1 12 68 https://globalhealthchronicles.org/files/original/ae283c36492aea299ab0b89dcd2ae4dc.jpg f0d4a4924b280243ce2018d0f9bf5f3b https://globalhealthchronicles.org/files/original/da2113082249191878b93b8f89cc5bdb.pdf aca0615c0585e539e2c4bb36c56a3825 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> Interview Patrick McCannon | with Interviewer [unnamed] Transcribed from audio: January 28 2009 | Duration 0:07:47 Interviewer: This is an interview with Patrick McCannon on April1, 2008 at the Centers for Disease Control and Prevention in Atlanta, Georgia, about his involvement with the India Smallpox Eradication Project. How did you get involved in Public Health? Patrick McCannon: I was a recent graduate or about to graduate from the University of Wisconsin and back in the stone age when they actually sent people to recruit new graduates on the campus, and I went to several interviews and I had job offers from Dunn &amp; Bradstreet, DOW Chemical and outfit that was trying to eradicate Syphilis from the United States and that one sounded interesting and I'd never heard of CDC before then. They talked about it being with the Public Health Service. So I put in my application for the recruiter and followed up several times, and that was it. Interviewer: So was Public Health something that you always knew you were interested in? Patrick McCannon: No. I absolutely had no idea of public health. I wish I could say that I was dreaming about a career in public health since I was eight years old, but I didn't have a clue about it. Interviewer: So how would you describe your early life and education through high school? Patrick McCannon: Wow! I grew up in small towns in Minnesota and Wisconsin. Sort of typical for that area, interesting, I enjoyed school immensely, I played all the different sports and got involved in all the different kind of activities in school that they offered and had a very good time, enjoyed it. I went to Catholic school early on and then public school. Interviewer: So how did you decide that you wanted to go to India on the Smallpox Eradication Project? Patrick McCannon: Well actually, it wasn't India, for me, it was Bangladesh, but I had joined CDC in 1967 - February of 1967, and one of the programs that was rolled out several years after that, I think it may have been '69 or '68 was the Smallpox Campaign in West Africa and I desperately wanted to get involved in that. I'd been on the job for several years and it sounded exciting and really sort of a golden opportunity, but I wasn't able to compete. I didn't have enough years in service and they had a lot of people volunteering for the West Africa Campaign; and I kept an eye on things as they were looking for volunteers for Bangladesh, I put my name in and went through some interviews and I was selected to be one of the people to go over on the first team that they sent after they discovered the re- introduction of smallpox in Bangladesh. Interviewer: What were some of the hardships that you faced upon arriving in Bangladesh; any culture shock? Patrick McCannon: I'm sure I'd suffer from culture shock. Like everybody I had limited travel experience. I'd traveled in Europe but nothing that approached a third world country, and at that time Bangladesh was just coming back from a terrible war with Pakistan and for the entire country there were either news reports of Bangladesh being the basket case of the world. You know, very, very difficult living in Bangladesh at the time, for the residents there. So I'm sure that I had culture shock seeing third world country and people living in very deprived conditions. Interviewer: Were there any main changes between the work that you did here and the work that you did in Bangladesh, with the new responsibilities? Patrick McCannon: The environment in which we did the work was just totally different and it required a lot of attention to be attentive to the environment around you and the people and all the things that make up a third world country and the condition that Bangladesh was in; and then you add on the disease that you're dealing with. Smallpox was a real killer and this really very major and as soon as we arrived we went to the old cholera hospital that had in part been turned into a smallpox ward for the indigent and isolation area and we were given a three-day course on differential diagnosis of smallpox and identification of smallpox, and how to handle specimens and how to handle patients, and how to set up remedial care for the people that were afflicted with smallpox; and this was prior to our going out into the areas that we went to. So just the foreign environment, the sort of dealing with the disease that basically there was no treatment for except for to care, remedial care, and with substantial mortality. So that combined to be a very unique experience, regardless of the background that I had. There were some things that I was very pleased with, I mean in retrospect, like the training that I had had and I was a public health adviser, and basically that was CDC's management entry point for people that they would build into managers, who eventually would be, maybe, in senior management positions at CDC, and you learn by doing, you had mentors that provided you assistance along the way. You were put into State assignments and moved all around the country in different assignments and progressed up the ladder, and then some people came to CDC [Audio ended prematurely - 0::07:47] </pre> Player html for embedded player to stream video content <iframe src="https://www.youtube.com/embed/vjCOeeNtJC8" frameborder="0" width="560" height="315"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource MCCONNON, PATRICK Subject The topic of the resource WHO oral history smallpox eradication CDC Bangladesh Description An account of the resource Pat McConnon was a Public Health Advisor assigned to Bangladesh Smallpox Eradication Program. Creator An entity primarily responsible for making the resource McCannon, Patrick (Interviewee) Date A point or period of time associated with an event in the lifecycle of the resource 2008-07-29 Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of Southeast Asia and East Africa Smallpox Workers (2008 : Atlanta, Georgia) Format The file format, physical medium, or dimensions of the resource 9170640000 bytes video/x-dv Language A language of the resource English Type The nature or genre of the resource interviews motion pictures moving image Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/15pgc emory:15pgc https://globalhealthchronicles.org/files/original/5ae751bfe51494ebcf75aa420dd9f12a.jpg 021fd2b974511da23572654ff240c961 https://globalhealthchronicles.org/files/original/40c3a75e49d51549676aa87717383164.pdf 0e752bf27f54a5ac6a48ce8809866ca9 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> Interview Dr. David Adcock with Dr David Sencer Transcribed: January 2009 | Duration: 0:23:51 Interviewer: I am Dr. David Sencer, I am interviewing David Adcock. It's the 3rd of March and we're in Studio-B at CDC. Welcome, David. David Adcock: It's good to be here, Sir. Interviewer: Tell me where you're from. David Adcock: I am from Kannapolis, North Carolina and went to school there, and it was interesting, I went to Pfeiffer College, a very small Methodist school, and graduated on a Thursday and started at CDC the following Monday. That was in 1965 - May of 1965. Interviewer: Why did you call CDC? David Adcock: That's what was interesting. I didn't. That was a point in time when Vietnam was heating up pretty good and everyone was taking their single/senior[inaudible0:01:01] trips to Vietnam and the interviewer who came in from CDC, no one was talking to him; and the coordinator for the interviews asked me to simply go in and have somebody for him to talk to. I thought that it was very interesting. I filled out the paper work, sent it in. I was sitting in Psychology class, got a note to come to the door, and that was to call Washington instantly. I had a job with CDC. Interviewer: And where was the job? David Adcock: It was in Shelby, North Carolina. I started there as a Venereal Disease Investigator and went from Shelby to Greensboro; Greensboro to St. Louis; St. Louis to Jackson, Mississippi, changed to the Immunization Program at that point, went to Oklahoma and stayed there for seven years before returning to CDC. Interviewer: And when you came back to CDC-physically? David Adcock: That was in 1976 and I left the immunization program and joined the Laboratory Communications Group in laboratory training and was a consultant in Laboratory Methodologies, and particularly, management. Interviewer: When did you go to Southeast Asia? David Adcock: That occurred in August of 1974, and it was very interesting, I had wanted to go for some time. I had tried to get to Africa and that didn't pan out for me and the call did come, and I had just a number of days to get my act together, get my clothing together and leave. I left my wife and three young kids in Oklahoma for almost 100 days and took off to India. Interviewer: And when you got to India, what was your first impression? David Adcock: The smell of curry was overwhelming. I was fascinated with the number of people, the clothing they were wearing, the modes of transportation, and the job at hand, I thought was overwhelming with that many people that close together. Interviewer: What was your job in Delhi? David Adcock: I was assigned to the State of Bihar, India, the largest State in India-Northwest India, and I was a Management Officer for the Smallpox Program in Bihar. Interviewer: In Patna? David Adcock: In Patna. Interviewer: What did that entail? David Adcock: My responsibilities included getting the Docs in, the investigators in; 147 of them. I was over the entire motor pool, making sure the transportation was available for everyone, that they had adequate housing, that they did in fact, get paid, and setup the monthly meetings that occurred in Patna. That's when Bill Foege came out from Delhi to hold these meetings and I think D.A. Henderson was at one of those meetings also. Interviewer: Who was the Management Officer in Delhi at that time? David Adcock: Interesting question. I frankly do not remember. Interviewer: Tony Scardachi[inaudible name0:04:36]? David Adcock: I think so. Interviewer: It was either Tony or Larry Sparks? David Adcock: Larry Sparks. It was Larry Sparks. This was between August and January of '75. Interviewer: Were you in charge of pay rolling the Indian employees too? David Adcock: I was Sir, which got to be very interesting because I would have people lining up outside the hotel, looking for jobs from the moment I came out. So I always had an entourage around me, wanting to drive the vehicles, and quite frankly, to protect me. The payroll was always very interesting. On one occasion, I was requested to fly from Patna back into New Delhi and literally, picked up the payroll in Rupees in duffle bags, and I didn't think anything about it. I had no protection from the embassy back to the airport and flew back into Rajgir at that point; and when the plane landed, there was a large military contingency on the ground. I had no idea what was going on. So I was very slow about getting off the plane and I came off with my two duffle bags, and they were there to protect me with the amount of Rupees I had with me, and I did not consider it dangerous at all. It tells you where my mind was at that point. Interviewer: I rode from Delhi to Patna with Dr. Foege one time on the train when he had his two duffle bags and I remember in one of the little stops that we made along the way, all of a sudden, people on the outside were shaking the train, there was a student unrest at the time, and I'll admit, I was frightened. David Adcock: I don't know why I didn't even think about that, but the way I was traveling with the backpack and the duffle bag, it seemed to fit with the kids who were roaming around India and going to Patna, so it kind of got my attention big time at that point. What's really interesting to think back on it, the Choki Guards, the guards who were with me all the time were being paid like Three Rupees a day, that was Twenty-four Cents at that point in time and I had two duffle bags of Rupees. It could be a death defying issue if you were caught with them. Interviewer: Did you get out in the field much or were you limited to Patna? David Adcock: Unfortunately, I did not. I did go out a couple of times with Dr. Larry Bryant and saw several of the villages and got to see a number of active smallpox cases. I know in one particular village I was in ...Sadat[inaudible name0:7:26], my interpreter, could find no one who could speak a dialect that he could understand. So, I was just walking around the village and found a guy with a water buffalo on the backside of the village, who had the most beautiful handlebar mustache I think I'd ever seen, it was waxed perfectly, and he spoke the King's English perfectly. He had been in the British military and he became our interpreter. It was also in the very same village, there was a young lady who had died. She had very aggressive smallpox and was asking for anything. I only had aspirin, and she died that afternoon [teary voice]. Interviewer: Were you a part of the campaign that prevented other people from dying? David Adcock: Yes. [Pause] I think the smallpox effort in India and worldwide is almost beyond comprehension that we achieved what we achieved. The number of people moving, going back to religious events was almost uncontrollable. The fact that this team, this very small team of very dedicated people, both from U.S., Europe and other parts of the world who came in, lived under unimaginable conditions in some cases were able to literally pull it off; to make it happen, is something I don't think the world will ever forget. Interviewer: I think the inspiration of several of the leaders had a lot to do with it. That Dr. Foege's dedication, his belief and accomplishment, I think was one of the major parts of the whole effort. David Adcock: Bill had a presence about him, about the smallpox. There was no doubt in his mind whatsoever that we would accomplish our goal. The significant problems we had, transportation, paying the people, certainly giving our own staff adequate medical care was a big issue. But it was an event that I think the public health advisers, the Docs at that time, it wasn't the job; it was the mission which was all critical; and looking back on it, I hate that I cannot remember everyone I worked with then, but the many events, the fact that in my position, they were trying to keep the motor pool going, the equipment up to what it should be, we had like 125 Mahindra &amp; Mahindra Jeeps, we had 44 motorcycles, and it got to be a real problem for us to maintain this equipment. Some of the things we did to make the jeeps work for example: a World War II junkyard was in Patna; there were hundreds of U.S. World War II variety relief jeeps there, the Mahindra &amp; Mahindra jeeps were the exact duplicate; in fact, the stamping equipment was transferred from Toledo[0:11:25], Ohio to Bombay, and that's where the jeeps were made. I would literally go to the U.S. jeep junkyard, and it was simply an open field, and take all starters, springs, and put them on new Mahindra &amp; Mahindras, and they worked. We were fortunate to establish a relationship with the Loyola Institute. It was a Catholic organization that was open to kids who had no place to go and they were training these kids as machinists, as mechanics, autobody repair people, and we could take a jeep in - because the monthly meetings occurred over a weekend usually, two or three days, so all this equipment came in very quickly. These kids were able to take these jeeps, recamber[inaudible0:12:12] springs, replace parts, get them running again, even to the point of doing body work and repainting in a period of three days and getting them out to keep our guys in the field and operational. It was truly amazing to see what these kids could do, and it was a good relationship for us because they were able to take the money we gave them for the repair to support their institution. Interviewer: And learn a trade? David Adcock: And learn a trade. You know, it was interesting to go there and we always had hot tea. The sugar was always sitting on the table. It was always covered in ants. I grew a mustache so I could strain the ants out of my tea while I was drinking it. Interviewer: When you came back from India, was it a letdown? David Adcock: The intensity and the overpowering dedication to the mission and the fact that you could see immediate change going on, it was a letdown. I returned to Oklahoma where I was the Director of Immunization Program there and to know that what we were doing for the American people, the young people in providing the immunizations, to have seen what I saw in India, the rampant disease, the fact that immunization was not in place there effectively, particularly for polio, and to know there are people who had this at their finger tips and it's actually taken for granted. It was just one of those almost mundane things you do, but to know what the end result was, got to be a very strong mission for me and it continues today. Interviewer: You would do it again? David Adcock: In a heartbeat. There are several things that I would like to do, to go back and see what Patna looks like today. I did have the advantage over many of the people who were assigned to the field. I lived in a three-star hotel and you had to have been in Patna to see what that really means. But I did have a bath. I was able to go down and have food in the lounge and a number of people who I worked with very closely, Roy Mason who was from England who had been in India since World War II, he had never returned home, got to be a very, very good friend and he was the knowledgeable part of what I was doing in Patna as a Management Officer because he had the insight and knowledge of working directly with the country that I did not. So when particular issues came up, I would go to Roy and say, "Roy, how do we solve this?" "Come on, Dave;" and we'd go do it. I have lost touch with him. Jay Smith from CDC was there also, I think he was assigned to Katmandu and he would come down occasionally and we would work through - Interviewer: For free? David Adcock: Yes. But to bring all these KSAs together at that point in time and see how it all fit, made the world a much smaller place for me, and it has continued to get smaller over time. Interviewer: Have you read the book E.M. Forster's A Passage to India? David Adcock: Yes, Sir. I have. Interviewer: It was written in Patna and I think it was written in that hotel that you stayed in. David Adcock: Ah! Interviewer: Did it have balconies that looked over a little river? David Adcock: No. This was downtown and it was directly over the Mahindra &amp; Mahindra Dealership and has only about three floors of it, and it was quite small. It was interesting that we had the sounds of India, the music was 24/7 and it never stopped. I was surprised one late night, I was awoken by the sound of large bells, it sounded like church bells, and got up and went to the window, and a caravan of elephants were coming down the main street of Patna. In a straight line, the bells were tied over their backs and they kept them in pace to step. Each time they stepped, the bells would swing from one side to the other and I had never seen anything like that-this was a National Geographic moment and I had no camera. Interviewer: That time in India is something. David Adcock: With the way the average citizen in Patna had to work, the difficulty in finding work, simply finding adequate food in many cases was a problem; and I never got over the fact that the number of people who would stand around the front of the hotel, begging when I came out. It was a situation that you could not encourage it because the crowds just got larger. But even the vehicles we had, they held the World Health logo on the side of them, got to be an issue because every time they were parked or we went some place, the crowds would gather because they knew we had money and I suppose, we're almost easy marks because of where we came from, our affluence there. It was hard to deal with over a period of time. I think it took me maybe two months to realize that I had gone through culture shock and had actually started to assimilate somewhat there. At that point in time, it was a mind-boggling experience, you might say, to realize that you have lived here this long and you've seen so much change in such a short period of time, and so much could be done. It was truly a Third World involvement at that point and I would love to go back