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Swampy Sugar Lands: Irrigation Dams and the Rise and Fall of Malaria in Puerto Rico, 1898–1962

Published online by Cambridge University Press:  13 November 2018

Matthew P. Johnson
Matthew P. Johnson*
Affiliation:
Doctoral candidate at the Department of History, Georgetown University, Washington DC
*
*Corresponding author. Email: [email protected]
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Abstract

Two environmental re-engineering projects clashed in south-eastern Puerto Rico in the early twentieth century. Between 1910 and 1914 the Puerto Rican Irrigation Service built three large dams to water canefields owned by US sugar companies. The new canals and holding ponds created ideal breeding grounds for malaria-carrying mosquitoes, and demand for fieldworkers encouraged greater numbers of Puerto Ricans to work and live near these mosquito swarms. Malaria rates soared as a result. Meanwhile, public health officials tried to control malaria, but their efforts faltered, especially when efficient irrigation was prioritised above all else. It was not until the 1940s and 1950s that health officials controlled and then eliminated malaria. In Puerto Rico, malaria rose with the commitment to irrigated canefields and remained tenacious until wartime exigencies inspired greater control efforts, DDT became available and, most importantly, manufacturing eclipsed sugar production as the island's dominant economic activity.

Spanish abstract

Dos proyectos de reingeniería medioambiental chocaron en el sudeste de Puerto Rico a principios del siglo XX. Entre 1910 y 1914 el Servicio de Irrigación de Puerto Rico construyó tres grandes presas para irrigar cañaverales pertenecientes a compañías azucareras estadounidenses. Los nuevos canales y sus estanques crearon un terreno ideal para la reproducción de mosquitos portadores de malaria y la demanda de trabajadores alentaron a un mayor número de portorriqueños a trabajar y vivir cerca de los enjambres de estos insectos. El resultado fue un gran incremento de la malaria. Mientras tanto, funcionarios de salud pública trataron de controlar la malaria, pero sus esfuerzos fracasaron especialmente cuando una irrigación eficiente se hizo más prioritaria que todo lo demás. No fue sino hasta los años 1940s y 1950s que los funcionarios de salud controlaron y luego eliminaron la malaria. En Puerto Rico, la malaria se incrementó con el compromiso de irrigar los cañaverales y se mantuvo muy arraigada hasta que las exigencias en tiempos de guerra inspiraron esfuerzos por un mayor control, el DDT estuvo disponible, y aun más importante, las manufacturas eclipsaron al azúcar como la actividad económica dominante de la isla.

Portuguese abstract

Dois projetos de reengenharia ambiental entraram em conflito no sudeste de Porto Rico no começo do século vinte. Entre 1910 e 1914, o Serviço de Irrigação de Porto Rico construiu três grandes barragens para irrigar plantações de cana de açúcar pertencentes à companhias do ramo dos Estados Unidos da América. Estes novos canais e tanques criaram zonas de reprodução ideais para mosquitos portadores de malária e a demanda por trabalhadores para as plantações incentivaram um grande número de porto-riquenhos a trabalhar e viver perto desses enxames de mosquitos. Como resultado, os índices de malária dispararam. Enquanto isso, oficiais da saúde pública tentavam controlar a doença mas seus esforços eram praticamente em vão, especialmente porque um sistema eficiente de irrigação era priorizado acima de tudo. A situação permaneceu a mesma até meados de 1940 e 1950 quando oficiais de saúde controlaram e subsequentemente eliminaram a malária. Em Porto Rico, a malária cresceu devido ao comprometimento com a irrigação das plantações de cana e perseverou até que exigências de tempos de guerra pediram por maior controle, DDT se tornou disponível, e mais relevantemente, produções manufatureiras superaram o açúcar como atividade econômica dominante.

