File No. 468/79–80.

Minister Fox to the Secretary of State.

No. 390.]

Sir: I have the honor to inclose herewith, with great pleasure, a translation of a law creating a public health service, recently enacted by the Ecuadorian Congress, and to give the very satisfactory information that Dr. B. J. Lloyd, of the United States Public Health and Marine-Hospital Service, has been appointed by the council of state, on nomination of President Alfaro, as director of this service. Secretary Root will recall that his final personal instruction to me before I left Washington for this post, nearly two years ago, was that the Government of the United States, and especially that of the Canal Zone, was deeply and practically interested in the proper sanitation of the port of Guayaquil, and that I was exhorted to be alert to do everything in my power to accomplish it.

On my arrival in Ecuador I found Dr. B. J. Lloyd, of the United States Public Health and Marine-Hospital Service, already thoroughly imbued with the same idea and was agitating the matter. It will be recalled that several agreements had been reached between the department and Ecuador, looking toward an arrangement whereby the United States should superintend the sanitation of this port. This plan was balked by the opposition of the superior board of health of Guayaquil, which had ample authority and at that time some funds, and also by the municipality of that city. This would have been the situation to-day had it not been for the advent, in February last, of the bubonic plague.

Dr. J. C. Perry, of the health service of the Canal Zone, was sent here. He came to Quito and I presented him to Gen. Alfaro, and together with Dr. Lloyd we had a conference. The President was at first doubtful, and made more so by a continuous stream of telegrapic protests from Guayaquil. When, however, he became thoroughly convinced and made up his mind to the correctness of our position, he acted not only promptly, but energetically, and created by executive decree a special sanitary commission, naming Dr. Lloyd as president, and providing him with a fund of 20,000 sucres ($10,000) per month. Dr. Lloyd took charge on March 27 last, permission having been granted him by Surg. Gen. Wyman, in response to my telegraphic suggestion to the department. At this time the epidemic was at its height. The public was panic-stricken and commerce practically at a standstill. Through Dr. Lloyd’s efforts traffic was almost immediately reestablished, confidence restored, and the epidemic rapidly reduced to a few sporadic cases.

By July 1 of this year Dr. Lloyd began to turn his attention to yellow fever and smallpox, with the result that the latter disease has been exterminated from Guayaquil, and the former greatly diminished and is actually in the process of extermination. It is significant that the total number of deaths since January 1, 1908, is considerably less than in former years, in spite of the plague epidemic.

As will be seen, the law practically abolishes all other sanitary organizations (art. 11) in the Republic, placing everything pertaining to health matters under the immediate supervision of the new service, including maritime and land quarantines, and involving [Page 286] the transfer of all the property of the superior board of health of Guayaquil, including an excellent steam tug. The superior board of health will, as soon as the new law goes into effect, cease to exist. The municipality is being reorganized and Dr. Lloyd has been assured of its cooperation.

On examination of the records for several years past, the department will find that that which the isthmian health authorities originally desired, viz, the placing of the sanitation of Guayaquil in the hands of our experts, has now, by consistent effort on the part of this legation, supported by the United States Public Health and Marine-Hospital Service in the person of its able and indefatigable representative in Ecuador, been accomplished by indirection, and if not in the exact form originally hoped for, in a really much more satisfactory manner. The organization is entirely Ecuadorian. It is fortunate that Dr. Lloyd has been long enough on this South American detail to have inspired the confidence of the people, not only in Ecuador, but in Peru and Chile as well. He should, therefore, be heartily sustained by his bureau in Washington and every facility afforded him to continue his work.

The seed which has been planted here has already brought forth fruit. I look forward to this as only the beginning. Long before the completion of the Panama Canal, Guayaquil will have lost its reputation as a pest hole and travelers will not be afraid to come here, where for half the year the climate is one of the most salubrious to be found anywhere in the world.

There are many reasons why the work of sanitation has been and will continue to be difficult, but results are being obtained in the face of adverse conditions, though Dr. Lloyd expects a recrudescence both of plague and yellow fever during the coming wet season (Jan. 1 to May 15).

I need not point out to the department and to our Public Health Service the importance of what we have thus far been able to do. It certainly means much, and in the future we may be sure that Ecuador will go step by step with us in sanitary measures.

I have, etc.,

Williams C. Fox.
[Inclosure.]

Public-health service.

The Congress of the Republic of Ecuador, considering that the public health is the supreme law of the people, not only in its relation to the well-being of the people, but also with regard to our international relations, decrees:

  • Article 1. That there shall be established a public-health service whose personnel shall, if possible, be composed of physicians and shall consist of—
    (1)
    One director and two assistants.
    (2)
    One subdirector and two assistants for each city or town where their services may be necessary.
    (3)
    Such employees as the director may deem necessary.
  • Art. 2. The director of public health shall be named by Congress or by the council of state when Congress is not in session and shall be under the immediate direction of the minister of the interior. The director shall reside in Guayaquil and his duties and attributes are as follows:
    (1)
    To name his assistants and, with the approval of the President, the sub-directors for the different cities and towns in the Republic.
    (2)
    Remove from their places his assistants and the subdirectors.
    (3)
    Formulate regulations relating to hygiene and public health, and also regulations governing maritime, interprovincial, and interurban quarantine, and submit these regulations for the approval of the President.
    (4)
    To see that these regulations are enforced.
  • Art. 3. The assistants of the subdirectors shall be named and remunerated by the municipality of the canton where they are required to serve during the first days of January of each year on the approval of the subdirectors.
  • Art. 4. The duties of the subdirectors shall be as follows:
    (1)
    To see that the provisions of this act and the regulations made in pursuance thereof are enforced.
    (2)
    Formulate special regulations for the cities or towns where their services are rendered, which regulations, on being approved by the director of public health, shall be transmitted to the municipality for their approval and enforcement. The political (Federal) and municipal authorities shall aid in every way possible in the enforcement of these regulations.
  • Art. 5. The salary of the director of public health shall be s/.800 (sueres) per month and that of each of his assistants s/.500 (sueres) per month.
  • Art. 6. The several municipalities shall furnish such funds as may be necessary to protect the public health in their respective jurisdictions unless there is a special fund provided for such work.
  • Art. 7. The subdirectors of public health shall be, ex officio, presidents of the boards of health in their respective cities and towns.
  • Art. 8. The director of public health is authorized to suspend, at his discretion, any regulation made in pursuance of this act if in his opinion it is to the interest of the public good to do so.
  • Art. 9. Municipal health regulations which may be in conflict with the regulations of the public-health service shall be void.
  • Art. 10. The director of the public health shall give bond in the sum of s/.5,000 (sueres) for the faithful performance of his duties and the management of the public funds intrusted to his care; and if it can be proven that he knowingly misused these funds, or if he receives or knowingly permits others to receive any pay or emolument for the purpose of influencing for or against any measures to be enforced, or if it can be proven that he has unlawfully used his influence or faculties for private gain, this bond shall be forfeited wholly or in part, according to the gravity of the case, and on conviction he shall be punished by a fine of from 500 to 2,000 sueres, or by imprisonment for a term of from six months to two years, or both, in the discretion of the court, funds so collected to belong to the funds of said service. In order that the director of public health may be punished for derelictions of his subordinates it shall be necessary to prove that he had guilty knowledge of the acts and that the guilty subordinate should be previously convicted. If the director of public health knowingly consents that his subordinates shall misuse their faculty or influence for private gain, he shall be responsible in the manner already stated, and his subordinates, on conviction of such dereliction, shall be fined not less than 500 nor more than 2,000 sueres or by imprisonment for a term of from six months to two years, or both, in the discretion of the court.
  • Art. 11. With the naming of the director of public health the other organizations in Guayaquil having similar duties shall cease to exist and shall deliver, by inventory, to the director of public health all their funds, rents, offices, accessories, books, accounts, lazarettos, etc. The Comisión Especial de Saneamiento will transfer all of its offices, accessories, books, accounts, lazarettos, etc., to said director for the use of the public-health service; and in the act of effecting this transfer the Comisión Especial de Saneamiento shall be dissolved and its duties and attributions shall devolve upon and pass to the public-health service herein provided for, duties and attributions which are defined in the executive decree of March 24, 1908.
  • Art. 12. The public health service shall be provided with a fund of 240,000 sueres per annum, authorized by the law of general appropriations, which fund shall be destined for the payment of salaries, the acquisition of materials, sustaining of lazarettos, and other expenses of the service, and shall be administered in accordance with the laws governing the administration of public funds. The public-health service shall deposit its funds in the Bank of Ecuador, in the city of Guayaquil, and shall check on such funds, the accounts to be approved by the governor of the Province of Guayas. In case of urgent necessity, as in times of epidemics, the President of the Republic shall increase these funds at his discretion. The funds mentioned in this article shall be [Page 288] dedicated to the work of sanitation of the city of Guayaquil in conformity with the decree of March 24, 1908.
  • For the sanitation of other places in the Republic funds shall be provided by the respective municipalities, and those municipalities are authorized to impose the necessary taxes; but in case of urgent necessity the funds herein provided for may be drawn upon, but in this case the amounts taken shall be refunded to the public-health service.
  • Art. 13. The director of public health on assuming charge of his duties and responsibilities will formulate regulations which he shall submit to a commission formed of the deans of the faculties of medicine and law and one other member of each of these faculties for the approval of said commission. The rector of the University of Guayaquil shall be president of this commission.
  • Art. 14. Authority is hereby granted to impose fines and imprisonment for violations of this act or of regulations made in accordance therewith.
  • Art. 15. The Federal and municipal police will enforce the provisions of this act and of the regulations made in accordance therewith, imposing fines and penalties for violations, failing in which they shall be responsible in conformity with the penal code.
  • Art. 16. All laws and parts of laws which may be in conflict with this act are hereby repealed.


Jenaro Larrea,
President of the Senate.
Abelardo Montalvo,
President of the Chamber of Deputies.
Celiano Monje,
Secretary of the Senate.
L. E. Bueno,
Secretary of the Chamber of Deputies.

Approved.
Eloy Alfaro.

By the President:
A. Reyes V.,
Minister of the Interior, Hygiene, etc.