and see what has changed now. Interviewer: I haven't been in India since the mid-80s, but even then, you began to see the changes of billboards, advertising, spas, and fat farms, and - David Adcock: It was interesting, and upon my return from India, I went back to Oklahoma in the Immunization Program and then transferred to CDC in '76 with the Laboratory Program. I was able to go back to India in about 1984 and worked in New Delhi and Bombay and taught Laboratory Management to the State Laboratory personnel at that point. At that time we were working with the United States Public Health Laboratory Association and several of the State Health Officers and Laboratory Directors went with us. But the status of their laboratories; the old buildings they found themselves in, the equipment they were using, and to finally realize that much of their glassware was literally stacked out back in the open, the facility we taught in was an old British military barracks type room, the lighting was extremely poor, no air-conditioning, and you wondered about the quality of laboratory result they got; which were quite good by the way. Many of the laboratorians were trained in Europe, particularly England and came back, had all the current technology, but not the equipment in which to use it. So it was interesting to identify what their needs were, what we could help them with in obtaining from our side, and yet, to work with them particularly on the State Public Health laboratory side, guys who'd been there working in this country to help them expand their horizons as to how they could not only test, but manage the results of their testing for the nation. Interviewer: In 1964 I believe, Dr. Roger Feldman was assigned to the Christian Medical College in Vellore, his major responsibility was to develop a Virology Laboratory; and he developed a laboratory on the roof of another building that was totally Indian. There was not a piece of equipment, not a supply that could not be obtained in India and that was an accomplishment. David Adcock: It was amazing to see what the Indians could do for themselves. They are brilliant people. In most cases, well- educated and they were always searching for education, if they simply had the place to work and to do. I know in getting laboratory supplies, we worked with a glass blower and he and his family had done this forever, and we simply told the guy what we wanted, how we wanted the design, and in some cases we had the exact example and he could duplicate it almost perfectly, and it was all done by hand. It was amazing, and the cost of it was in my U.S. thinking, free for all practical purposes. But yes, they do have the skills by which to do what needs to be done. As far as the equipment goes, it was adequate for the job. It was not a Zeiss microscope and such, but it was more than adequate for what they were doing at that point in time. Interviewer: Are you a different person because of your experience in India? David Adcock: Absolutely. What India has done for me as an individual, have been mind boggling to see what the other part of the world looked like, to understand that we in this country take so many things absolutely for granted, to say nothing of public health or what this institution does for them at CDC, and to see how two aspirins, not much, but it did make a difference-could do there. How such a little effort on our part would be such a monumental result there is huge; and I think CDC has been on the forefront of this, particularly on the health side, for an awful long time and it cannot quit. It's got to move forward. Interviewer: Thank you, David. David Adcock: It's been my pleasure, Sir. Interviewer: It was a good interview. David Adcock: Thank you. [End of Audio - 0:23:50] </pre> Player html for embedded player to stream video content <iframe src="https://www.youtube.com/embed/kuD_i6L1rmw" frameborder="0" width="560" height="315"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource interviews motion pictures moving image Date A point or period of time associated with an event in the lifecycle of the resource 2008-03-03 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/15p9p emory:15p9p Subject The topic of the resource CDC Smallpox Eradication USAID WHO Management Format The file format, physical medium, or dimensions of the resource 5146560000 bytes video/x-dv Creator An entity primarily responsible for making the resource Sencer, David (Interviewer) Adcock, David (Interviewee) Contributor An entity responsible for making contributions to the resource Centers for Disease Control Title A name given to the resource ADCOCK, DAVID Description An account of the resource David Adcock, served with the Smallpox Eradication Program in Bihar, India from August 1974 - January 1975 as a Management Officer. David describes his responsibilities to get doctors and investigators into the country, arranging their transportation, housing, and monthly meetings in Putna, doing payroll for Indian staff, and witnessing the death of a woman from severe smallpox. He reflects on the importance of the smallpox effort and the practice of immunization. "It wasn't the job. It was the mission." Language A language of the resource English https://globalhealthchronicles.org/files/original/5886931fc3a8d668deb94810253b6946.jpg b003e03025e4df2a0b83f48b49651638 https://globalhealthchronicles.org/files/original/220e2a27fe5ca76edb23c2260a5fef66.pdf f241df0c4eed163ea5776e099e069586 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/sANYn6J6hh4" frameborder="0"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource interviews motion pictures Date A point or period of time associated with an event in the lifecycle of the resource July 12, 2008 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16rqm emory:16rqm Format The file format, physical medium, or dimensions of the resource 8188200000 bytes video/x-dv Creator An entity primarily responsible for making the resource Altman, Lawrence K. (Narrator)5th, Kenline, Carolyn (Interviewer); Emory SPH; Grad Student Contributor An entity responsible for making contributions to the resource Centers for Disease Control Title A name given to the resource ALTMAN, LAWRENCE K. Description An account of the resource As an EIS officer, Dr. Larry Altman was initially assigned to Upper Volta (now Burkina Faso) to follow the field trials for the measles immunization program, which eventually became the smallpox eradication effort in West Africa. After completing his training in internal medicine, he joined The New York Times as a medical correspondent. He wrote about the end of smallpox after the eradication program had progressed to the last cases in India and Bangladesh. Subject The topic of the resource Smallpox Eradication Program India MOH Language A language of the resource English https://globalhealthchronicles.org/files/original/b9b83bfd3b6aacbe19923616d2ac1f53.jpg d76b262f53586773bb099f4f0c75d12c https://globalhealthchronicles.org/files/original/dce1934d690883ba00beedcd2696038b.pdf 83847124f5f38046f59cde7abfd4cf94 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> This is an interview with Bob Baldwin, on July 13, 2006, at the Centers for Disease Control and Prevention in Atlanta, Georgia, about his role in the project to eradicate smallpox in West Africa in the 1960s. The interviewer is Melissa McSwegin Diallo. Baldwin: Thank you. My name is Bob Baldwin, and I know that I am being taped during this interview. Diallo: Okay, fantastic. All right, well, let's go ahead and get started. Baldwin: Okay. Diallo: To start out with, can you talk a little bit about how your upbringing and education led you into the field of public health? Baldwin: That's a very interesting question, because I guess I was fortunate enough to stumble on a career in public health. It wasn't anything that I aspired to from early childhood. I grew up in an inner city in the Northeast, in New Jersey, and amidst poverty, and went to the university. And when I had an opportunity to be interviewed by a number of companies, as I was about to graduate from the university, the one from CDC was the most attractive, and that meant working in sexually transmitted disease in New York City, where I met a number of people who you will meet in the next couple of days, who were working there also. So that's how I got in to that, and then once I started in New York City, I became aware of this opportunity in the smallpox eradication program. And I was fortunate enough to be selected for this, because there were a lot of people who competed for this, these positions. And I was in the about second or the third phase of this effort, and I was fortunate enough to be selected, and that really made the difference that shaped my whole career in public health. I just retired about 2 years ago from CDC, and I had the good fortune of spending at... More than two-thirds of my career working in public health, and I attribute that back to those early days in the smallpox eradication program. Diallo: And what was your degree in? Was it... Baldwin: Now that's a funny question, because people say what, with all the experience that you've had over these 40 years in so many different parts of the world, and so many different disciplines, what did you major in? I said, well, I was an English Literature major at Rutgers University. And it always really just baffles people, it throws them. They say, well, how can you... How can you have done this? And today you probably couldn't. You couldn't, no. You do have to have a master's degree to get in around here in public health, and to do the things that we did, but we were fortunate in our generation to be able to get in at the ground level and learn by doing, and applying, and making the stakes, and that sort of thing. Diallo: Could you name one, if you can, one influential person in your life that, maybe how they inspired your early career? Baldwin: (unint.) Bill Foege [William H. Foege], who you haven't met, you will. And he's an imposing guy, a tall guy. Very visionary. And just being around Bill is, in a sense, inspirational. And when I was in the smallpox eradication program, Bill was then the director of the program, and he'd come out from time to time and spend, you know, visit with us in Cameroon and all that. And he later became the director of CDC. But Bill's been sort of a hero, a role model to... So he was very influential, I think. Diallo: So how do you think... You said that you started out with CDC in sexually transmitted disease. How did the smallpox eradication campaign interest you? What motivated you to join it? Baldwin: Well, ever since I was a kid, I always had this desire to go to Africa. You know, I had probably read too many Tarzan novels and saw too many Tarzan movies, and I've always wanted to go to Africa. It was the mysterious, dark continent. And so, when this opportunity came along, I said, this is an opportunity of a lifetime. I would never forgive myself if I don't try, at least try, to get accepted for this program. And also, the lure of participating, even in the small way that I did, in an accomplishment like this. The eradication of a disease from the world. I mean, this is, I believe, a major accomplishment in the history of mankind, and certainly in the history of medicine. And I said, if I could be part of that, I would really be... I would be really happy. Really happy. And I was overwhelmed when I was chosen. And so I went to Africa, and that was a definite eye-opener, because when I arrived in Africa, there are so many things about Africa that you remember. The smells, which are entirely different from any other place on earth. The heat, when I stepped out of the airplane in Lagos at 8 or 9 o'clock at night, and set foot on African soil. It was like you were walking into Saran wrap. You were enveloped by the humidity and the heat, and you felt like you couldn't breathe. There was fog on the windows in the airplane, and all that. And then I met the African people, who were nowhere like... Nowhere near the people in the Tarzan novels, and all that sort of thing. I mean, they were friendly, they were open, they were outgoing, they were creative, resourceful, and survivors, and I thought I'd known poverty, living in New Jersey and working in New York City. I started in Harlem and worked in Spanish Harlem in the Bronx. Well, when I got to Africa, I really saw poverty for the first time. And I saw people making do with very, very little. But doing it in a nice way, and not in a resentful way. It was just a great experience, and it... As I said, it influenced me to continue on in public health, because it broadened my perspective, my appreciation for different cultures, and for different perspectives, and it shaped me. I mean, I'll always be grateful for having had that opportunity to play a small part in this disease, and it inspired me to continue on. And so when I left here two years ago, I was Associate Director in the Office of Global Health, and I had responsibility for very wide geographic areas of the world, like the former Soviet Union, China, Eastern Europe, and that sort of thing. Diallo: Okay. Actually, you've already answered some of my next questions. All right, so can you tell me about... You said you were assigned to the (unint.). Actually... Baldwin: Yeah. I flew into Lagos, but I was on my way to Cameroon, because my assignment... Well, my initial assignment was supposed to be the Central African Republic, but the ambassador there said, this program is drawing to an end soon. I don't want to have another American coming in. Is there some way that we could avoid that? And so the program got very resourceful, and they said, well, let's assign Bob Baldwin to a regional position. They didn't have any regional positions other than... We had a regional office in Lagos, but we didn't have any regional operations officers, so they decided to assign me to a French military organization called OCEAC, which in English stood for The Organization for the Great Battle... The Battle Against the Great Diseases in Central Africa. And this was located in Yaounde, Cameroon. So they said to me, well, we're not going to be able to put you into CAR, the Central African Republic, we're going to send you to OCEAC. And from there you will be responsible for Cameroon, for Congo, the Central African Republic, Chad, and Gabon, what was formerly French Equitorial Africa. And so we had in the past, either we had operations officers there. Russ Charter [Russell Charter] at one point was in Chad, and then he left and went on to Guinea. So they started pulling those operations officers out of there, and put me into Yaounde, and they said, and you're in... And this was in a consolidation phase, when surveillance for the disease was intensified. And any time there was a suspect case of smallpox, we jumped on it like fleas on a dog, and we got to it as fast as we could, investigated it, and tried to determine whether it was smallpox or chicken pox, which was an imitator of smallpox. And so that's how I got into Central Africa. And working... Speaking French, as it did, and I had studied it in the university and in high school, I had an opportunity then to exercise it there, because I was working with a French general, who was the Director General of OCEAC, and he was a physician, but he also became a general, because the French military ran French assistance and health in French-speaking Africa, as opposed to the British system, which was totally different. So I was working there, and the other thing that I remember, in addition to being a regional person, was the fact that throughout our days in smallpox eradication, we were funded by the United States Agency for International Development. And it was always this pull and tug, this relationship that was very cantankerous, it was combative between the two agencies. And people in Washington resented the fact that we were the technical agency, that we, in a way, were getting more credit than they were, even though they were funding the whole activity. So there was always this push and pull, and this battle between AID and CDC. So when I got to Cameroon, I was thrown right into that. And I ended up having four bosses. I had the Aid Mission Director, who was really a good guy, but a stickler for detail, and questioned everything that we did. I was working for the General at OCEAC. I was also accredited, though, to the Ministry of Health in Cameroon, so I had to answer to the Cameroonian government, too, and then to CDC. So I had four bosses, and I had to balance this constantly to try and keep them all happy, and at the same time, try to get the job done. To make sure that there were no cases of smallpox left in Central Africa, in French-speaking Africa. So that was a task that required a great deal of skill, and I don't know where I got that skill from. But I do remember that in my training session here in Atlanta before we left, our... George Lythcott, who is now dead, but who was another important person in the early smallpox days, told the group, when I was there, that we had to be medical diplomats. I remember that. He said, you not only have to know about all these diseases, and about smallpox and measles, and how to fix gun ped-o-jets, and how to repair cars, and clean carburetors, he said, but you have to be a diplomat, too. And so you had to deal with a wide range of people, from the Minister of Health to the Director General of OCEAC, to visiting dignitaries and all. And that was one thing that people back here never really understood. When I came back, and I was assigned to Atlanta, and I sat on a number of promotion panels and reassignment panels for jobs, and I would try to explain to the people who sat on the panel, who had never been outside the country, never worked in Africa, never knew the difficulties of working with, you know, the Minister of Health at one point during the day, and then working with an immunization team later on in the day. And they didn't understand the difficulties and the range of skills that you needed to do that. So they would tend to bypass people for promotion who had been overseas, and say, well we don't know what he did for that 3 or 4 years. We don't understand, we don't know. We don't understand... So that was... I became an, almost an ombudsman for some of our former smallpox people, or people who worked overseas, kind of a spokesman to interpret for those back here who didn't understand and didn't care to understand what they'd done. Diallo: Because you talked a little bit about the training that you had before you left. Could you talk more about that? Baldwin: That was pretty intensive. That was... It involved the epidemiology of smallpox and of measles, and of other diseases that we might likely encounter. It also involved learning how to clean carburetors and fix... Do major car repair work, is minor ones, and also to repair the ped-o-jets, the jet injector guns that we were doing. And in addition to that, since I was going to a French-speaking country, I would spend my evenings over at the Berlitz school, polishing my French. Despite the fact that I'd had four years in high school, it was, you know, academic French, it wasn't conversational. So I had to do all that during the day, and then in the evening, go over every evening about 5:00 till 9:00 to Berlitz, and do this total immersion stuff. Which was good, because in the long run it really paid off. But with all that training that I got, being in the smallpox program was a humbling experience for me, because I found out what I really didn't know. There was so much I didn't know. And when you went to a place like Cameroon, or anywhere in Africa in those days, in the 70s, in the late 60s, you represented CDC. So the ambassador would look to you for any medical questions that he had, and so would the others, the French doctors. For something they didn't understand, they'd come to you. And for them, you were the expert. So in addition to knowing how to repair cars and ped-o-jets, you had to know about a whole slew of diseases. And what made that difficult is that we weren't, we didn't... We're not doctors. We weren't doctors. We were operations officers, and we didn't go through all that. So the other thing that complicated it was that, in those days, there was no email, it was difficult to make telephone calls. The way we communicated, when you needed, really, really needed something, whether it was a car part, or whether it was knowledge about a certain disease or condition, or how to intervene in a situation, you had to send cables. That's how we existed. We communicated by sending cables. And they had to be very precise, and very pithy and to the point, so what you had to do was to... When you