Keywords

Puerto RicoenvironmentirrigationsugarcanediseasemalariaPuerto Ricomedio ambienteirrigacióncaña de azúcarenfermedadmalariaPorto Ricomeio ambienteirrigaçãocana de açúcardoençasmalária
Type
Research Article
Information
Journal of Latin American Studies , Volume 51 , Issue 2 , May 2019 , pp. 243 - 271
Copyright
Copyright © Cambridge University Press 2018 

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References

1 The term azucarero is used in this article to refer to cane planters, mill owners, managers and others whose financial interests were wedded to sugar cultivation. The Serrallés family owned 12,700 acres and two large sugar mills, known as centrales, on the south coast, as well as the only sugar refinery in Puerto Rico. See Rafael Bernabe, ‘Prehistory of the Partido Popular Democrático: Muñoz Marín, the Partido Liberal, and the Crisis of Sugar in Puerto Rico, 1930–35’, unpubl. PhD diss., State University of New York, 1989, p. 58.

2 Sucesión J. Serrallés to Governor Blanton Winship, 2 Sept. 1934, Archivo General de Puerto Rico (hereafter AGPR), San Juan, series: Irrigation (Aguas), record group (hereafter RG): Public Works (Obras Públicas), box 509. This article is based primarily on reports and correspondence written by Irrigation Service engineers, azucareros, public health officials, malariologists and others who commented on sugar, irrigation and malaria in Puerto Rico, as well as contemporary scientific articles about mosquito biology. Collectively, these sources say a lot about the ecological changes that unfolded on the island between 1898 and 1962. The records of the Puerto Rican Irrigation Service at the AGPR in San Juan and the US National Archives in College Park (NARA II) were particularly helpful. Also invaluable were records of the Rockefeller Foundation's International Health Division at the Rockefeller Center in Sleepy Hollow (RAC), records of the Pan American Health Organization from their digitised Institutional Repository (IRPAHO) and the documents from the Puerto Rican Department of Health from the University of Puerto Rico's digitised Historical Repository for Health Science Information in Puerto Rico and the Caribbean (HRSCIPRC).

3 Both principal types of human malaria, Plasmodium falciparum and Plasmodium vivax, were present in Puerto Rico during the first half of the twentieth century. Each represented around 50 per cent of the cases diagnosed and this article makes no effort to distinguish between the two when referring to malaria.

4 An. grabhamii and An. vestitipennis were also present but were much less prevalent than An. albimanus.

5 Dietz, James L., Economic History of Puerto Rico: Institutional Change and Capitalist Development (Princeton, NJ: Princeton University Press, 1986), pp. 149–54Google Scholar, 171–2.

6 Bergad, Laird W., ‘Agrarian History of Puerto Rico, 1870–1930’, Latin American Research Review, 13: 3 (1978), pp. 63–94Google Scholar; Dietz, Economic History of Puerto Rico; Bernabe, ‘Prehistory of the Partido Popular Democrático’; Scarano, Francisco, Puerto Rico: cinco siglos de historia (San Juan, PR: McGraw Hill, 1993)Google Scholar; Ayala, César J., American Sugar Kingdom: The Plantation Economy of the Spanish Caribbean, 1898–1934 (Chapel Hill, NC: University of North Carolina Press, 1999)CrossRefGoogle Scholar; Ayala, César J. and Bergad, Laird W., ‘Rural Puerto Rico in the Early Twentieth Century Reconsidered: Land and Society, 1899–1915’, Latin American Research Review, 37: 2 (2002), pp. 65–97Google Scholar; Ayala, César J. and Bernabe, Rafael, Puerto Rico in the American Century: A History since 1898 (Chapel Hill, NC: University of North Carolina Press, 2007)Google Scholar.

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8 César Ayala briefly noted the connection between the irrigation project and malaria. See Ayala, American Sugar Kingdom, p. 182.

9 On bilharzia, see William Jobin, ‘Sugar and Snails: The Ecology of Bilharziasis related to Agriculture in Puerto Rico’, American Journal of Tropical Medicine and Hygiene, 29 (1980), pp. 86–94; Dams and Disease: Ecological Design and Health Impacts of Large Dams, Canals, and Irrigation Systems (New York: CRC Press, 1999), pp. 97–150.

