As of 2015, this remarkable book is exactly one hundred years old. It was written by an outstanding pioneer of malaria control. Sir Malcolm Watson, when serving as a sanitarian in Malaya, devised and oversaw the world’s first successful large-scale effort to control malaria in what was then a British colony. In the first part of this book, he describes this work. He does so in an understated way that hardly does justice to his own role and contribution; Watson succeeded at a time when other large-scale efforts failed, such as that at the British military base in Mian Mir, India. His contemporaries recognized his accomplishments, however, and when he wrote this book, he was already a celebrity, as is evident e.g. from Section 14.7.
The central part of the book is devoted to the sanitary work done by the Americans in Panama, which Watson visited when the construction of the Canal was in full swing. The conditions of the climate, combined with the continual environmental disruption caused by excavation and construction, were extremely conducive to the spread of yellow fever and malaria, which had caused the previous French construction project to end in failure and disaster.
When the Americans took over, they brought in Colonel Gorgas, who had been part of the team around Walter Reed that had discovered the transmission mode of yellow fever and subsequently driven the disease from Havana, Cuba. In Panama, Gorgas created a uniquely effective sanitary organization that achieved the elimination of yellow fever and the tight control of malaria, thus ensuring the health of the workforce and the success of the construction project. Watson gives a vivid and detailed account of this large-scale sanitary work, and he provides an insightful discussion of the challenges which the Americans faced and ultimately overcame.
Throughout the text, Watson displays a keen eye for detail, but also a broad, understanding outlook on the general conditions of life and work to which sanitary rules and provisions must be adapted. An open mind, a keen scientific interest, and a strong practical sense round out the set of qualities that allowed him to succeed where many others failed.
Watson’s account is historically interesting, but its relevance is not limited to history alone. Considering that malaria is often perceived as an almost insurmountable challenge even in our scientifically advanced age, it may be quite startling to read how pioneers like Watson and Gorgas managed to get the better of it, using careful surveys of mosquito breeding places, followed by simple measures such as drainage of swamps and creeks, and oiling of standing water.
It bears mention that, later on, Watson and his co-workers put this approach into practice successfully also in Africa, in some mining towns of what is now Zambia (see his book African Highway: The Battle for Health in Central Africa; John Murray, 1953). Overall, Watson showed that simple measures of environmental management, if thoroughly and diligently applied, will effectively control malaria in virtually any geographic setting. This lesson has lost nothing of its relevance today, and for this reason, his book remains important one hundred years on.
About this edition
I obtained the page scans of the original edition from archive.org. For this version, I have reformatted the text, and made some minor editorial changes, as follows:
In sum, while the layout has been gently updated, the content is essentially unchanged. However, if you prefer, an unaltered reproduction of the original book is also available from my website.