had a difficult problem or situation, you had to size that up, and be able to be very focused as to what you thought you needed to know, and to put that in the cable in this very terse language, and hope someone in Atlanta understood just what it is that you wanted to know, what you needed. So that, you know, was the age... It was well before the age of emails. Today it would be so much different. I could just sit down at my computer and send an email off, and... As I've done here, in my work with the former Soviet Union. I'm talking with a colleague in USAID, and I say, let me send you this, and while we're talking, the message gets (unint.). That's right on this computer. Didn't exist then. It didn't happen. We had to... And phone calls, you know, you never... There weren't satellite phones in those days, it was just the early days. And once you got out in the bush, it was even worse. You were totally on your own. So you had to be very resourceful, and, as I say, it was an unbelievable experience, because, you know... I could write volumes about the things I did and that I learned. And to do it in the... And the other thing that complicated it, too, was that you were doing it in a foreign language. It wasn't just English. Diallo: Right. How did you find, since you were working with francophone countries, and the former French colonies, how did you find that that colonial legacy affected your work in smallpox? Baldwin: Oh, it's funny you raised that question, because I thought about that too. There were two different systems. The French system was, I felt, very humane. The French system was what they'd call prospeccione# (ph.), or... Every year, they would go out in teams, in mobile teams, and visit a third of the country. They would visit village by village, and they would immunize, treat every disease they saw, and so at the end of three years they'd have covered the entire country. Now, that was very humane. The British system was one where they made fixed posts, or hospitals, or clinics, outpatient clinics, and that sort of thing, and if you could get to them, fine. If you couldn't, well, too bad. So those are the two different systems. But the French system tended to be sort of patronizing, in a way. And my relationship with the French, and everybody's relationship with the French, and I can say this and hopefully it won't be published widely, is one of a love and hate relationship. And I worked with these guys on a daily basis, and even the doctors who were in the Ministries of Health were French military assignees in those days, because the Ministries hadn't been totally Africanized. So you're dealing with French doctors who were military also. And so we had this hate, love-hate relationship. Some days you just thought they were the greatest people in the world, and other days you'd say, oh, these guys are so arrogant, they don't understand, what is it they aren't understanding about this? We'd have these debates about how valid the smallpox vaccination was. They would say it was good for lifetime, we would say it was good for 7 years, or, you know, we'd have these kinds of debates. But they also... The difference too was when I had the opportunity to go out into the bush with some French teams from OCEAC once or twice. And when these guys went out into the bush, they would have tents, they'd have tables, they'd have tablecloths, they'd have wine, they'd have all these dishes and napkins and all that, and it was like, you know, we're going on a picnic, and we're going to go first- class. And when we went out in the bush, you know, myself, and I had two different... Through my stay in Cameroon, I had two different epidemiologists. But when we went out in the bush, we had cans of what they call koskuit #(ph.), you know, cassioulet (ph.), which was like baked beans and frankfurters. And we'd eat out of these cans, or, if we were fortunate enough to get them heated up, we'd eat, and then we'd drink warm beer, and... Instead of French wine. And we'd sleep on cots that fortunately had mosquito netting, but we'd sleep out under the stars, and... Which was fun. And I had a beard at the time, which was very useful, because if you ever had to shave, you never shaved. But if you've ever had to shave with cold water, you know how uncomfortable that is. Diallo: I've bathed in cold water. Baldwin: Yeah, bathing in cold water. Bathing was another thing. We... Sometimes we'd go for a few days without bathing, and wearing the same clothes, and that was an interesting experience, too. But we went out into the bush, and that's what we called it, going into the bush, and when you remember... You always remember the first experience riding through what they call washboard roads in Africa. They were dirt, they were laterite red clay, and they were up and down, up and down, like a washboard, if you've ever seen an old washboard. You'd just go on for miles like this, sometimes holding the windshield with your hand, because if there was a car in front of you and it's kicking up rocks, it could shatter your windshield. And so you remember that, and you remember getting... Having to go into villages to immunize, and you couldn't drive in. You had to leave your truck, and you had the truck, and you had to carry your equipment, your ped-o-jets, your vaccines in the cold chest, into the village and walk for miles, 3-4 miles to get in to the village. And sometimes you'd have to take a boat, a dugout canoe, to get there. And meanwhile, as you're trudging through the bush, you're... In Cameroon we had green mambas, which are poisonous snakes that come out of trees. They don't live on the ground, they live up in trees, and so you always have to worry about whether, you know, looking up to make sure you weren't getting a green mamba coming out at you. But those are the memories that I had, and those are just... You just can't take those away. Those are fond memories, and the people... The other thing was the concept of crowd control. I think they didn't tell us enough about that here before we left. I do remember being out there and immunizing kids with a ped-o- jet in each hand, smallpox in this gun and measles vaccine in this gun, and I'm pushing down on the foot pedal for this gun, to charge it and give the kid an immunization, and the other one with the other hand. And they're crowding around, and crowding to the point where you couldn't work. The Africans were so afraid that you were going to run out of vaccine, that their children weren't going to get immunized, that they would just... And so I had to, a number of times I had to stop and just say to the headman or to the chief, you've got to get the people lined up, in a line. I can't work here. I mean, if I can't work, I can't immunize them. So that concept of crowd control. And the other kind of memories that I remember, you know, when you're going into the village, before you go in to immunize, well, we had to do a survey, to do a vaccination survey. You'd have to sit and palaver or talk with the headman or chief, and he'd get all the village elders, and you'd sit around on these stumps, these chairs, and they'd take this big jug of palm wine, which is... They'd go up a tree for, and they'd drink this palm wine, and then pass it around. In those days, we didn't think about, you know, whether you could get a disease like HIV from mucous or things, you know, and so we ate, we drank our palm wine, and it would be very disrespectful to say no, and to refuse it. And then if you came across a more educated person in the village, I remember very distinctly one Saturday morning going and trying to do an immunization survey in a small village, in the Central African Republic, and the educated person in the village was a schoolteacher. And he had... And I had a guy from Atlanta with me at the time, my supervisor, and he and the schoolteacher wanted us to sit down and have a drink with him before we began our work, and so he pulls out this bottle of scotch. And it was a very nice bottle of scotch, and I'm sure it cost him a lot of money, and we had to drink scotch with him at about 9:00 in the morning, warm scotch, and if you have more than 2 of those, it kind of sets your day off. So those are... Those were fun times, though. Diallo: How did you... What kind of challenges did you face in working with your African counterparts, coming in as an outsider? Baldwin: Well, fortunately, see, my counterpart was designated as my driver. His name was Simon-Pierre Ndenge (ph.), and he was not a driver. And I never did treat him as a driver, or use him as a chauffeur. Only when we went out into the bush. When we went out in the countryside, it was recommended to us, in fact, it was told, don't drive. Because there had been instances where people had, and I just heard of one of these, just the other day. Where people had hit children with a car and gotten stoned to death, in kind of a retribution thing. So we always let the designated driver or chauffeur drive when we went out. But Simon was not a driver. I treated him as if he was my counterpart. I tried to mentor him in the ways of planning and organization, and management, and that sort of thing. And in return, he mentored me in, you know, adapting to the culture... He could speak 5 different dialects, plus French and English. A little bit of English; most of the time we spoke in French, though. But he taught me about the customs of the various tribal groups, because there were over 200 tribal groups in Cameroon alone. And so, Simon-Pierre, he would just, you know, he was my guardian angel, in a way. And the frustration in there... We never had any problems, personal problems with each other. We always understood each other, he was always there when I needed him, and I hoped I was there for him. Excuse me. But my biggest disappointment was that when I left, I was not able... I had tried, for almost a year to get him a position in administrative health. Because when I left, the work still needed to continue. We were told that we were coming home because we'd done the job with smallpox, but measles... We were on the cusp of eradicating measles in some places in Africa, for instance, the Gambia and others. But when... Before I left, I tried to get him into administrative health, in a full-time position. And eventually I did succeed, but it had a much lower pay than what we were paying him. See, we were using (the ID forms?), and so we were paying people more than the local economy would bear, so for a man of his skills, he could have made much more money in working for a pharmaceutical company. He could have made a lot more money, but he wanted... He was there to cater to that, too, and he actually did get a job with the Ministry of Health for less money, than... Now, as I continued on working in Africa well after this into the 80s, in a large program called CCCD, or Combating Childhood Communicable Diseases, we had other talented people like Simon who weren't able to get picked up, and they ended up going off to WHO, or to UNICEF, or to the Institute Pasteur, or a drug company. And they wouldn't necessarily be there to help the country itself. You know, their country, it'd be assigned here or there. So you'd still be in the health field, but it wouldn't benefit, say, Cameroon, or Chad, or Central African Republic. So that was really a disappointment, there. I never had any great difficulties in dealing with the Africans that were my counterparts. Diallo: That's good. Did you have, or could you talk about adjusting to living in Africa? Baldwin: Oh, yeah. Okay, I didn't write that down in any of my notes, but that's a good point. That, you know... Diallo: You had never traveled there before, had you? Baldwin: No, I hadn't. But since then, you know, since that experience, I've been to 48 different countries in Africa. But getting to Africa, as I say, was an eye-opener for me, because it just wiped out all the stereotypes that I had. But they kept telling us here, you're in for a culture shock, don't be surprised at this or that happening, and I didn't have any problem. Not at all. I did not adjust. I had my culture shock when I came back to the United States. And I think a number of my colleagues did, too. We just sort of accepted what was there, and we didn't get excited about it. It's Africa, and there was an expression that we had in French. "C'est l'Afrique." That's it. "C'est comme ça." It's like that. Or when something went wrong, we had another expression you might hear called "WAWA". And that stood for West Africa Wins Again. Because there were things beyond your control. If you expected your vaccine to arrive at a certain time on this plane, and that plane had to come from the United States and make 3 or 4 different stops, 2 or 3 in Africa, and you expected it to arrive at this time, because you were told, you had got a cable that said, your vaccine will arrive on Air Afrique, flight number 421, arriving at... And so you went to the airport, or Simon went to the airport, or I went to the airport to get it, and it wouldn't come. But then we had to trace it. Where was it? You had to go down the line and find out, send cables, find out where this vaccine was, because it was such a fragile thing, and you couldn't allow to be sitting on a hot runway somewhere, because somebody just offloaded it and didn't put it back on a plane. Or parts. So when that kind of stuff happened, and it was 2 or 3 days before we finally located where it was, or it never arrived, the old expression was, WAWA. West Africa Wins Again. Those were some of the frustrations, because, as I say, this was 1970, the late 60s, and each... During that time, it was a period of emerging nationalism, emergent nationalism, and each country felt like it had to have its own airlines, too. No matter how good or bad they were, or how substandard, they had to have their own, and the country's name had to be on the airlines. So that was an important thing. The other thing we did encounter, though, from time to time, was some suspicion, because there are... There was a faction of people who felt that if you were associated with USAID, and at the time AID was pushing contraceptive devices and birth control, that perhaps you were part of a plot to keep the African population down. So we... At times we encountered that, but I think most of the time people knew we were good folks and we were doing good things. Trying to do good things. Diallo: And were... Did you find that people in the villages were generally accepting of the vaccines? Baldwin: Oh, yeah. They were very accepting and very generous, and that was almost very embarrassing, because they would try to give you things, what little things they had, whether they were food, or chickens, or bananas, or whatever, to take with you when you left as some token of their gratitude. You knew they had so very little, and you know that you could get this stuff back in the capitol city when you got back. And so, well, we couldn't refuse it, though. We would take it and we would express our gratitude for the meals they provided for us if they did, or for whatever they gave us, and then usually I ended up giving to Simon. Now Simon had the fortune, I guess the good fortune of having 4 sets of twins in his family, so he could use this stuff. Or if he couldn't, we'd give it to a few other people on the vaccination team, that sort of thing. Once we were out of range of the village. Because people were just so generous, and you remember that. You really do, because they had so very little. But they gave freely. Because they were just so grateful you came. Diallo: Did your family travel over there with you, to Cameroon? Baldwin: They did, I had my wife and a stepson. But they didn't get out into the bush too much, because we went to some... You know, we did vacation kinds of things, but never out in the bush. It was... Diallo: How did they adapt to life in Africa? Because they were, I imagine, living still in the city, but if they were... Baldwin: Yeah. Well, it was a difficult adjustment for my wife, because she came from the New York area, and so, I mean, Africa, New York, two different... It's like two different worlds. And she had some difficulty. She also had some difficulty even adjusting to the French language. And so she felt at a disadvantage. She eventually acclimated and was able, say, on Monday morning to go down to the market where they slaughtered the beef that had been driven down from Chad, and be able to pick out... Among the blood, the meat that we wanted to have. And then having to filter water, and that sort of thing. And the other adjustment that we had to make was that it was normal, pretty much normal, for people to have household staff to... It was a form of employment, you know, you would employ household staff and a cook, and we started off... And a night guard. And we started off with a cook, who, fortunately or unfortunately, was... Had been a cook for the Vice President of the country of Cameroon. And he insisted on making these big meals at noontime. And I just could not get used to that. And he was a nice guy, and he really was, and so we were able to get him placed with some other family, preferably a French family who would like those big meals. I couldn't... The thing I never could get used to, when I was in the city, was these, the hours. We worked from 8 in the morning until 12, and then we went home, and from 12 to 2:30, you're supposed to eat and have a siesta. Well, I could never lay down after I ate and just fall asleep, and do that. So I never could do that. And then, when I started eating these big meals, I said we can't have it. So we actually placed him, got him placed at some other family, but we did go on with the house person. And that was an adjustment for my wife to make, too, having a house person around. The guardian, though, was absolutely essential, because you... There was thievery. And people would... I mean, it stands to reason that people would, are living in abject poverty, and they look in through the fence and see what this very nice house, and you have guests coming in, and food, you know. So you... That was pretty normal. Diallo: And in general, when you think back on the smallpox project, how did participating in that particular program change your life? Baldwin: Well, I think it really did change my whole outlook on life, and it really wanted... Made me want to continue to work internationally. I know there are many, many problems here in the United States, and when I did come back, I did work for a while here in sexually transmitted diseases again, in Pennsylvania, but I just... I was just itching to get back into international health. And back in 1980, I came back into international health, and worked at the project that we called "sheds", it's SHDS, with Boston University and AID unit transitioned over into the Combating Childhood Communicable Diseases, the CCCD project. And then I started, because it was the period of famine in Africa, and extreme famine in the 80s began, so I got into coordinating CDC's international disaster and refugee work. And I did that for 10 years, the international stuff. Some of it I was still doing the CCCD stuff, too, and supervising people in Africa. So that got to be too much, so I did (unint.) into emergencies and disasters totally. And from there I just transitioned into the former Soviet Union, because by that time, in 1991, the Soviet Union had collapsed, and we had a terrible problem, in the 15 republics of the former Soviet Union. So I got involved in coordinating the CDC's activities in that. I was probably... I was in the first wave of a few of us who went over right after the collapse of the Soviet Union. But what it did was it just taught me that there was a bigger world outside the United States, and there are... I have very competent colleagues here, who could handle the domestic side of things, but I felt that my skills were better applied internationally. That I could do the diplomacy thing, I could still help to make life better for some of those people who have much, much less, by just showing them how to do things, and that was it. It was trying to just show people, and transfer tecnhnologies. Not to do it for them. The one thing we got accused of doing in the smallpox eradication program by our colleagues in AID was, well, you guys did a great job. You eradicated smallpox, but you didn't leave anything behind. You didn't leave any institutional memory behind. But that's not entirely true, because, as I said, I've tried to get Simon-Pierre hired, and others in other countries tried to do the same thing. So we did train people and try to leave an institution behind, but the overall effect as far as AID was concerned was, we accomplished