10 Donald Worster, Rivers of Empire: Water, Aridity, and the Growth of the American West (New York: Oxford University Press, 1985); Richard White, The Organic Machine: The Remaking of the Columbia River (New York: Hill and Wang, 1995); Matthew Evenden, Fish versus Power: An Environmental History of the Fraser River (New York: Cambridge University Press, 2004); Christopher Sneddon, Concrete Revolution: Large Dams, Cold War Geopolitics, and the US Bureau of Reclamation (Chicago, IL: University of Chicago Press, 2015).

11 Margaret Humphreys, Malaria: Poverty, Race, and Public Health in the United States (Baltimore, MD: Johns Hopkins University Press, 2001), pp. 87–92, 106–8; Linda Nash, Inescapable Ecologies: A History of Environment, Disease, and Knowledge (Berkeley, CA: University of California Press, 2006), pp. 76–9, 108–10; Eric Carter, ‘Malaria Control in the Tennessee Valley Authority: Health, Ecology, and Metanarratives of Development’, Journal of Historical Geography, 43 (2014), pp. 111–27.

12 Gordon Harrison, Mosquitoes, Malaria, and Man: A History of Hostilities since 1880 (Hialeah, FL: Dutton Press, 1978); Randall M. Packard, The Making of a Tropical Disease: A Short History of Malaria (Baltimore, MA: Johns Hopkins University Press, 2007); Marcus Cueto, Cold War, Deadly Fevers: Malaria Eradication in Mexico, 1955–1975 (Baltimore, MD: Johns Hopkins University Press, 2007); James Webb Jr, Humanity's Burden: A Global History of Malaria (Cambridge: Cambridge University Press, 2009); The Long Struggle Against Malaria in Tropical Africa (Cambridge: Cambridge University Press, 2014); James McCann, The Historical Ecology of Malaria in Ethiopia: Deposing the Spirits (Athens, OH: Ohio University Press, 2015).

13 Eric Carter, Enemy in the Blood: Malaria, Environment, and Development in Argentina (Tuscaloosa, AL: University of Alabama Press, 2012); Frank M. Snowden, The Conquest of Malaria: Italy, 1900–1962 (New Haven, CT: Yale University Press, 2006); Humphreys, Malaria.

14 J. R. McNeill, Mosquito Empires: Ecology and War in the Greater Caribbean, 1620–1914 (Cambridge: Cambridge University Press, 2010).

15 Paul Sutter, ‘Nature's Agents or Agents of Empire? Entomological Workers and Environmental Change during the Construction of the Panama Canal’, Isis, 98: 4 (2007), pp. 724–54; ‘The First Mountain to Be Removed: Yellow Fever Control and the Construction of the Panama Canal’, Environmental History, 21:2 (2016), pp. 250–9.

16 Spain's eager embrace of irrigation dams came only in the twentieth century. See Erik Swyngedouw, Liquid Power: Contested Hydro-Modernities in Twentieth-Century Spain (Cambridge, MA: MIT Press, 2015).

17 Annual Report of the Governor of Porto Rico, 1919, pp. 509–10, AGPR, Annual Reports.

18 Dietz, Economic History of Puerto Rico, pp. 103–4.

19 Ayala and Bernabe, Puerto Rico in the American Century, pp. 35–41.

20 US dominance was regional. In the north and west, large sugar mills and canefields were mostly owned by Puerto Rican azucareros, but in the south and east, US companies dominated. For more on Central Aguirre Sugar Co., see Manual of the Sugar Cane Companies (New York: Farr & Co., 1935), pp. 12–15; Ayala, American Sugar Kingdom, pp. 108–11, 226; Bernabe, ‘Prehistory of the Partido Popular Democrático’, pp. 52–3, 56–60.

21 Ayala and Bernabe, Puerto Rico in the American Century, p. 37. Ayala and Bernabe note that such disregard showed the political weight that sugar interests had among the US officials appointed to administer Puerto Rico.

