the other four thousand being vacant lots in the city, or fincas rusticas, in the rural districts. “At least twelve in every thirteen inhabitants live in one-story houses; and as the total civil, military, and transient population exceeds two hundred thousand, there are more than twelve inhabitants to every house. Tenement houses may have many small rooms, but each room is occupied by a family. Generally, the one-story houses have four or five rooms; but house-rent (as also food and clothing) is rendered so expensive by taxation, by export as well as import duties, that it is rare for a workman, even when paid fifty to one hundred dollars a month, to enjoy “In the densely populated portions of the city the houses generally have no back yard, properly so called, but a flagged court, or narrow vacant space into which sleeping-rooms open at the side; and in close proximity with these, at the rear of this contracted court, are located the kitchen, the privy, and often a stall for animals.” “Messrs. Ariza and Herrera report that in Havana the average height of the ground floor is from seven to eleven inches above the pavement, but in Havana, and more frequently in other Cuban towns, one often encounters houses which are entered by stepping down from the sidewalk; and some floors are even below the level of the streets. In Havana some of the floors; in Matanzas more; in Cardenas and Cienfuegos many, are of bare earth itself, or of planks raised only a few inches above the damp ground. “The privy and the sink for slops, the open kitchen shed, and the stable immediately adjoin each other, confined in a very contracted space close to sleeping-rooms. The privy consists of an excavation which often extends several feet laterally under the stone flags of the court. Even if the sides be walled, the bottom is of the original porous earth or subsoil rock, thus permitting widespread saturation of the soil.” LA LUCHA OCTOBER, 21, 1896“These houses are veritable pig-styes. Houses which rent from thirty to forty-five dollars per month—an extremely high price for a country where wealth has been destroyed by war—are devoid of all comfort. They are unhealthful habitations. A very distinguished stranger, who visited us some time ago, said of them: ‘They are composed solely of four walls and a pavement which are stained with dampness and a privy whose fetid and constant emanations poison the air that must be breathed.’ |