the mission, but we didn't. We didn't build infrastructure. So as we got to the point of the SHDS project, and the CCCD project, and everything else since then, the objective has been to teach them how to fish. You know, to teach them how to do it. And teach them what has worked. And that has always worked for me, I mean, successfully in my dealings with people in the former Soviet Union, who are always very distrustful of Americans, they thought we were all CIA. But... And some of them just couldn't believe the approach I took was, I'm here, I'm going to show it to you, what we've done in the United States, what we've done in other parts of the world, and it's worked, and then also, here are some things we did in the United States and other parts of the world that didn't work. Now, it's up to you to take these things, if you want, and tailor them to your own environment, and see if they'll work for you. And find a way. Let's modify and find a way, see if they'll work for you. Well, that was baffling for people in Russia and former republics. They said, why are you doing that? People would come up to me, I would be chairing a large meeting, and a man comes over and he said, you need to be beating your own drum. You need to be telling people they have to do it this way. And I said, yeah, but you see, they're used to it. For 74 years they were told they had to do things this way, there was no other way to do it, and so they were so surprised at that. And they were also surprised at us talking about our failures, because if you did that in the former Soviet Union, if you even revealed that you'd had a failure or a #(unint.) he'd send you off to a gulag. You'd go to Siberia, or you'd get demoted, or your pay would be taken away. But anyway, you asked me that question, it's helped... It shaped my whole career, it's influenced the way I look at things in the world, and it made me a more tolerant person, a person who's much more culturally sensitive, I think, than I would have been if I'd just stayed in New York City, or New Jersey, for that matter. Diallo: So what would you say... You've talked a little bit about some of the difficulties that you faced. What would you say was the biggest problem that you faced, and how did you work to solve it? Baldwin: Well, I think it was the lack of good communications in those days. I mean, back and forth to where you needed, either to alert people that you were coming to a certain village on a certain day to immunize, or it was communicating to Lagos, to the site we needed certain ped-o-jet parts, because, you know, 10 of our guns are down, and we really need these for the next campaign, and the rainy season is coming, and we need them tout suite, you know, right away. Or communicating back to Atlanta. For instance, when we had cholera. When cholera broke out in Cameroon, and I knew nothing about cholera. That was one of the diseases they didn't tell me much about. And we had a pandemic of cholera, and so I had to try to get as much information, for myself and for the epidemiologist, fortunately I had an epidemiologist working with me, who was, you know, so that we could deal with this, because the American ambassador was asking us how we'd deal with it. Because the ambassador wouldn't hesitate to call you at 2:00 in the morning, 3:00 in the morning, if something urgent came in. And you were the CDC person. You've got to know the answers. You have to know the answers. And so, you know, it was communications. It was trying to get that information you needed. Either from people or out to people. And I think that was the biggest challenge. And then, of course, the political infighting was also very challenging, between AID and CDC. And, of course, you know, the push-and-pull of the French, too, they had their own way, they looked at medicine much differently than we did. So there were all kinds of challenges. It was... As I say, there was never a day without challenges. And fortunately I did have, during the time I was there I had 2 different epidemiologists who worked with us. And they, themselves, presented difficulties, at least one of the two, in getting along with the French, because the style was, like, totally different. This guy was very good, but he was very informal, and he just didn't, you know, fit in to the French system, you know, where they're very formal, and all. I had said... So I had to sort of be a buffer between him and the French, too, I had to get in the middle from time to time. You became very resourceful, you tried to become very resourceful, and very inventive, as much as your abilities let you be. But we... As I say, we weren't physicians. We were, you know. Diallo: Right, right. Was there a particular point... Well, first of all, what years exactly were you...? Baldwin: I was there between '70, the beginning of '70 and the end of '72. Diallo: Okay. And was there a particular point during your work with smallpox where you knew that it was a successful program, and that smallpox was going to be eradicated? Baldwin: Yeah. I think it was when I left the country, and we didn't have many cases of smallpox, which, in a way, it's difficult to say this because it's a disappointment for me in many respects, I never did actually see a case of smallpox, because by the time I got there, we were in the consolidation phase. The hard work had been done by those who went before me. What my job was to be, it was to maintain and keep everyone vigilant, looking for smallpox, and... Because it could occur any time, and in any place. And so I'm not only in one country, as most of the people have, I had 5 countries to worry about. And I had to stay in communication, again, this communication issue, with each of these countries to make sure they were immunizing on a regular basis, on a monthly basis I would get vaccination figures done, and I needed to know that those teams were out there daily. They were not only immunizing against smallpox and measles, but they were looking for cases of measles occurring, and that they would alert us as soon as some suspicious case, you know, came about. And so we would jump on those things, and with a high degree of anxiety we'd drop everything and just run out to wherever it was, where that was said to be a suspect case of smallpox. But fortunately, we didn't see any. And so when I left, I was pretty much assured that things were going well, but you couldn't be totally certain that smallpox wouldn't just rear its ugly head in some small village that was missed, or among some person who, when the vaccination team were in the village, he wasn't there that day, or he was out in the field, you know, working, so you just never knew for sure, and we didn't know for sure until 1977 and that last case occurred, and then when they certified it years after. There no certainty, you know. I mean, we felt we had done a good job, but we couldn't go home and say, we eradicated smallpox. You couldn't do that, we never did. You could never say that. Diallo: So thinking back now, you know, with the blessings of hindsight, is there anything that you would have done if you had been running the program? Is there anything that you would have changed, if you were Bill Foege, for example? Baldwin: If I was Bill Foege, would I have changed anything? I don't know, you know, Bill did his utmost, and he had the support of David Sencer, and Dave, as our director at CDC, really went above and beyond the call to try to support us all in the field. Because he realized the magnitude of the effort, and he knew... He knew better than any of us, I think, what the eradication of smallpox would mean to the world. So he was as supportive as he could, within the boundaries of the the rules(unint.), the administrative limits. I mean, there were things that we could have used, two-way radios maybe, walkie-talkies, communications kinds of things, or others that we were bound by regulations that we couldn't purchase, or buy. It was the same way with the vehicles. We had these great Dodge trucks, they called the Great White Whales, that had 2 gas tanks, and they were big, but they were American cars. So we were constantly needing to have American spare parts. And we weren't allowed to buy, say, French cars, which would have an abundance of spare parts... Or, French trucks, that sort of thing, which would always be available. And so we had limitations there. And Dave did everything he could, and so did Bill, I think, to push down the restrictions#(unint.), but I couldn't... Not being back here in Atlanta, I couldn't tell you if there were any things they missed or not. But I think they did a great job, and... Diallo: With what they had available. Baldwin: Yeah. With what they had available, and they pushed as far as they could, and tried to make the system as flexible as they could make it. But laws are laws, you know, and the government has regulations. But years later, I mean, in our work in Africa, we still tried to get waivers from this Buy America act, because it just made good sense to be able to not have a car... You know, when a car went down, when a truck went down, and you couldn't get the parts for it, you had to go out and eventually cannibalize others, you know? And so eventually, you'd go, you'll see pictures here of trucks that are either wrecked, or they're sitting in a garage, or in a field, in a yard, and they're all down, you know. People are taking parts off of them to make the other cars work. That's cannibalization, not in the sense that you'd think of it, the cannibalization in keeping things moving. So that was a challenge, too. Diallo: Okay, I have one final question, and then you can add anything else that you would like, but what were some of the important lessons that you learned from the smallpox eradication program, that you were able to then apply to your other work in international health? And you've talked a little bit about some of that, but... Baldwin: Yeah, I think I have... I mean, the ability, I think... To develop the ability to actually hone in and focus in on what the real problem might be, or is what it appears to be, and what the alternatives, or the alternative solutions might be, and then trying to find a way to make those solutions happen, because sometimes the solutions are there, but, as I say, your system doesn't allow you to do that, or to... And so I think that's one of the biggest skills that I had to learn how to do. And the other thing was just to learn to be diplomatic and understanding of different people's culture, and their perspectives in looking at things. And they don't always see that the way we do, and they don't have necessarily the same work ethic. Now, I don't know, that's neither good nor bad, but in later years, as I was on a (yaws?) assessment for six weeks in 1980, I think, in the Ivory Coast, and it really hit me because I had a young EIS officer with me, and he was taking... It was his first trip to Africa, and we were working really hard. We had six weeks to do an entire assessment for the entire country, and we were working 10, 12 hour days. And, you know, finally the driver we had said, I refuse to work. He said, we don't do that here. You guys are Americans, maybe you do that. But we don't operate that way. And, you know, that just really hit me, because they don't. And you have to respect the way they do things there. But at the same time, you still don't lose sight of your goal, and you still try to accomplish your goal. So that is a challenge for you, to find your way, to incorporate, within their... Within the parameters of their own system, of their own culture, how you can accomplish what it is that you need to accomplish without offending them, and still get it done within the time frame. Sometimes it's possible, sometimes it's not. Sometimes it's gonna take a little longer to do. So that... Diallo: Well, that's great. Baldwin: That was a skill we had to learn. Diallo: Right. Well, if you have anything else that you'd like to add, I don't know if you want to look through your notes and see if there's anything particularly... Baldwin: Not too much, no. I mean that patience, developing that patience. Because I remember later, in '82, '83, when I was in the CCCD program, and I was hiring people to go out, to work in Africa. And I went and interviewed a number of people, and I settled on this one guy, who had been in 90-day experiments in smallpox. And I'd known this guy throughout the years, and I thought, well, he'll be perfect. He'll be perfect for this job. So, sent him to Africa, to West Africa, to the Gambia, small country. He had difficulties adjusting from day one, because things just didn't happen the way he thought they should happen. Even to the point where we met, and (unint.) before we went down, and we had dinner, and he ordered white meat and got dark meat, you know, and I said relax, relax. Because you know, you're going to get a heart attack, you're going to get an ulcer, if you don't just sort of, you know, be a bit more accepting and a bit more patient. And if they say your car will be ready tomorrow and it isn't ready, and it's going to be 3 days before it's ready, you know, you don't... You can still keep bugging them, but don't let it bug you. So it's... Even when the guy had worked overseas, he just hadn't had the patience, because it's different. You know, a different ball game. Well. Let me see. Is there anything else? I mean, the language skill was also a challenge, too. Diallo: Did you learn any local languages? Baldwin: Oh yeah, I did. I learned French like you wouldn't believe, and many French customs, too, and French-African customs. But, you know, all in all, I just... I just thought... I wouldn't do it any differently if I could, you know, if I had an opportunity. But this kind of always reminds me of this Robert Frost poem, you know, "Two roads". Have you ever heard that one? "Two roads diverged in a wood, and I/ I took the one less traveled by." And that's made all the difference for me, and it's been great, it's been a great experience. It's the... When I look back on my professional career, I think it's the most important thing that I've ever done professionally, in the smallpox eradication program, and I'm the proudest of it, even though it was a relatively minor role that I played. Well, we all played our roles, we all did our share, and some more than others, but, you know, it was great. And you know, I used to sometimes, in the former Soviet Union, as an example of how countries can work together. Because this whole issue of the smallpox eradication program, and the eradication of smallpox from the world was first brought up by the Russians, in early... During the Johnson administration, when Johnson was President. And Brezhnev was the Premier in Russia, and he had this idea surface at WHO several times, that perhaps the United States and Russia could do this worldwide effort, this global effort to eradicate smallpox from the world. First couple of times they threw that on the table, they didn't bite, you know? But a little later on, the Americans decided, okay, let's do this. And so, as a result of this, you had the two major superpowers of the world, I mean, these were the two big gorillas in the world, working together, and they got other people to work together, because other people saw them working together, to eradicate a disease from mankind, and this just hadn't been done before. So when I go into Russia, I used to tell that story, and people were kind of impressed, because they didn't know it. They didn't know that the initiative actually was suggested by the Russians. And so that... You get some political mileage out of that. Diallo: Well, that's great. Baldwin: Well, I guess... Diallo: Yeah, thank you very much. I think this is great. I think this is fine. Baldwin: I hope you get something you can use. Diallo: Oh, yeah, all of it. All of it. Baldwin: You're very nice. And I wish you a good career, too. Diallo: Thank you. Baldwin: I mean, you know, I have an edge on appointment over there, and it's always refreshing to talk to folks like yourself, because you bring a whole total new perspective, and, you know, as I said, I say it to students, I say you know, you're not going to make the same mistakes we did. Because hopefully we'll tell you about the ones we made, so you're going to make your own mistakes, all new ones, but hopefully you'll have the benefit of our experience, so that you won't go out... At the same time, that you don't go out and reinvent the wheel, either. We can tell you what we did, and what worked and what didn't, and what you... What you ought to think about modifying, and all that. And the smallpox experience was a learning experience for all of us. The surveillance, the containment, the ring containment... Ring vaccination. Everything was a learning experience. Every day was a winding road. Diallo: Well, thank you very much. Baldwin: All right. Well, thank you. Diallo: No problem. </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310122873%3Fsecret_token%3Ds-RvxYD&amp;color=ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false" frameborder="no" scrolling="no" width="100%" height="166"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource sound recording - nonmusical interviews Date A point or period of time associated with an event in the lifecycle of the resource 2006-07-14 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/156mg emory:156mg Subject The topic of the resource Smallpox Eradication USAID WHO CDC Operations Officer Format The file format, physical medium, or dimensions of the resource 596867040 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Diallo, Melissa McSwegin (Interviewer); Rollins School of Public Health; Graduate Student Baldwin, Robert (Interviewee); CDC; Operations Officer Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of West and Central Africa Smallpox workers (2006 : Atlanta, Georgia) Title A name given to the resource BALDWIN, BOB Description An account of the resource Bob Baldwin, served as an Regional Operations Officer in French-speaking West Africa. Baldwin makes comparisons between poverty in the US and Africa, speaks about working as a Regional Operations Officer with OCEAC, and life as a "medical diplomat." In 2004 Bob retired from a long career with CDC in international health. Language A language of the resource English https://globalhealthchronicles.org/files/original/c215d343bf676f3390d2e0e1963eafd0.jpg 23428dbfd085fa74a84e03bd24d4f91c https://globalhealthchronicles.org/files/original/afe843374ec9931aad541f8c40fb4d48.pdf 8390e84ee46b280b09f3102a3cfe6a86 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> Interview Dr. Dan Blumenthal with Dr. David Sencer Transcribed: January 23, 2009 Dr. Sencer: This is the 1st day of April at CDC. I'm David Sencer and I'm interviewing Dr. Dan Blumenthal, a Professor at Morehouse University School of Medicine on his experiences in the Smallpox Program. He knows he is being taped and he has signed a release. Good morning, Dr.. Dr. Blumenthal: Good morning. Dr. Sencer: Do you want to tell me a little about who Dan Blumenthal is? How he got to be Dan Blumenthal? Dr. Blumenthal: Well sure. I started out, I think - picking up maybe when I was in high school really intending to be a research type of person, pursuing a PhD in the biological science and - Dr. Sencer: Where did you go to high school? Dr. Blumenthal: In the suburb of St. Louis, Missouri, my college experience in particular; a summer research experience had convinced me that I really needed to pursue an MD rather than a PhD, or perhaps both. My original intention was to go after both, but I put myself in a position to do Biomedical Research as something that would be more immediately relevant to humans. By the time I did some more research in medical school, I decided I really didn't want to pursue a research career, but rather, more of a medical practice career. So I kind of changed my career direction again. I was then, I think - eventually headed for some kind of pediatric practice, but - Dr. Sencer: Where did you go to medical school? Dr. Blumenthal: I went to the University of Chicago. Actually, I went there because they had a good combined MD/PhD Program and that was what I thought I wanted to do at that time, but as I said, after a few more laboratory experiences, I decided that it really wasn't for me. I wasn't a laboratorian. I thought I was a clinician and maybe I still am to some extent. I got into public health as a result of the war in Vietnam and I had actually - I was so opposed to the war that I just knew that I wasn't going to serve in the military. I was prepared to move to Canada if that was what was required, but I was looking for an alternative