22 J. W. Beardsley, ‘Bulletin 18’, 10 Oct. 1910, p. 13, NARA II, RG 350, Records of the Bureau of Insular Affairs, series: General Classified Files, 1898–1945 (GCF), box 10. The total cost upon completion was US$5.1 million. For more on the project's cost, see Eugenio Latimer Torres, Historia de la Autoridad de Energía Eléctrica: implantación de los sistemas de luz y fuerza en Puerto Rico, 1893–1993 (San Juan: Autoridad de Energía Eléctrica, 1997), available at the Library of Congress (hereafter LOC), Washington DC.

23 The project was led by James Beardsley. Raised in New York, Beardsley received a degree in civil engineering from Cornell University in 1891. Between 1910 and 1916 he was the chief engineer of the Puerto Rican Irrigation Service, where he oversaw the construction of SCIP. See Willi H. Hager, Hydraulicians in the USA 1800–2000: A Biographical Dictionary of Leaders in Hydraulic Engineering and Fluid Mechanics (Boca Raton, FL: CRC Press, 2015), p. 1819.

24 Antonio Lucchetti to Miguel Muñoz, 26 Dec. 1927, NARA II, RG 350, series GCF, box 10.

25 Antonio Lucchetti, ‘Irrigation and Hydroelectric Systems of the South Coast of Porto Rico’, in A. B. Gilmore (ed.), The Puerto Rico Sugar Manual, 1930–1931 (New Orleans, LA: Gilmore, n.d.), pp. 32–40.

26 Azucareros also increased the harvest by switching to high-sucrose cane varieties, which began in the effort to find strains resistant to cane mosaic disease in the late 1910s. See Lucchetti, ‘Irrigation and Hydroelectric Systems of the South Coast of Porto Rico’, p. 34. Stuart McCook argues convincingly that varietal shifts were the most important factor for production increases throughout the island, but irrigation mattered more in the south-east. He himself notes that Aguirre traditionally planted varieties of cane less susceptible to mosaic disease and was not compelled to plant high-yielding alternatives until much later. See Stuart McCook, States of Nature: Science, Agriculture, and Environment in the Spanish Caribbean (Austin, TX: University of Texas Press, 2002), p. 96.

27 Sidney Mintz, Sweetness and Power: The Place of Sugar in Modern History (New York: Viking, 1985), p. xviii.

28 Ayala, American Sugar Kingdom, p. 187.

29 Ayala and Bernabe, Puerto Rico in the American Century, p. 38.

30 Dr C. C. Pierce and Dr L. L. Williams Jr, ‘Report of a Survey of Problems of Sanitation and Medical Care in Puerto Rico, April 25–May 12, 1938’, p. 16, NARA II, RG 126, series: Classified Files, 1907–1951 (CF), box 870.

31 To get a sense of just how severe this malaria burden was, consider the following example: In 1942, when the US Department of Health began spraying DDT to control malaria, it considered counties with a morbidity rate of just 5 per 100,000 as officially malarious. See Humphreys, Malaria, p. 148.

32 Pierce and Williams Jr, ‘Report of a Survey of Problems of Sanitation and Medical Care in Puerto Rico’, p. 16.

33 For example, the Rockefeller Foundation's first malaria control programme began in 1924 in Fajardo, an area then mostly planted to sugarcane on the north-east coast.

34 E. Christian Frederickson, ‘Bionomics and Control of Anopheles Albimanus’, Technical Paper No. 34, 1993, Pan American Health Organization (hereafter PAHO), Washington DC.

35 See Allan Saul, ‘Zooprophylaxis or Zoopotentiation: The Outcome of Introducing Animals on Vector Transmission is Highly Dependent on the Mosquito Mortality while Searching’, Malaria Journal, 2: 32 (2003), pp. 1–18. For more on zooprophylaxis in the Americas prior to 1898, see Webb, Humanity's Burden, pp. 82–3.

