The Provisional Government and Cuban Stability 211sanitation program, the entire public health system must be
nationalized. On August 26, 1907, citing Kean's reasons almost
verbatim, Magoon created the Department of Sanitation.^73
Local sanitary officers, in lieu of municipal boards of health,
under the direction of a national Chief Sanitary Officer, were
introduced. The national government assumed all costs, but
the municipalities had to remit 10 per cent of their annual
income for public health services. At the national level, a
board of distinguished doctors and public health officers would
advise the Chief Sanitary Officer.
74
The creation of the Department of Sanitation brought Kean
and Magoon into conflict over the role of the department in
political affairs. Part of Kean's motive in advocating nationali
zation was to get public health out of politics and make it
responsive to his trusted Cuban associates, Drs. Carlos J.
Finlay and Juan Guiteras, and to the Cuban medical profes
sion. Because he realized that to be efficient the department
would have to employ many (potentially corruptible) public
health inspectors, he hoped to place it under non-partisan,
professional control.^75 He clearly intended that the depart
ment should do more than police the yellow fever problem.
Already Kean had four Army medical officers supervising
public health work (primarily yellow fever control) and he
shared their frustration at not having the money or authority
to tackle the entire infectious disease problem.^76
Magoon agreed that Cuba's good health was related to
national development, commerce, immigration and foreign
trade, but the Governor was not so enthusiastic about profes
sionalizing the Department of Sanitation as was Kean. Magoon
would not appoint men as sanitary officers solely on their
professional qualifications as certified by the National Sani
tary Board. As he told Kean, "everything in this Island is
political and the political chiefs must be consulted.... "^77
Kean's analysis of the Governor's reasoning was that the
sanitary officers would be ineffective without public sup
port and this depended on the politicos approval. Although
Magoon had not appointed unfit men, Kean observed, they
had been drawn totally from the political factions. Kean