in the U.S. instead and I applied to the Indian Health Service. I think today, admission to the Indian Health Service would not be a problem, but in those days it was, so I didn't get into the Indian Health Service. I talked to my father who's also a physician and he said, "Well, why don't you try applying to the NCDC?" As it was known at that time, the National Communicable Disease Center, and I said, "What's that?" and he explained to me that it was a Public Health Service facility located in Atlanta, and I did apply to the EIS; and I was admitted to the EIS. At the time, I really knew very little about public health. I had learned almost nothing about public health in medical school and very little more during my residency, but this was certainly an attractive alternative, so I learned about public health here at CDC and it clearly made an incredible difference in my career. I still do practice clinical pediatrics, but public health is a major part of my life, and it is probably the biggest part of my career now. Dr. Sencer: Who was in charge of the EIS program when you were there? Dr. Blumenthal: Phil Brachman was the Director of the EIS at that time and provided great leadership. I still talk to Phil from time to time. He's teaching at Emory and we keep in touch. Dr. Sencer: What did you do in the EIS? Dr. Blumenthal: I spent a year in the Nutrition Program and then the Nutrition Program went out of business, and so I spent a second year and then a third year in the Parasitic Diseases Branch, and did some work with Ascaris and other intestinal parasites here in the U.S. Dr. Sencer: How did you end up in India? Dr. Blumenthal: When I was in the Parasitic Disease Branch a call, I guess, went out for epidemiologists to participate in the Smallpox Eradication Program in India and I wanted to do it, I guess, for two reasons. One was because it was a noble cause. It was something that really sounded like it could make an incredible difference in health for people in India and around the world, and second because it sounded like a great adventure. It was really working on the frontlines of something important and the frontlines in this case were far away from places where American physicians usually work. Far away from all the things that we know and it sounded exciting and different and unusual, and that was very appealing to me at that time. Dr. Sencer: When did you go to India? Dr. Blumenthal: 1974. I was assigned to Bihar which was in the Northeast part of India, just South of Nepal and I was assigned to Samastipur District which is - Patna is the capital of Bihar State, and from Patna you cross the Ganges River and go a ways further on, and eventually arrive in Samastipur. We flew in to New Delhi originally and had some orientation there and then - Dr. Sencer: Who did the orientation? Dr. Blumenthal: Well, Bill Foege was there but I actually don't - I remember the hotel, I remember the swimming pool, but I don't remember too much about what we did in New Delhi. I remember the train ride then from New Delhi to Patna in a train drawn by a coal-burning engine and cinders and smoke flying in through the windows, and it was done that way because Bill Foege thought that he shouldn't send everybody by airplane because he was afraid the plane might crash. So some people went by plane but I was with the group that went by train. Dr. Sencer: Who were some of your colleagues? Dr. Blumenthal: Steve Jones was in the next district over, it was Jafarpur, and when I got lonely for the company of a fellow American, I would get in my jeep and drive over to Jafarpur. I'd probably do that two or three times during that time that I spent in India and spent a couple of days with Steve sitting around and speaking American to each other, and then I was re- energized and could go back to work in Samastipur. There were a number of others in the surrounding districts and I'm afraid I can't remember everybody's name, but I know that we did a couple of R &amp; R to Katmandu which was a fairly easy hop from Patna to Katmandu by airplane. So I had some good friends at the time whose names I can't remember now. Dr. Sencer: Where you working - did you have an Indian counterpart or were you just sort of off on your own? Dr. Blumenthal: Well, I had a driver, I had a paramedical assistant, and for part of the time when I was there, I had a young Indian physician colleague who traveled around with me and shared responsibilities. I think that was maybe only for a month or so though. Dr. Sencer: What sort of duties did you have? Dr. Blumenthal: The basic program was to follow behind my Indian colleagues who were permanent workers in the healthcare system to ensure that the search for smallpox cases and smallpox outbreaks was being appropriately carried out. So on a typical day I would visit the health office, the local health office, where, posted on the wall was a list of all the outbreaks that were being worked; and I would say, "Let's go to that one," just kind of picking one at random. Typically, the local health officer would say, "No. You wouldn't want to go to that one. That one is far off of the paved road. You'll get stuck in the mud. It's very difficult. You'll have to walk. I suggest we go to this one which is right on the paved road." And I'd say, "No. Since you've told me that now I know that I want to go to the first one that I picked." So we'd get in the jeep and he was right, we got stuck in the mud, and so we had to get out and walk, and we'd eventually get to the outbreak; and of course few people there had been vaccinated, and it was typical the work that was supposed to have been done hadn't been done, so his interest in having me not go there was both related to the difficulty in getting there and the fact that he knew what we'd find when we did get there. So that was the biggest part of it, and there were periodic meetings that I would have to go back to Patna to participate in, and reporting, and we filled out a lot of forms, but it was mostly that kind of spot-checking and supervision and traveling from one health office to another in the district. I'll tell you a story about getting stuck in the mud. We were traveling to one of those outbreaks and the jeep got stuck in the mud and it was clear that we couldn't get any further on that road in a motorized vehicle, and it was still quite a ways to the village we were traveling to. But just down the road was the estate of a very wealthy landowner who kept an elephant as a pet. This was the sort of beast of burden that in past times in India was used for actually doing work. The elephants, I guess are no longer used for work in India, or very little, but they were still, at least at that time, kept by some of the wealthy Indians as a kind of status symbols. So we walked down the road. My paramedical assistant was not very enthusiastic about this, but I insisted that this would work. We walked down the road, knocked on the door, introduced ourselves, we were invited in for tea, and I asked the gentleman if we could please borrow his elephant; and he agreed and we all climb on the elephant and there was an elephant driver who urged the elephant along. It was sort of worrisome because he had a metal rod and every now and then, he would whack the elephant on the side of the head with the metal rod and I was just seriously concerned that the elephant was going to react to this in some way, but it didn't seem to bother him. We eventually got to the outbreak and all the kids were excited to see us coming and they all ran around yelling "Hati! Hati!" Which means elephant; so we did our work there, rode the elephant back, and four years later when I was in Somalia, somebody in the smallpox program that I was introduced to said, "Blumenthal, you are the guy who rode the elephant to the outbreak. Aren't you?" So that little episode gave me a certain amount of fame in the smallpox program. So that was not a typical day but it represented the kind of work that I was doing in India. Dr. Sencer: The word is improvisation. Dr. Blumenthal: The word is improvisation. Right. Dr. Sencer: Do you have any other tales of your time in India? Dr. Sencer: Well, I guess there are many. One that I enjoy telling from time to time involves a visit I was to make the next day to a village that was located on a river, and I was having dinner with a number of Indian colleagues and I asked them, "Are there crocodiles in that river?" and one of them said, "Oh yes. Crocodiles are available." Another one said, "He doesn't want crocodiles. You goof." So, we got a chuckle out of that one. Dr. Sencer: But you lived to tell the tale? Dr. Blumenthal: Yeah, I lived to tell - I actually never saw any crocodiles. I suppose they were available, but I didn't see any. So I would have to say that that period of time I spent in India was one of the most rewarding of my professional career; and the reason is this, that when I got there and began visiting these outbreaks and visiting villages, there were so many outbreaks and so many cases of smallpox, and it was such a terrible disease that I said to myself and to others, "This is absurd. This is never going to be eradicated. There is no hope for success here. This is an interesting experience and a great adventure for me, but I can't imagine that this is going to succeed;" and yet, by the time I left only a few months later, I couldn't find a case. It virtually disappeared before my eyes during just three months while I was there, and I would have to say that that's the part that I remember most. That was the most satisfying part of that experience. Dr. Sencer: It was an achievement. You mentioned you were in Somalia. Dr. Blumenthal: I was, four years later - Honestly, what happened was four years later, I just decided I needed to go to Africa. I had never been to Africa and it was a place I wanted - Dr. Sencer: Are you still part of CDC? Dr. Blumenthal: No. At that time I was no longer working for CDC. I was working for Emory University. But nonetheless, word reached me that CDC was looking for people to go to Somalia. This was what appeared to be the last outbreak of smallpox, smallpox's last stand, and I really not only wanted to go to Africa, but when I heard about that, I wanted to be part of that. I was hoping to get there in time to see the last case. So I succeeded in getting a period of leave from my position at Emory and signed up and went to Somalia a bit too late. The last case had already taken place, so I missed that. I spent three months in Somalia, conducting a search, really knowing that I wasn't going to find any smallpox. So we did other things. One of - somebody back at CDC I guess was interested in studying other pox - Dr. Sencer: [crosstalk/inaudible 0:15:43] Dr. Blumenthal: Well, other pox viruses, so they had me looking for camel pox which is a pox disease with camels; and I actually found a camel that had camel pox and gathered some material from some of the lesions and send it back to CDC. I don't know what happened with that study, but I'm sure we know a little bit more about camel pox now than we did before because of that. A story from Somalia: The work in Somalia was fairly similar to the work in India in the sense of going around and checking to make sure that the - in this case, that the search had been done properly because there wasn't any smallpox to be found. So in one local health office, I went through my routine of identifying a place that I wanted to visit and having the health officer there explain that this was a very difficult place to reach and so I probably shouldn't go there, and having me say, "Well, in that case, that's definitely the place I want to go." So my job was to go to the place and take the little smallpox picture that we used and go from one dwelling to another, asking if somebody had been there and showing this picture, and asking about any cases of rash. Now this was in a part of Somalia that's called Gedo. Now I digress at this point to say that on my way to Somalia I had stopped in Geneva for a couple of days to, I don't know, fill out some forms or something at WHO, and one of the people who was returning from Somalia said, "Listen. When you get there, you can go to any part of Somalia. It doesn't matter where they assign you, as long as it's not Gedo. You don't want to go to Gedo." So, of course when I got there, that was where they sent me. This was fairly a remote part of a remote country located where Somalia, Ethiopia and Kenya all meet. It was a little risky because there was a bit of a war going on at that time between Somalia and Ethiopia over the Ogaden Desert. I'm not sure why anybody would want the Ogaden Desert, but both of these countries did, so they were fighting it out. Dr. Sencer: Still do. Dr. Blumenthal: Yeah. So we had to stop from time to time because we were told there were land mines in the road up ahead and so we'd spend the night by the side of the road and the next day we were assured the land mines had all been cleared away and we would go on. I'm off of my story. The story is - I need to further explain that the populace in this area was mostly Nomadic; and they would herd camels and some goats and some sheep from one place to another, looking for food for the livestock; and they would set up their huts and stay in one place for a few days and then move on to another place. This was the dry season and there were some places that were - where food for the livestock could be found and there were other places where no food for the livestock could be found. There were some settled villages along a river that flowed through the area, but mostly, the population was Nomadic. So this is a backdrop. I will return to the story where I had identified the place that I wanted to visit and so myself and my driver, and my interpreter, and the local health officer all set out in our land rover to visit this site; and we traveled for a long way in the land rover and then we got to a place where the health officer said, "You know, I really don't know this area. We'll have to find somebody here, a local guide who can take us to the place where we want to go." So we hunted around and we found somebody who said he knew where that place was, and so we put him in the jeep - in the land rover and we drove until we came to a dry wadi, which is a dry riverbed, a gulch. In the dry season there's no water in it, but we couldn't drive across so we had to leave the land rover there and we got down and we walked. We probably walked five miles and it was hot and it was dry, but we finally got to a place where our guide said, "Here we are." And I said, "Where are we?" He said, "We're at the place you said you wanted to go." And I said, "But there's nobody here." And he said, "Well, of course not. There's never anybody here this time of the year." So, all I could say was, "Well, I guess there's no smallpox here." Then we turned around and walked back. So that was Somalia - I met bed bugs in Somalia. I had never seen bed bugs before, but traveling around from one place to another in some of the little towns there are little hotels. We stayed in a little hotel, and some of the little hotels had bed bugs so that was - Dr. Sencer: And you had bed bugs? Dr. Blumenthal: I had bed bugs. The bed had bed bugs and they came out and fed on me. My experience with bed bugs was I woke up in the middle of the night - my first experience with bed bugs, I woke up in the middle of night and I was being bitten by an insect which I thought must be mosquitoes so I pulled my cover up around my head and the more I pulled the cover up around my head, the more I got bitten by the bugs. So I finally got out of bed, got out my flashlight and shown it around, and found bed bugs. I've never seen them before, but I figured out what they were. So I found ways to deal with the bed bugs, but basically I just sort of coated myself with insect repellent and that kept the bed bugs away. Dr. Sencer: Was that your only health problem overseas? Dr. Blumenthal: Well, occasional diarrhea but I never got seriously ill during the time I was overseas, took malaria prophylaxis and I was reasonably careful about what I ate and drank. Dr. Sencer: To what extent do you think your experience with the smallpox influenced the rest of your career? Dr. Blumenthal: I've maintained an interest in international health and I feel like I have had more of an international health experience than many of my colleagues who also do international health. But their international health work may involve going to the capital city and giving some lecture at the medical school and it sort of entitles me to scoff and say, "You call that international health? That's not really international health." I've maintained that it has stimulated an interest in infectious disease, so although I would not attempt to pass myself off as an Infectious Disease Specialist, it does help me keep current and I know a lot more about infectious disease than many of my other non-infectious disease specialist colleagues, because I think more than anything, it has given me a lifelong feeling of satisfaction that I was part of this program that achieved one of the greatest public health accomplishments ever, and I've always been glad to have that on my curriculum vitae. Dr. Sencer: Well, good. Anything else you want to say? Dr. Blumenthal: Seems like enough. Dr. Sencer: It's good. Thank you. Dr. Blumenthal: Thank you for the opportunity. [End of audio 0:23:30] </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/I1j3i7A74pY" frameborder="0" allowfullscreen></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource interviews motion pictures moving image Date A point or period of time associated with an event in the lifecycle of the resource 2008-04-01 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/15p8j emory:15p8j Format The file format, physical medium, or dimensions of the resource 5075640000 bytes video/x-dv Creator An entity primarily responsible for making the resource Sencer, David (Interviewer) Blumenthal, Dan (Interviewee) Contributor An entity responsible for making contributions to the resource Centers for Disease Control Title A name given to the resource BLUMENTHAL, DAN Description An account of the resource Dan Blumenthal participated in the Smallpox Eradication Program (SEP)in Bihar, India in 1974. Dr. Blumenthal began his public health career with CDC. As an EIS officer at CDC, Dan applied to take a short-term assignment with the SEP. Dan describes his daily responsibilities. Later, Dan took a leave of absence from his position at Emory University to become involved with the last efforts to eradicate smallpox in Somalia. Subject The topic of the resource WHO CDC Smallpox Eradication Language A language of the resource English https://globalhealthchronicles.org/files/original/0f9e8cc1387afe60977d283296e5243a.jpg c544921e5bb749c80cd71268fa005746 https://globalhealthchronicles.org/files/original/5ccfac23726aca4084cafc8bcedc3d77.pdf 71e40e2a6f3331d53bb9cbe147d87f71 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> Interview David Bourne with Elisa Koski Elisa Koski Transcribed: January 24 2009 | Duration: 0:31:00 Elisa Koski: This is an interview with David Bourne on July 11, 2008 at the Centers for Disease Control and Prevention in Atlanta, Georgia about his role in the Smallpox Eradication Project. The interviewer is Elisa Koski. With this interview, we're hoping to capture for future generations the memories of participants and their families involved in eradicating smallpox. This is an incredibly important and historic achievement and we want to hear about your experience. I have some questions to guide you, but please feel free to recount any special stories or anecdotes that you remember about events or people. The legal agreement that you signed says that you're donating the oral history to the U.S. Federal Government and it will be in the public domain. For the record, could you please state your full name and that you know you are being recorded? David Bourne: Yes, my name is David Bourne and I understand this is being recorded. Elisa Koski: Thank you so much, and thanks again for being here today. Now David, we just want to start with a brief background about you, how you grew up, your pre-college education and your college education, and how you came to be interested in public health? David Bourne: You bet. I was raised in New Mexico and I moved there when I was about five. My dad was a Public Health Officer for the State of New Mexico for most of his career while I was growing up. So I became interested in public health and in medicine generally through him and I graduated from high school in 1967 from Robertson High School in Las Vegas, New Mexico and I attended