36 Frederickson, ‘Bionomics and Control of Anopheles Albimanus’.

37 Annual Report of the Governor of Porto Rico, 1909, AGPR, Annual Reports; 1910 US Census, Supplement for Porto Rico, p. 571, US Department of Commerce, Bureau of the Census. Census reports are available online through the US Census Bureau.

38 Medical specialists at the time, who also lamented the dearth of statistics prior to 1914, reached the same conclusion. See Dr S. J. Crumbine, ‘Malaria’, 1930, RAC, RG 1.1, series 243 (Puerto Rico), subseries I (Malaria), Rockefeller Foundation Projects, 1913–1965, box 4, folder 47.

39 Dr Walter C. Earle to Dr Hector H. Howard, 27 March 1928, RAC, RG 1.1, series 243, subseries I, box 3, folder 43, Records of the Rockefeller Foundation; Pierce and Williams Jr, ‘Report of a Survey of Problems of Sanitation and Medical Care in Puerto Rico’, p. 16.

40 Walter C. Earle, ‘Demonstration in Malaria Control Porto Rico, Progress Report, 1925–26,’ RAC, RG 5, series 243, subseries 2 (Special Reports), International Health Board/Division Records, box 21, folder 133.

41 Earle to Howard, 27 March 1928; Dr Walter C. Earle to Commissioner of Health Dr A. Fernós Isern, 17 Feb. 1932, RAC, RG 1.1, series 243, subseries I, box 4, folder 49.

42 Ibid.

43 Memorandum from Rafael Nones to the commissioner of internal affairs, ‘Asunto: reglamento de sanidad sobre uso de aguas para fines del riego’, 9 Jan. 1935, AGPR, series: Irrigation, RG: Public Works, box 509; John M. Henderson, ‘Urban Malaria in Puerto Rico’, Puerto Rico Journal of Public Health and Tropical Medicine, 17 (1942), pp. 278–88.

44 Earle to Fernós Isern, 17 Feb. 1932, RAC, RG 1.1, series 243, subseries I, box 4, folder 49.

45 1910 US Census, Supplement for Porto Rico, p. 571, US Department of Commerce, Bureau of the Census; 1930 US Census, Population – Puerto Rico, p. 124, US Department of Commerce, Bureau of the Census.

46 According to the governor's annual reports, the relative land area devoted to cane and cattle in the south-east changed surprisingly little after 1910. This indicates that the transition from cattle to sugar began earlier, between 1898 and 1909, a period for which the governor's annual reports did not keep detailed records of land use. Moreover, after 1914 the herds on ranching land likely diminished as cane became the primary economic activity in the south-east. The governor's annual reports have no data on herd numbers after 1910.

47 Earle, ‘Demonstration in Malaria Control, Progress Report, 1925–26’, RAC, RG 5, series 243, subseries 3 (Routine Reports), box 73, folder 901.

48 Henderson, ‘Urban Malaria in Puerto Rico’.

49 An. albimanus breed in brackish water and can tolerate some salinity, and thus breed heavily in coastal mangrove swamps. For more on the natural habitats of An. albimanus, see Frederickson, ‘Bionomics and Control of Anopheles Albimanus’.

50 Dr Walter C. Earle, ‘The Relation Between Breeding Area, Anopheles Albimanus Density, and Malaria in Salinas, Puerto Rico’, Southern Medical Journal (1937), pp. 946–50. Accessed online through IRPAHO.

51 P. Morales Otero et al., ‘Health and Socioeconomic Conditions on a Sugar Cane Plantation’, June 1937, Health Division, Puerto Rico Reconstruction Administration and the School of Tropical Medicine, San Juan, Puerto Rico, National Archives, New York City (hereafter NARA NY), RG 323, Records of the Puerto Rican Reconstruction Administration, box 12.

