As I have before stated, when we visited the Isthmus in March, 1904, the French were still in possession of the property and we were their guests. On May 4, 1904, the property was formally transferred to the representatives of the United States, so that when we reached the Isthmus in June we were at once able to take possession of such sanitary equipment as there was, and to begin our organization. CHAPTER XI PRELIMINARY ORGANIZATION AND WORK AT PANAMA From the very beginning insuperable difficulties arose in the way of getting supplies. Very little could be obtained on the Isthmus, and the supply departments in the United States were so slow in being organized that, during the first year, very few requisitions that were sent to the United States were filled. The attempt of the first Commission to manage from Washington the work at Panama in all its details was fatal, and the arrangement whereby the Sanitary Department was made one of the bureaus of the Government, having no access to the Chairman, the real executive, except through the Governor, was equally fatal. In June, 1904, however, we all commenced work with a great deal of enthusiasm, determined to do the best we could under the circumstances. The $50,000 worth of supplies taken down, and the personnel brought along at the same time, enabled us to make a good start in all branches of the Sanitary Department, as outlined in the recommendations made in March. If it had not been for the supplies and personnel taken down at this time, we could have made no better showing than did the Engineering Department or the Quartermaster Department during the same period. We realized that the subject of yellow fever was by far the most important phase of sanitation with which we had to deal. We appreciated that, if the Americans were subject to this disease to any considerable extent, we should have great difficulty in keeping them at Panama, and in order to induce them to stay, we should have to increase wages to such an extent that the cost of the work would be very greatly increased. That even if we should find a white American force which would be willing to stay, and if we could afford to pay sufficiently high wages to induce them to stay, Congress, in all probability, would not sanction the continuance of the work, if we lost from yellow fever fifteen or sixteen hundred Americans every year. From the best statistics which I could get on the Isthmus, I found that the French lost yearly by death from yellow fever about one-third of their white force. If we lost in the same ratio it would give us about thirty-five hundred deaths among our Americans yearly. We, therefore, during the first year made yellow fever the first consideration, and gave it the most attention. The two principal foci of infection for yellow fever were the towns at either end of the railroad, Colon at the northern end, on the Caribbean Sea, and Panama at the southern end, on the Pacific Ocean.