a couple of years at New Mexico Highlands University there in Las Vegas and then I graduated from the University of Utah in Salt Lake City in 1971. During the course of my last year or so, I applied to the Peace Corps and was accepted approximately a year later. So I was accepted around March of 1972 having graduated in August of 1971. So my interest in general in the Peace Corps was to help with the health programs and they offered me the Smallpox Eradication Program in Ethiopia and I accepted that and became a volunteer in April 1972 with the intention of coming to Ethiopia and working with the Smallpox Eradication Program. David Bourne: Okay. So that's a unique way to get involved with CDC's Smallpox Program. David Bourne: Right. Elisa Koski: So what was your role when you arrived? David Bourne: I'm sorry? Elisa Koski: What was your role in the program when you arrived? David Bourne: Okay. In the smallpox program, I was called the Smallpox Surveillance Officer. So what they did, they had us have orientation here for a day or two in Atlanta with Dr. Foege on smallpox generally and after orientation we went to Ethiopia for approximately eight weeks of language and cultural training, and then we went to our various provinces where we were to work. I was a Smallpox Surveillance Officer, as they were called. So in Ethiopia, the way it was setup, it was run jointly by the World Health Organization (WHO) and the Ethiopian Ministry of Health and the Peace Corps Volunteers worked in concert with people from the Ministry of Health and the WHO to do the eradication. So our job or role was to go village to village from where we were assigned and look for smallpox. When we found it, we would in effect, evacuate - vaccinate the affected village and the surrounding villages. Functionally, I think the goal was a 2- hour walk around the village, but the villages were sufficiently spread out, so it worked out that the affected village and the surrounding villages - the adjacent villages, vaccinate them and move on to the next area where there was smallpox. I worked in two areas of North Central Ethiopia primarily. The first problem area I've worked in was Gojam, and then I worked in that province along the Western edge of the Blue Nile and then I transferred - they transferred us out of Gojam and I went to Wollo which was essentially on the other side of the Blue Nile, and I worked in Eastern Wollo. So I spent most of my career on each side of the Blue Nile, the Blue Nile Gorge and there was an awful lot of smallpox. By that time, '72 into '73, a large part of the remaining smallpox was in the North Central Highlands of Ethiopia and that's where I was; and during the course of the year, during the rainy season which is in the summer, all of us in Wollo, of which there were four or six volunteers, we would move to the desert because the rain would make the - we didn't have roads or vehicles but the paths were impassable due to the mud, so during the summer we would move to the desert in Western Wollo and then we would deal with a totally different type of people, these were the Nomads, they were subject to a Sultan, and we would work with the Sultan and his people to find out where the Nomads were at that particular time; they always knew where they were and we would vaccinate them, so that's essentially - I spent most of my time in the Highlands, probably about 9,000 feet elevation. The weather - it was near the equator, the weather was beautiful most of the time, and then in the summertime I would go to the dessert. Elisa Koski: It sounds like you were quite a young man when you first arrive there, coming out of college and then the Peace Corps. Can you describe to me a little bit of what it was like to arrive in such a foreign place and begin to work on such an important program? David Bourne: It was to me very exciting, initially certainly, to what I found - I was probably 23 when I arrived there and it was very, very new and very exciting. No one spoke English. What we did, we lived in a provincial capital. There were probably three of four of us in the Peace Corps that had a house together, and we would go to different parts of the provinces - of that particular province. So I, for 30 days at a time would not see any Americans or any white people for that matter or anyone who spoke English, with the exception of a translator that I had the first year, and I would fly to, in effect, the county seat of - fly commercially to the county seat of the district where I was working. In that particular area there was very little smallpox; the smallpox was focused in the Northern part of that county, so we would walk approximately 50 miles the next day, leaving at dawn and getting there at dark to get to the center of the Northern part of the county where most of the smallpox was. For the next 30 days, I would go village to village or to markets, trying to find smallpox which was relatively easy to find. There was a lot of it. One of the most interesting things, and far the most interesting ultimately was that the second year I didn't have a translator so I never heard English or spoke English during those entire 30- day segments, I had a guide, but no translator. So that made a very enriching experience; and then it got quite mundane after the initial excitement; months after months, year after year, going village to village vaccinating. The people were not - they were very, very - always very hospitable. They were not always very enthusiastic to see me. They had other diseases that they were worried more about than smallpox, but they were always very hospitable even though they were very poor. I'd live with the people; there was nowhere else to live. They gave me what food they had, they share that with me. That was the most incredible thing and it was very interesting to live in a place where they had not seen white men. Certainly the children never had, and it was very good and to deal with; and from time to time the people at WHO in Addis Ababa, Dr. Henderson, came there once in a while, so I did meet him once. So it was very exciting initially, then it became quite mundane and difficult throughout the course of the two years and a half. Elisa Koski: Thank you. You mentioned that you lived with families while you were staying in these villages? David Bourne: Right. Elisa Koski: Are there any specific memories or stories you can tell me about that experience? That must've been interesting. David Bourne: The interesting - there's a tremendous - I understand that those guys that worked in Southern Ethiopia had a different experience than those of us that worked in the North. Even though the people in the North were always very hospitable, as I mentioned, they weren't particularly enthusiastic, but each day it was assumed that you would be able to spend the night with someone, and it would be only for one night typically because you would be moving on and the people would talk to the Governor and the Governor would - usually have him yourself, but if he weren't available, occasionally, there'd be a - I could understand everything they could say even though sometimes they didn't realize it. Sometimes they'd say, "You take him." "No. You take him." "No. I don't -" But it was fun for us to batter with our Southern colleagues when people would fight over them, "I want him." "I want him." They would kill a sheep for the people in Southern Ethiopia quite often. Nobody ever killed a sheep for us. They killed a few chickens, which was always very welcome and very good. But now I don't think they had as much up in the North and they were certainly a different tribe, but they were always very friendly. One night, I was sleeping outside, even though I was in the company of a family - because it was very hot. I remember waking up to a dog barking very close to me and very scary because the dogs there, they're not exactly pets and not all that friendly, so that was one particular case at that point where I was pretty scared to be out there. But in general they were so friendly and I felt no danger whatsoever. Elisa Koski: You did say they weren't always enthusiastic about what your purpose was in the village. Oftentimes maybe because they had other diseases that they were a little bit worried about. Did you ever run into any problems or difficulties accomplishing what you came to do? David Bourne: Yes. From time to time, they absolutely would refuse. In general, the way it worked is that the decision makers had had smallpox before, so these were the adults and it was very [inaudible0:13:26] minor in Ethiopia so the mortality rate wasn't very high. So they would often be able to survive and they knew they couldn't get it again, so the people, the governors, the decision makers, the adults, they weren't enthusiastic, but they would almost always let their children be vaccinated. But you had to go seek them out, generally speaking. They might come in small groups. I understand many times our colleagues in the South, they would have to have the police control the crowds too because they wanted to be vaccinated. So it was a little different. But occasionally, people would absolutely refuse. "No. Get out. We don't want you in our village. Leave." In that case, I would ignore the affected village, but vaccinate the surrounding villages. Thereby, they would be unwittingly protected to a large extent because I would be able to vaccinate those surrounding villages. Now during the course of our tenure there, the Emperor, Haile Selassie, was overthrown in a coup but I assume they are the people who are still in power today. It was a Military Junta and the types of people at least - if they were still in power today - and that created a situation of anarchy to a large extent in the countryside because the Government had been overthrown, I think in general, the Government did not affect the people, they were farmers, kind of under a feudal system, but everyone had a gun in Ethiopia. There was one situation, where right after that revolution, in the county seat in the effect I flew into, some students had surrounded a judge's house who was being transferred and they were in the spirit of the revolution and they said, "No. This judge expropriated property from the people. He's unjust and he's not leaving." So the judge hired some robbers, in effect, highway men, they were fairly common there, "Shift" as they called them; and these robbers were well armed and he hired them to escort him and his family and his stuff. They were planning to go by mule or whatever to the next town, but when these shifters came, these highway men came to his house, the students and the people in the town, they had a gun battle. The judge's wife was killed certainly and most of his family and about half of the highway men were killed. This is the gun battle that occurred the day before - the day of the evening I was walking back there. So the guy I was staying with was in effect the Public Health Officer who was a doctor, and he was treating the wounded - the remaining wounded who were very badly wounded, and the people in the house, they threatened to burn down our house, his house, the one I was staying in because he had done that, but they fortunately didn't do that. But talking about refusal, the next day I was scheduled to go back North and no one would go with me because the people that got killed were from the Northern part of that county; and they were rumored to be coming down to burn down the town. Kind of like the Old West. Then the next day, the judge's family arrived by plane from Addis Ababa, the capital, armed with machine guns and whatnot to exact revenge on the people and I left on that very plane. It was time for me to go. In fact, that was the last time I was in that part of the country. Elisa Koski: It seems like that would've been quite a dangerous situation. David Bourne: It had appeared to be. Everybody else really thought so and I was ready to go, and I was pretty - I guess I was 24 by that time, 25. But I could understand that the guide I had usually: he said, "What good would that do me if I got killed up there-I'm from the South;" and there was going to be a big feud between the North and the South. During that whole period there were a lot of situations like that where the citizens took advantage of the roles of the anarchy in the country, and then soon after that, Peace Corps offered people to leave voluntarily because of the deteriorating situation. Most of us stayed, I stayed through my tenure and a couple of months beyond, but the next year, I'd say, I think it was probably in '75, they actually kicked the Peace Corps out of Ethiopia, and everybody left. Elisa Koski: How far along into your time with the Peace Corps did this occur; and after it occurred, did that change how you played your role in the Smallpox Program? David Bourne: I was pretty well - I was there a total of about two and a half years and this was probably about two years into it. So I had about three months to go and I think if memory serves me right, it was time to go to the desert anyway which was totally different. Their political situation was - there weren't that much people, there wasn't much Government and the Nomads that we dealt with went back and forth between what was called then the territory of [inaudible 0:19:42] in Ethiopia; I think it was Somalia Land or - So the political considerations and the security situations were far different in the desert. So I finished out my tenure in the desert and then I agreed to remain a couple more months to train the new group of smallpox volunteers, about nine or 12 of them that came, and I stayed for about two months or three months helping the Ethiopian contractors train this new group. Elisa Koski: Now you mentioned a little bit earlier that you did have some contact with WHO and CDC counterparts such as Dr. Henderson. Can you tell me a little bit more about that relationship? David Bourne: I remember meeting him only once, but we had - with regard to CDC, I only met only one CDC person. I don't recall his name. He was an EIS Officer that came from Atlanta for a period of time, three months or so, and he actually worked in a different - in a neighboring province but I did meet him. So there were very few CDC people in Ethiopia and there were a few WHO people, Dr. Vitello[inaudible name0:21:09] was the head of the program there in Ethiopia for WHO. I dealt with a Brazilian Epidemiologist Dr. Ciro de Quadros and an Indonesian Epidemiologist, Dr. Peter Kaswar[inaudible name0:21:25]. There was actually also a Russian Epidemiologist I know who came down there; so they had an office there in the capital city in Addis Ababa. I dealt mainly with Dr. Kaswar, to some extent with Dr. De Quadros. So we would occasionally meet with Dr. Hen - I would happen to be in the office one day-It might have been literally, right after I'd left the troubled area, the plane was going to Addis, so I went there to Addis Ababa and I may have met him there. I remember the conversation, I was talking to him about my - the success with those jet guns, the people seemed to like them on the one hand, but on the other hand, they so often broke down especially in the desert. So in effect that turned out - I thought it was a good idea and told him so; and he thought that was interesting, but in the end, they didn't work for me very well. But I did have a brief conversation; he wanted to know the status, where I'd come from, that kind of thing, and the country. It was an honor to meet him there because at that time, he was the Director of the global program. So that was the extent of my dealing with WHO From time to time I would go to the office, not very often: the day to day efforts would be just me and a guide and we're out for 30 days at a time and then go back to the provincial capital of the town of about 60,000; and we had an office within the Ethiopia Ministry of Health, in effect the Health Department. So we had a smallpox office there that - even though there were four of us, we were gone so much, we rarely saw each other. Elisa Koski: Were there any specific challenges or positive aspects to working with the Ministry of Health? David Bourne: With working with the Ministry of Health? Elisa Koski: Yes. David Bourne: They were very - actually I don't recall if we were in any challenges particularly, they were very enthusiastic, very dedicated; and there weren't that many of them either. We probably outnumbered them. They would have - maybe within the province, they would probably have a staff of maybe four and there were four to six of us, so it was pretty equal and in general we wouldn't have a lot of interaction with them because like we did, they would go to different parts of the province. So when we did come together they were very dedicated, good friends of ours and so forth. Then I had nothing but praise for them and their dedication and their competence. Elisa Koski: Great. You mentioned early in your interview that you had about four to six team members who were also Peace Corps volunteers, but that you didn't see them incredibly often. You were on your own most of the time. David Bourne: Right. Elisa Koski: Were they doing the same sort of thing and how often did you get to share your experiences together? David Bourne: They're doing exactly the same thing. Now this was just in that particular province. So I think we might have had four people there. Throughout the country, there might have been at any one time, 20 Peace Corps volunteers in the Smallpox Program, or 25, in different parts of the country. But each of us did exactly the same job. We would go to different provinces because they were - in our province, Wollo, that was probably - if I remember right it almost led the nation in a number of smallpox cases by that time and I think they were among the last cases in Ethiopia after I left Wollo province or near there. So we had plenty to do. I would say, my area and other people's might have been similar, but I in effect, I think was responsible for an area maybe 40 miles wide and 120 miles long, maybe 250,000 people, the way I remember it, but there were no roads, no electricity, no towns. Well, there were some towns, but there were no roads with the exception of an old road built in the '40s that was impassable, or mostly so. I would walk up and down that area for two years and mainly in the North, and my colleagues would do the same. They would go to other areas and they did a lot of walking as well. Elisa Koski: I'd like to talk a little bit about how this whole experience in Ethiopia really influenced your life after; and how it impacted your career in Public Health? David Bourne: Great. Right after I came back, I came back around October of 1974; and actually, as a result of my conversation with this EIS Officer in Ethiopia, he told me about working for CDC, about the process, and that's what I wanted to do. That was the single purpose I had. At the time before I met him, earlier in my career in Ethiopia, I was thinking about coming back and going to Pharmacy School, but I decided I would try to work for CDC. So I immediately, probably the next day, applied to CDC there in October of '74 and I had an interview and I was hired to start in Los Angeles in January of '75 with the VD Program as everyone in CDC virtually then, and maybe today I'm not sure, I think it may have changed now; but that was the path. You started out as a VD Investigator for CDC, and I started out in Los Angeles. So I went from Los Angeles to CDC; to Anchorage, Alaska, and to Gallup in New Mexico. So New Mexico happened to be where I'm from, so when the time came to be transferred, I decided I didn't want to be transferred and wanted to remain in New Mexico so I resigned from CDC after about eight years and then I - So the Peace Corps was directly responsible for my remaining in Public Health and remaining in and being at CDC, and I did that for about eight years and then for other reasons I didn't - I remained with CDC. From there I worked for the U.S. General Accounting Office for similar number of years, maybe 10 years, and I currently work with the U.S. Department of Energy. So I've stayed with the Federal Government from the time I started the Peace Corps in several different agencies including CDC, and it was directly responsible for my decision and my ability to work for CDC. Elisa Koski: Thanks. Just in closing, I would like to ask if there is anything else, any other particularly poignant memories or stories you would like to share about your time in Ethiopia that we haven't covered so far? David Bourne: It was basically a - it was a very hard job. At first it was very exciting, it relatively quickly became hard and mundane, but it was very