52 Earle to Fernós Isern, 17 Feb. 1932, RAC, RG 1.1, series 243, subseries I, box 4, folder 49.

53 Memorandum from Dr Walter C. Earle to Dr Russell, ‘Subject: Porto Rico, Houses for Laborers’, 7 Dec. 1928, RAC, RG 1.1, series 243, subseries I, box 3, folder 44; Morales Otero et al., ‘Health and Socioeconomic Conditions on a Sugar Cane Plantation’.

54 Dietz, Economic History of Puerto Rico, pp. 64–9.

55 Dr John B. Grant, ‘Hookworm Infection Survey and Malaria Survey of Porto Rico, From December 26, 1919 to January 26, 1920’, p. 66, RAC, RG 5, series 243, subseries 3, box 73, folder 899.

56 Earle, ‘Demonstration in Malaria Control Porto Rico, Progress Report, 1925–26’, RAC, RG 5, series 243, subseries 2, box 21, folder 133; Crumbine, ‘Malaria’.

57 Frederickson, ‘Bionomics and Control of Anopheles Albimanus’.

58 Dietz, Economic History of Puerto Rico, p. 102.

59 Lt Col. J. P. Sanger, ‘Report on the Census of Porto Rico, 1899’, p.156, US War Department, Office Director, Census of Porto Rico; Sam L. Rogers, ‘Fourteenth Census of the United States, 1920, Population: Porto Rico’, pp. 5–11, US Department of Commerce, Bureau of the Census.

60 To be sure, migration patterns were not so simple. In some cases, such as the highland municipality of Lares, populations grew after 1898. Likewise, some districts on the south coast, such as Juana Díaz, showed only modest growth between 1898 and 1920. The picture is further complicated by the fact that some municipalities, such as Ponce, included both lowland canefields and highland coffee plantations.

61 Crumbine, ‘Malaria’.

62 Dr Howard W. Green, ‘Malaria in Puerto Rico, Preliminary Report’, 1925, RAC, RG 5, series 243, subseries 2, box 21, folder 132.

63 Central Lafayette was in Arroyo in the south coast irrigation district.

64 Of 4,400 people surveyed in Central Lafayette and its environs, 456 were diagnosed either as ill or as hosting malarial parasites. In 357 of the 411 malaria cases, the presence of parasites was confirmed in blood tests but those infected showed no symptoms. See Morales Otero et al., ‘Health and Socioeconomic Conditions on a Sugar Cane Plantation’, p. 29.

65 Ibid., pp. 24–31.

66 Ibid., pp. 8–9.

67 Sidney Mintz, Worker in the Cane, p. 41.

68 Ibid., pp. 50–3, 98.

69 Packard, The Making of a Tropical Disease, pp. 29–31.

70 For a short overview of this effort, see Franco, Rafael Miranda and Vélez, Alfredo Casta, ‘La erradicación de la malaria en Puerto Rico’, Revista Panamericana de Salud Pública, 2: 2 (1997), pp. 146–50CrossRefGoogle ScholarPubMed, IRPAHO; and for an even shorter overview in English, see ‘Malaria Control in Puerto Rico: A Summary of Accomplishments, 1924–1954’, Boletín de la Oficina Sanitaria Panamericana, 39: 5 (1955), pp. 489–93, IRPAHO.

71 See Packard, The Making of a Tropical Disease, pp. 111–50.

72 Briggs, Laura, Reproducing Empire: Race, Sex, Science, and U.S. Imperialism in Puerto Rico (Berkeley, CA: University of California Press, 2002), pp. 100–1Google Scholar. Recent scholarship has argued that the Rockefeller Foundation's agenda more often aligned with, and in some cases was shaped and altered by, the interests of host governments. See Birn, Anne-Emanuelle, Marriage of Convenience: Rockefeller International Health and Revolutionary Mexico (Rochester, NY: University of Rochester Press, 2006)Google Scholar and Palmer, Steven, Launching Global Health: The Caribbean Odyssey of the Rockefeller Foundation (Ann Arbor, MI: University of Michigan Press, 2010)Google Scholar. In contrast, it seems that in Puerto Rico the government's concern with tuberculosis did not align with or alter the Rockefeller Foundation's agenda.