rewarding because you could and you would leave a village and know that they've had - that area had smallpox for maybe 2000 years and will never have small pox again. At the time, I think that feeling and perspective is growing with time especially when you view the global program in perspective of disease control programs that they're seeking now. So it was very, very rewarding. I did have the opportunity - also there was a massive cholera outbreak in the desert during one of the summers there, and that was a situation where far more people were dying and it was far more serious, but we were able to - myself and a colleague, particularly another Peace Corps volunteer, were able to maybe vaccinate several thousand people and even start a couple of IVs which we'd never done before and haven't done since. But that was rewarding as well. So on balance, it was really quite difficult, but very, very rewarding and I appreciate the chance talking about it. Elisa Koski: Thank you so much for talking to me about your experience. It sounds like it was very rewarding and had a great impact on your life. We really appreciate sharing your experiences. David Bourne: Great. Thank you. Elisa Koski: Thanks. [End of Audio - 0:31:00] </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/bGFAnlxexFw" frameborder="0" allowfullscreen></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource interviews motion pictures moving image Date A point or period of time associated with an event in the lifecycle of the resource 2008-07-11 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16rgn emory:16rgn Format The file format, physical medium, or dimensions of the resource 6690960000 bytes video/x-dv Creator An entity primarily responsible for making the resource Decker, Alicia (Interviewer) Bourne, David (Interviewee) Title A name given to the resource BOURNE, DAVID Description An account of the resource David Bourne describes his work as a Peace Corps Volunteer in Ethiopia 1972-74. Subject The topic of the resource Smallpox Eradication Smallpox Eradication Language A language of the resource English https://globalhealthchronicles.org/files/original/a661fea7dee214a20ea9e7271f5ef133.jpg 7cde4355f210715732bf6ac981f302e1 https://globalhealthchronicles.org/files/original/e327786249e1e9de0297f0448fc8d2fc.pdf 9319854875dbb7a21d3da048a4012eab Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> This is an interview with Anthony R. Masso on July 14, 2006, at the Centers for Disease Control and Prevention in Atlanta, Georgia, about his involvement with the West African Smallpox Eradication Project. The interview is being conducted as part of a reunion marking the 40th anniversary of the launch of the program. The interviewer is Kata Chillag. Chillag: So, what we want to hear is any stories. We have a series of issues we'll want to cover, but it's a bit loose. So, the first is, how did you come to public health as a career? Masso: I was in the Peace Corps for several years before joining the Smallpox Eradication Program. I saw a piece in the Bulletin that CDC [Centers for Disease Control] and the World Health Organization (WHO) were about to launch a smallpox eradication- measles control program in Africa. I was interested in continuing my international experience, learning another language, and doing something good. So I decided to send in an application. I also thought it was a good thing to do in the '60s instead of going to Vietnam. After my application went in, I was interviewed by D. A. Henderson [Donald A. Henderson], the WHO Director at that time. We met in Washington, DC, in a bar, and over a couple of beers he said, "Hey, listen, you're great for the program. Come and join us," and that was it. Chillag: Where had you been in the Peace Corps? Masso: In Latin America. So it was a completely different experience to go from Panama in Latin America to Africa. Chillag : And where were you in Africa? Masso: Niger. Chillag : And so, what was your role in the smallpox program? Masso: My role was to be the operations officer along with a medical officer, Don Moore [Donald J. Moore]. Together, we formed the team of about 16 West African health workers, all male. The West African health workers, the nurses, were men; no women. It was a Muslim country. I'm sure that's the reason. And with about 25 trucks, our job was to go throughout the entire country and make sure everyone got vaccinated and to contain any outbreak that we saw. Chillag : What were your expectations of the work? Masso: Well, there was no real expectation other than knowing that it was hard work and that the conditions would not be good. I had lived in the United States, a privileged citizen with all the modern conveniences. And even as a Peace Corps volunteer, although there were no real conveniences, Panama had a lush environment, with greenery and the ocean. To go to a desert country, Niger, the size of Texas and California combined, with a hundred miles of paved road in the entire country and virtually all desert and mountain, and to see people live at the edge of existence was quite a different experience completely. There was no way to prepare for that. Our training was mostly to learn French and to study epidemiology, but it didn't prepare us for the life in that country. Chillag : And what were you most prepared for? You mentioned the sort of people living at the edge of existence. Masso: Well, we were prepared to do the work. We knew what we were there for, so from a technical point of view, we knew how to operate the equipment, how to maintain the vaccines, how to map out each town we were going to for vaccination. I remember one of my first impressions was seeing people living as they did 2,000 years ago, during the time of the Bible. You saw people literally with no more than one little clay pot and a little fire and a few seeds. and certainly no meat or anything-there are no conveniences at all-moving from place to place on the back of a donkey. I mean, it was exactly the way the world was 2,000 years ago. And many parts of that country are like that today. So there's very, very little progress. The country is exceptionally poor, large and vast, no real resources, no real agriculture. There's almost no rainfall. I remember many times I'd say to myself, people shouldn't be living in places like this. Not very hospitable. But our job was to contain the disease and wipe it out over a period of a couple of years, which we did, of course. Chillag : What were your specific living conditions? Masso: Our personal living conditions were good because we were attached to the American Embassy, and they gave us a small ranch- style house with a couple of bedrooms and a kitchen. We had air- conditioning, we had nice furniture, which was brought in just for the smallpox program. We had a car for our family as well as a truck that we would use for our work. We had servants, a houseboy. That was the norm. So the living conditions weren't bad at all. We were all young, and we didn't care that much to have super luxury. Chillag : And you traveled around the country. Masso: We traveled around the entire country. We worked so hard. We would try to schedule the trips to go to look at certain villages to see if smallpox was still rampant. Don and I would try to schedule a trip on a Thursday or toward the end of the week so we could travel and do the work outside the capital city on the weekend, on Saturday and Sunday, then come back during the beginning of the week to do anything we needed to do back at the health ministry. It was an arduous type activity because we'd be out for sometimes days at a time, and on big long trips, sometimes a couple of weeks at a time away from home, with no communications, no cell phones, no faxes, no telephones. When we were gone, we were really gone. Chillag : And you were there with your wife too. Masso: I was there with my wife. She was pregnant when we arrived. We had 2 children born to us while we were in Africa, which was a little bit unusual, although not too unusual. There were several people who had children there. And it was because we were young and we had both been in the Peace Corps that we were able to endure the conditions. But even others who hadn't had a prior international experience did fine. Being young and well motivated, I think I always rolled with the punches. Chillag : You had to work, I'm sure, with lots of local partners. What was that like? Masso: Well, the work with local partners was mostly frustrating because what you expect in a counterpart in a country like that is different from what reality is. Their motivation, especially at the higher echelons, was how to do the minimal amount of work and take a lot of credit, and they just didn't have the drive that we did. We were very focused on what we had to get done. Now, on the local level, with the people who worked "under us," who were the health nurses, it was completely different. I mean, we'd get up at a 4:30 AM, 5 o'clock in the morning and we were off. We would travel all day long, 12 or 14 hours, to get to a location. We'd work all night setting up camp. These people, the vaccination teams, would go out in the worst of conditions to perform the vaccinations. So they would work very hard and very long with meager pay and meager food available to them. But at the Ministry of Health, where the bureaucrats were, it was completely the opposite. They just saw this as a free ticket for them. Chillag : Was there general receptivity at a government level to the program as a whole? Masso: Yes, there was. These countries really are developing or Third World countries, and they knew that the United States was coming in with lots of equipment, lots of money, talented Americans, to "give them something" that they wanted and needed to improve their health. But it was also free, and so they were very receptive to opening their doors and getting the equipment and the opportunity to do something in public health. We encountered no resistance to our work at all from any government leaders or local chieftains. We were there to do good, and they knew it. Chillag : Were there any particular cultural differences that were very striking to you or very challenging to you in living there? Masso: Well, I remember having learned in the history of medicine that the little lighted, red-and-blue swirly cone with a white background that you still see today outside of barber shops, symbolized blood. Because the old barbers were blood letters, even in Europe and in this country, 150 years ago. When a person was really sick, they would let out blood. I had thought this was a practice that you only read about in history. When we got there, sure enough, there were practitioners right outside our office-a modern office with maps on the wall and vaccines that came from the States and the latest in hydraulic vaccination equipment. There would be people out there paying some practitioner to cut their backs or their arms and put suction devices on them to pull blood out. They thought if they were being bled, it would cure them of a headache or a stomachache or whatever it was. So that was a weird practice. There are a lot of Muslim practices that were unusual: the feast of Ramadan, where they'd fast every day for 40 days and not eat until sundown; slaughtering of animals in a ritualistic Islamic way; preparing sheep, kind of skewered, spread-eagled, which is called mishlee [phonetic], roasting the sheep. So we saw plenty of unusual practices. But after a while, they just became part of life. We didn't see them as strange; we saw them as part of their culture. And I think that's the way it's supposed to be. Chillag : What do you think was the biggest challenge about the work? Masso: I think the biggest challenge for us was the logistics. It was unbelievably difficult. We were forced to use American Dodge trucks, which was unfortunate because we should have been using Land Rovers. The trucks broke down frequently; axles would break. It got so bad that we'd have axles air-freighted in from Detroit to Niger at a humongous cost just because we had to use American equipment. And Niger was not like the coastal countries, like Ghana or Nigeria, where you drove on paved roads. We were in mountainous dirt-road locations, with these trucks that just wouldn't keep up. So the logistics of that, plus moving the vaccine around, keeping measles vaccine refrigerated where there was no refrigeration, was a big problem. And getting around the country, I mean, the size of Texas and California combined, with a small team and doing all of that in a couple-year period was very challenging. But, nonetheless, we got it done. Chillag : Yes. What were the biggest rewards? Masso: Well, the reward was very simple. I didn't realize that, in a couple of years, we would actually be able to see that there was no more smallpox in the whole country, and that was phenomenally rewarding. I can remember being out under the desert skies with a team of African male health workers, and we looked up at the stars. That was about the time, by the way, when we first went to the moon, the late '60s; '69 was the first moon landing. And I remember saying, "Look at those stars and look at the moon." The American space program was going up there. And here we are, and we're going to do something just as important. We're going to wipe a disease off the face of the earth. And we're not alone, you know; like that big sky, those stars are not alone; we're not alone. We are in each of 20 West African countries doing the same thing, and if we all do our job, we'll see it removed from Africa as a disease. That was tremendously rewarding to be able to say that to those people, to believe it, and then to leave when it was all done. Chillag : Has that affected the choices you've made afterwards, your career and your personal life? Masso: Well, certainly. I think what it's done to me as a person was to realize that there's no hardship you cannot endure. There's no obstacle that you can't surmount. There could be nothing tougher. You can be successful at something if you put your mind to it, if you work hard at it, and if you've got the tools to do it. CDC gave us tremendous tools to work with. And I don't mean just physical tools. We had the backing and support that were required to do it. And like the space program or like any other major achievement in history, we were able to get it done, and that leaves you with the sense that you can do almost anything if you have the right approach and the right support. Chillag : I didn't ask anyone else this, but I'm just interested. Did you have any issues coming back to the United States in terms of reintegrating here? Masso: When I came back, I went to Syracuse, New York, where there was 157 inches of snow that first winter. And, of course, when you leave a country which is 120°F in the shade, not unusual in the Sahara, and you come to New York, you get the climate difference. But the bigger difference wasn't that. It was that after 3-1/2 years of living like this in Africa, getting back into modern society doesn't seem real. The United States was now not real. Africa was real. Speaking French and speaking dialects were real. The superficiality of normal American suburban life, which is what we came back to, seemed like a movie, and Africa, then, was the real place, where at first it had seemed just the opposite. So the biggest cultural change was readjusting, which, of course, we were able to do after 6 months or a year or so. Chillag : Do you think there's anything else that it's important for people to know about the endeavor? Masso: I think that the most important thing for people to know is that it's unusual for the USAID [US Agency for International Development] program, or for any type of American foreign aid, to be looked at as being very successful. But I think CDC leadership in Atlanta and the people they were recruiting were uniquely able to demonstrate to the world that you could say we have a goal of eradicating a disease, and spend a modest amount of money doing it, and be tremendously successful in accomplishing it. I think that's a once-in-a-lifetime activity. The legacy is certainly something that we should all be proud of. People who listen to these tapes or people who see what's been done should realize that it was accomplished by normal people under abnormal conditions, but with exceptional leadership and dedication on the part of everyone. Chillag : Well, thank you very much. Masso: Thank you very much, Kata. # # # </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310130241&amp;color=ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false" frameborder="no" scrolling="no" width="100%" height="166"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource sound recording - nonmusical interviews Date A point or period of time associated with an event in the lifecycle of the resource 2006-07-14 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/158r7 emory:158r7 Subject The topic of the resource CDC Smallpox Eradication USAID WHO Operations Officer Format The file format, physical medium, or dimensions of the resource 175409808 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Chillag, Kata (Interviewer); CDC; Anthropologist Masso, Tony (Interviewee); CDC; Operations Officer Contributor An entity responsible for making contributions to the resource Centers for Disease Control Title A name given to the resource MASSO, TONY Description An account of the resource Tony Masso, Operations Officer was assigned to Niger. Tony relates his impressions of Niger, working in the field and with Ministry of Health officials, cultural differences, and the greatest challenges and rewards of his time spent in Niger. Tony notes, "People who listen to these tapes or people who see what's been done should realize that it was accomplished by normal people under abnormal conditions, but with exceptional leadership and dedication on the part of everyone." Language A language of the resource English https://globalhealthchronicles.org/files/original/a9f3467b7db2391364bee10ac5687a6d.jpg 12d6c00d1ea77ebb7d729b86916fc2ed https://globalhealthchronicles.org/files/original/fe408524bbac2714bd3af07fabbfb22d.pdf e2dc6b2f07dfdc5accb0f12094f47f38 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> This is an interview with Leo Morris about his activities in the West Africa Smallpox Eradication Program. His wife, Jane Morris, is also present. The interview is being conducted at the Centers for Disease Control and Prevention, on July 14, 2006. This is during the 40th anniversary celebration of the launching of the Smallpox Eradication Program. The interviewer is Kata Chillag. Chillag: How did you come to choose public health as a career? Morris: It was a bit serendipitous. My background is statistics, and I was studying statistics at the University of Florida. Usually every summer, I went home to Miami to work, usually in the hotels, to get money to go back to school the next fall. But during my junior and senior year, I thought I'd better get some experience. The Public Health Service had a traineeship program for statisticians, and 1 other person and I were selected from the University of Florida. Our assignments were just random. He got assigned to the Department of Agriculture, which turned out to be pretty boring, he tells me; and I got assigned to the Tuberculosis Program, Public Health Service, before it was transferred to CDC. After that summer, they asked if I'd consider coming back after graduation. And I might add, in those days-'59, late '50s- a statistician, even one with just a bachelor's degree, was in great demand. There just weren't many around. And I said, "Well, you know, I'd like to stay closer to Florida," and they told me about CDC. The Serfling-Sherman Polio Immunization Surveys were being conducted then, so CDC was looking for statisticians. So they recommended me to CDC, and there I was. Chillag: And so, how did you get tracked into smallpox eradication? Morris: I started out in the Polio Surveillance Unit, when we had cases of polio in the United States. I worked in that unit for 3 years in the EIS [Epidemic Intelligence Service]. Then Dr. Langmuir [Alexander Langmuir] supported me for employee development, and I left and got my Ph.D. at Michigan, where our first child was born. (The first was born in Michigan where I got an MPH in biostatistics in biostatistics, the 2nd in Atlanta, and the 3rd in Brazil,.) Then I worked with D. A. Henderson [Donald A. Henderson], mostly on viral diseases in the Surveillance Section. The Investigations Unit was devoted to bacterial diseases back in those days, with Phil Brachman. I also worked a lot in reviewing material for the MMWR [Morbidity and Mortality Weekly