73 Pierce and Williams Jr, ‘Report of a Survey of Problems of Sanitation and Medical Care in Puerto Rico’, pp. 16–21; Estus H. Magoon, ‘Impressions Obtained in an Inspection of Malaria Control Operations in the Island of Puerto Rico, October 9–13, and December 7–16, 1933’, pp. 5–6, RAC, RG 1.1, series 243, subseries I, box 3, folder 40.

74 Ibid.

75 Dr Walter C. Earle to Dr Hector H. Howard, 27 July 1934, RAC, RG 1.1, series 243, subseries I, box 4, folder 53.

76 Dr Walter C. Earle to Dr Frederick Russell and Dr Hector H. Howard, 10 Jan. 1929, RAC, RG 1.1, series 243, subseries I, box 3, folder 45.

77 Magoon, ‘Impressions Obtained in an Inspection of Malaria Control Operations in the Island of Puerto Rico’, pp. 5–6.

78 Pierce and Williams Jr, ‘Report of a Survey of Problems of Sanitation and Medical Care in Puerto Rico’, p. 16.

79 Paris green was selective in that it killed only filter-feeding anopheles larvae but spared those predatory larvae of the Aedes, and other genuses. See John Farley, To Cast Out Disease: A History of the International Health Division of the Rockefeller Foundation, 1913–1951 (Oxford: Oxford University Press, 2004), pp. 112–13.

80 Magoon, ‘Impressions Obtained in an Inspection of Malaria Control Operations in the Island of Puerto Rico’, pp. 5–6.

81 ‘Summary of Malaria Activities in 1931’, RAC, RG 5, series 243, subseries 3, box 74, folder 910.

82 Dr Walter C. Earle to Dr Hector H. Howard, 13 Jan. 1932, RAC, RG 1.1, series 243, subseries I, box 4, folder 49.

83 Magoon, ‘Impressions Obtained in an Inspection of Malaria Control Operations in the Island of Puerto Rico’, pp. 5–6.

84 Annual Report for the Year 1932 of Malaria Activities in Porto Rico, p. 6, RAC, RG 5, series 243, subseries 3, box 74, folder 911.

85 Dr Walter C. Earle to Dr Hector H. Howard, 18 Feb. 1932, RAC, RG 1.1, series 243, subseries I, box 4, folder 49.

86 Pierce and Williams Jr, ‘Report of a Survey of Problems of Sanitation and Medical Care in Puerto Rico’, p. 16.

87 ‘Reglamento de sanidad núm. 97 – sobre el uso de aguas para fines de riego y embalse, para evitar el aumento de la malaria y la formación, mediante el riego y el embalse, de nuevos focos de malaria endémica’, 20 May 1938, boletín administrativo núm. 575, AGPR, series: Irrigation, RG: Public Works, box 509. This law is also available online through the Puerto Rican Office of the Secretary: app.estado.gobierno.pr/ReglamentosOnLine/Reglamentos/278.pdf (last access 18 July 2018).

88 Dr L. B. de la Vega, secretary of the Insular Board of Health, ‘Reglamento de sanidad núm. 97’, 10 Feb. 1934, AGPR, series: Irrigation, RG: Public Works, box 509.

89 Sucesión J. Serrallés to Governor Blanton Winship, 2 Sep. 1934, AGPR, series: Irrigation, RG: Public Works, box 509.

90 F. A. Murray to the commissioner of internal affairs, ‘Asunto: reglamento de sanidad núm. 97’, 13 Oct. 1934, AGPR, series: Irrigation, RG: Public Works, box 509; ‘Reglamento de sanidad núm. 97’, boletín administrativo núm. 575.

91 R. Mendez Ramos, Department of Agriculture, to the secretary of the Executive Council of Puerto Rico, 28 Dec. 1934, AGPR, series: Irrigation, RG: Public Works, box 509; memorandum from Rafael Nones, Department of Public Works, to the commissioner of internal affairs, ‘Asunto: reglamento de sanidad sobre el uso de aguas para fines de riego’, 9 Jan. 1935; ‘Reglamento de sanidad núm. 97’, boletín administrativo núm. 575.

92 F. A. Murray to the commissioner of internal affairs, ‘Asunto: reglamento de sanidad núm. 97’, 13 Oct. 1934.

93 Antonio Lucchetti to the commissioner of internal affairs, ‘Asunto: reglamento de sanidad núm. 97’, 27 Sep. 1934, AGPR, series: Irrigation, RG: Public Works, box 509.

94 F. A. Murray to the commissioner of internal affairs, ‘Asunto; reglamento de sanidad núm. 97’, 13 Oct. 1934.

95 The Rockefeller Foundation had left the island by 1938 and the Puerto Rican Department of Health records in the AGPR were unavailable to researchers as of Aug. 2016.

96 Henderson, ‘Urban Malaria in Puerto Rico’, pp. 278–88.

97 Franco and Casta Vélez, ‘La erradicación de la malaria en Puerto Rico’, p. 150.

98 Malaria control during the Second World War consisted of the same methods implemented in the preceding decades, but it was better funded, better staffed and better organised, and it covered a greater area. The rapid injection of federal funding to fight malaria was most heavily concentrated in and around four prominent military bases: Fort Buchannan in San Juan, Camp Tortuguero in Veja Baja, Losey Field in Juana Díaz, and Roosevelt Roads naval base in Ceiba. However, Governor Rexford Tugwell used the additional resources to spread anti-malaria campaigns further throughout the island. See Luis D. Palacios, ‘Informe sobre la lucha antimalárica en Puerto Rico’, 1961, Puerto Rico Department of Health, Bureau of Malaria Control, HRSCIPRC.

99 Packard, The Making of a Tropical Disease, pp. 159–60.

100 Dietz, Economic History of Puerto Rico, pp. 184–5.

101 Franco and Casta Vélez, ‘La erradicación de la malaria en Puerto Rico’, p. 148.

102 Ibid.

103 Palacios, ‘Informe sobre la lucha antimalárica en Puerto Rico’.

104 Magoon, ‘Impressions Obtained in an Inspection of Malaria Control Operations in the Island of Puerto Rico’, pp. 5–6; Dr Walter C. Earle to Dr Hector H. Howard, 27 July 1934, RAC, RG 1.1, series 243, subseries I, box 4, folder 53.

105 Ayala, César, ‘The Decline of the Plantation Economy and the Puerto Rican Migration of the 1950s’, Latino Studies Journal, 7: 1 (1996), pp. 61–90CrossRefGoogle Scholar.

106 Franco and Vélez, ‘La erradicación de la malaria en Puerto Rico’.

107 Ayala, ‘The Decline of the Plantation Economy and the Puerto Rican Migration of the 1950s’, pp. 61–90.

108 Dietz, Economic History of Puerto Rico, pp. 149–54, pp. 206–12.

109 Ayala, ‘The Decline of the Plantation Economy and the Puerto Rican Migration of the 1950s’, pp. 61–90.

110 Ibid.

111 Increasing mosquito resistance to DDT, in addition to limited funding, was one of the principal reasons the WHO conceded defeat in its ambitious global malaria eradication campaign which lasted from 1955 to 1969. See Webb, Humanity's Burden, pp. 170–2 and Packard, The Making of a Tropical Disease, pp. 150–216.

112 Packard, The Making of a Tropical Disease, pp. 163, 187–93; Cueto, Cold War, Deadly Fevers, pp. 146–58, 160–1.

113 Malaria's return in Madagascar's highlands was part of a global resurgence of malaria during the 1970s and 1980s in countries where malaria eradication was not successful. In Mexico, the number of new malaria cases increased sixfold between 1982 and 1986, rising from 20,000 to nearly 150,000. See Packard, The Making of a Tropical Disease, pp. 174–5, 178–9.