Report]. That was '63. I worked on a big St. Louis encephalitis outbreak that year in Houston, Texas. In '65, I worked with Larry Altman. He became the first person to go to West Africa in the measles program in West Africa on a TDY [tour of duty]. We were getting involved in some smallpox work, and I was chosen to be part of it. We had a 5-person team in '65, including Don Millar [J. Donald Millar], who later became head of the Smallpox Unit at CDC, to evaluate the vaccine produced in Brazil. Basically, we were comparing the Wyeth freeze-dried vaccine with the freeze-dried vaccine produced in Brazil. We worked in the Amazon territory of Amapa, which is now a state. We were gone about 5 weeks. When we left here, it was winter. In fact, we had a snow storm, and that day we didn't know whether we were going to get to the airport or not. And there, of course, it was summertime and 100° in Rio de Janeiro before we went up to the Amazon. That was my first trip to Brazil. I did some polio work in Chile and Puerto Rico in 1960 and 1961. I really sort of fell in love with the culture in Brazil, and the people and so forth. That was '65. Then '66 was the start of the smallpox program, so I stood up with D. A. Henderson and others in the original group that started the Smallpox Eradication Program. I was in charge of the statistical end and evaluation. In '66, we trained the first group that went to West and Central Africa. I had interviewed many of the nonphysicians who had applied. Then the Pan American Health Organization (PAHO) came to CDC. At that time, Brazil was the only country with endemic smallpox in the Americas. There were some overflow cases into neighboring countries. It was variola minor, not variola major, so it didn't get the publicity of some areas. But PAHO, which is part of WHO [World Health Organization], said they were going to put advisors into Brazil. They had a newly created Smallpox Eradication Program, and they needed a statistician, an evaluation person. They had 3 physicians, 1 from Paraguay, 1 from Peru, who was the team leader, and 1 from Colombia. So I was asked if I might want to go to Brazil. I said, "Where do I sign up?" I was very eager for that. In February of '67, we left for Brazil. And that's how I got to Brazil. I was there 3 years as advisor to the Smallpox Eradication Program after I had participated in sending the first trained group over to West Africa. Chillag: And, Mrs., Morris, how did you feel about that? Mrs. Morris: I loved it. When Leo asked me, "What do you think about going to Brazil?" I said, "When?" Morris: We both learned how to samba. Chillag: Yeah, there you go. So, you mentioned that before the actual smallpox eradication, you did the trial between the 2 vaccines, correct? Morris: In '65. Chillag: In '65. And then, after that, was there a typical day for you as a statistician working on this in Brazil? Morris: Well, we had several primary objectives. I spoke Spanish reasonably well, but I took some Portuguese courses so I could forget my Spanish because it's hard to combine the 2 languages. The director of the program in Brazil was a man named Silva. He had recently retired from being the head of malaria control in all of the Americas at PAHO in Washington and returned back to Brazil. Because of his vast experience, they talked him into taking over this new Smallpox Eradication Program. He was the only one in the office who spoke English. Now if you went up to the Ministry of Health in Brazil, a good percentage of the people spoke English. But he was the only one who spoke it in this office back then in 1967. So on my first day there, we conversed in English, about the surveillance we needed, reporting, and so forth, and then he said to me, "This is the last day I'm going to speak to you in English," and he never spoke to me in English again. So in that environment, it was easy to really improve my Portuguese. We had 3 primary objectives. First was to develop a reporting system, which they didn't have. There were 22 states at that time, and I think only 6 or 7 were reporting cases of smallpox . Sao Paulo, the biggest state, with the most cases, never reported. Starting a surveillance report based on the reporting was the 2nd goal. And the 3rd was to start thinking about evaluation. I had worked on the system that they were going to use in West Africa for evaluating the vaccination program. We wanted to extend it to Brazil, although in Brazil we could be a little more sophisticated because they had better census data to use as a sampling frame. Chillag: When you talk about evaluation of vaccination, what all does that entail? Morris: Two primary things. One would be a sample of villages or towns, sometimes big cities in Brazil, to look at 2 things: 1) asking everybody in the sample households if they had been vaccinated in the campaign; and 2) checking everybody </pre> Player html for embedded player to stream video content <iframe width="100%" height="166" src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310131763%3Fsecret_token%3Ds-OergU&amp;color=ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false" frameborder="no" scrolling="no"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource sound recording - nonmusical interviews Date A point or period of time associated with an event in the lifecycle of the resource 2006-01-13 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/158th emory:158th Subject The topic of the resource Smallpox Eradication USAID WHO CDC Surveillance Format The file format, physical medium, or dimensions of the resource 574078512 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Chillag, Kata (Interviewer); CDC; Anthropologist Morris, Leo (Interviewee); CDC; Statistician/Surveillance Officer Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of West and Central Africa Smallpox workers (2006 : Atlanta, Georgia) Centers for Disease Control Title A name given to the resource MORRIS, LEO AND JANE Description An account of the resource Leo Morris describes the smallpox program in Brazil and the eradication of the disease. Jane Morris relates some of the challenges of life abroad. Leo, was already employed with CDC, and helped interview and train the initial group that went to West Africa. He served as a statistician for the Smallpox Eradication Program in Brazil, which was the only endemic area for smallpox in the Americas. Leo helped develop a smallpox reporting system and surveillance, as well as an evaluation program for the smallpox vaccination campaign. After his time in Brazil, Leo continued his work with surveys and evaluation techniques in the area of reproductive health. Language A language of the resource English https://globalhealthchronicles.org/files/original/7caccf7d31d87f29d9254d48fd266cb3.jpg 55676ea7b6bbf7b686871a6a40c769c7 https://globalhealthchronicles.org/files/original/5140a423b116905593143d0e2f83bf5d.pdf 0cebed1f61d26318afcf5a7fd2442c2d Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> This is an interview with William J. White, Jr., about his activities in the West Africa Smallpox Eradication Program. The interview is being conducted at the Centers for Disease Control and Prevention, on July 14, 2006. This is during the 40th anniversary celebration of the launching of the Smallpox Eradication Program. The interviewer is Kata Chillag. Chillag: How did you come to public health as a career? White: When I graduated from college, I was looking for a job. During an interview, I was asked, "Do you want to go to New York City and talk to people about sex?" So I went to work for CDC as a Public Health Advisor in the syphilis eradication program in '62, right out of college. Chillag: And how did you come to work in smallpox? White: I had been working for CDC recruiting personnel to work in the venereal disease program. I was getting a little bored, and I went to visit a friend who was at CDC operations in Hartford, Connecticut. He said he had heard that CDC was getting involved in smallpox, in international work. And I said, "Well, that sounds like something really interesting to do." So I put my name forward and said I was interested in being part of the group that was going to be looked at as possible candidates to work overseas. Chillag: Had you worked internationally? White: No. I had not even traveled outside of the continental United States. Chillag: So it was a big change. So, what were your expectations of the work before actually doing it? White: I thought that it was going to be an opportunity to be exposed to a different culture and a different environment. Then the project became more exciting as we went through the training in Atlanta before we went overseas. Chillag: And your role was what? White: I was to be the Operations Officer, based in Conakry, Guinea, but there was a disagreement between USAID [US Agency for International Development] and Guinea about assigning a team to that country. So the next assignment I was offered was in Upper Volta, which is now Burkina Faso, inland from the Ivory Coast . Chillag: And you were paired with a Medical Officer? White: Yes. I was paired with was Chris D'Amanda, who had responsibility as the Medical Officer for both Upper Volta and Ivory Coast. When I found out I was going to Upper Volta, I had a chance to meet and talk with a person who had been a US ambassador to Upper Volta, Thomas Estes. At that point my wife was 6 months pregnant. So we asked Estes, "Can you give us some insight into Ouagadougou, and whether or not it's even possible to think about delivering a child in the hospital there?" and he said, "Oh, yeah, no problem." Fortunately, my daughter was born stateside. Chillag: Did you come back, or you hadn't gone yet? White: No, we hadn't gone yet. It was clear that there was going to be a delay in the assignment and clearances and a whole series of things. There was an interim assignment arranged in Pennsylvania. So our daughter was born in Harrisburg. And then we went from there to West Africa. Chillag: What experiences, skills, and training from the VD program-and it doesn't just have to be that-were most relevant in terms of what you did next in Upper Volta? White: Even though I started off in the venereal disease program, I think that the next step, my assignment in Pennsylvania, was more critical because I was involved in recruiting for CDC on college campuses. The capability of interacting with people in a setting other than just a VD clinic was more useful. But I also think it was just kind of an understanding of what I was interested in at that time. It was the late '60s and getting beyond the United States and looking at international issues seemed to be relevant, at least for the folks that I knew in my generation. Chillag: If there was such a thing, what was a typical day like in your work in Upper Volta? White: Some of it was boring because it was basically office work and staying on top of issues, such as the budget. But other parts were interesting, such as the interaction with the vaccination teams, the development of the training of the teams, making certain that they understood what was expected, tackling issues like where we were going to store vaccine in a country, and looking at the cold chain. I did not understand, when I got in-country, what the issues were going to be in terms of being able to store smallpox and measles vaccine. We wound up having to find a large locker in which to store vaccines, and the only large locker that could keep things cold was at the abattoir, the slaughterhouse. So the vaccine was stored there. So when vaccine came in from the airport, getting it from there to the slaughterhouse was one of the major undertakings of the day. Chillag: And I assume part of your role was to negotiate things like storing it in the slaughterhouse. White: Yes. And that was made easy by being able to negotiate with the French, who really still formed the underpinning for the government agencies and were helpful in some ways, racist and hostile in other ways. I think that they were competitive in some ways with the American team there, but at the same time they wanted to see success with smallpox eradication. Chillag: So the remnants of the French infrastructure, is that who you primarily dealt with? White: No. There were Africans, but the French influence permeated a lot of the areas in the ministries, finance, health, and other agencies. This was in the late '60s, and the underpinnings were very much French. They still subtly controlled what happened in the economy and the government infrastructure, at least in Upper Volta, and, my understanding was, in some of the other francophone countries as well. Chillag: What were some of the challenges in dealing with Africans there? White: In our preparation for going overseas, there was a lot of attention paid to our becoming aware of the vehicles that we were going to be using and the maintenance and operation of those vehicles. Well, as it turned out when I got in-country, you could hire very qualified drivers and mechanics for relatively small dollars, and so it didn't make a whole lot of sense for me to figure out how to repair a Dodge truck. I also had political interactions within the American Embassy as well as within the French structure and with the Voltaic government in general. Chillag: So, starting out with the government in general and the French infrastructure, what were some of the politics that you faced? White: Initially, as I said, there was what I would regard as-jealousy is not quite the word-concern among the French that the Americans were there not just to do the job they were there to do but to basically insert ourselves between the French and the Africans who were ultimately in charge of the country and of the government. Even though there was a president then in Upper Volta, there was always the potential of a revolution. Interaction within the American community was also a concern because when we arrived, my family was located in Ouaga. There was a sense that we were somehow not just with the USA and USAID and not just with the Public Health Service. There was some suspicion that because we had learned some French, we were somehow connected with an agency based in Langley, Virginia. The suspicion was enhanced because our housing was outside of the immediate American compound. The other thing that made it complicated was that, as the smallpox/measles team, we had freedom to go almost anywhere within the country. And that was unusual; other Americans in the country had more limited passage for their visas. Chillag: So, how did you deal with those things? White: Ignored them, basically. I expanded and made changes. I just thought it was kind of funny that I would be considered as linked to the CIA [Central Intelligence Agency]. That connection was not anywhere near where my interests and politics were. So, I mean, it just made it kind of funny and interesting. I think the other challenge was being able to deal with the USAID infrastructure and how they perceived what we were there for-that we were really part of their operation but not quite part of their operation. I generally had a style of ignoring a lot of the paperwork and a lot of things that they were concerned about. My issues were public health issues-dealing with what we needed to do to train the teams, to get the vaccines out there, and to get out to assess outbreaks. I didn't pay a whole lot of attention to the USAID and embassy bureaucracy. I remember just the complexities of living. When we got there, I have a fairly vivid memory of getting off an airplane at like 5:30 in the morning, having left Harrisburg about 2 days before with a stopover in Paris. When we left the United States, I think it was probably about 30°F. When we got to Upper Volta, it was probably 30°C. I had second thoughts after we got off the plane and got located, and the housing we were supposed to be in wasn't ready yet. I'm thinking, "Wait a minute. My daughter is 6 weeks old, my son is a little over 2. What the hell did I get everybody into?" But then I think that there was a lot of interest in the American community, of seeing that somebody new had come to town. The Americans in-country were welcoming, even though it was a small community. So I think that that was helpful in adapting. But just learning that the electricity was going to out for so many hours, that the water was going to be out for so many hours, and that when the water was on, it was going to be on for a very specified period of time during the hot season- just coping with the living experiences in some ways helped us deal with things there. And we eventually realized, in spite of what former Ambassador Estes had said, that the health service and health options that were available in the community were not first-class or even second-class. Chillag: How did your wife feel with all this? White: I think that initially, she had some anxiety. She was nursing our daughter when we got there, and she had some concern because she had not been successful in nursing our son. But basically it was in some ways more relaxing and less stressful there than it was stateside; so she was able to get comfortable nursing our daughter. I think the next thing was that Claire needed to be able to find something to do, and that was unusual because I think other American wives who were there didn't necessarily feel that way, but Claire did. So she went out and found something connected with the USAID program and was able to work on that part-time. By background and training, she was a teacher, and so she arranged for Africans to come to the States through the African American Institute (which turned out later was funded by the CIA). That gave her a role in activities outside of the home. Both of us came from middle-income backgrounds, so it was ironic that one of the things that we were expected to do was to hire servants. Initially, we balked at that. But it turned out that it was an expected part of being in the community because you were contributing to the economy. So even though we hired a blanchisseur, which is basically somebody who did laundry and housework, you were expected to at least hire somebody to do some of the cooking and cleaning within the house. It turned out that you were paying the house staff the equivalent on a monthly basis of what the per capita income for the country was on an annual basis. It was complicated for us because the first thing that you learned was that they refer to you as patron, which means master, which didn't quite fit with who we were or what our self images were. It took a while to get the house staff to change that to monsieur. And they weren't quite comfortable with that initially but learned. So we learned to cope in an environment where things that you would normally expect that you'd have available, like fresh milk, weren't. There were things that you learned about shopping and buying things in the open market and things like that that made life interesting, fascinating, tolerable, and sometimes just really a huge pain in the ass. Every time you cracked an egg, you found blood in it. Chillag: You've alluded to some of the expatriate-like cultural differences, but were there other cultural differences that were really striking in the work or that affected your work? White: Mainly getting an understanding with the French that we weren't there to usurp what their authority had been. That we were there to contribute. That we were there because we wanted to encourage and teach the African teams that we were working with ideas that we believed they needed to know to be able to be effective in doing vaccinations and follow-up checks. It was clear that you could go back and check on the smallpox vaccinations and determine whether or not you had a take. You weren't always able to do that with measles, so you did the dipping of the fingers into-I forget what it was at that point, some kind of silver nitrate. Part of it was even learning to adapt and deal with the official American community that was in the country because it was a small community, but at the same time it was expected that you interact with them. Chillag: So your base was there, but I imagine you traveled out around the country. Is that correct? White: Yes. The base was in Ouagadougou. In the first several months we were there, we traveled to other areas of the country because we had a number of smallpox outbreaks. It was important to be out there with the teams if we were going to be able 1) to try to identify where the incident case came from and 2) to do the vaccinations and/or curtail what we thought might be spread of the infection. So I probably spent, on average, maybe 40%-50% of the time outside of Ouaga. The next largest city I spent time in was Bobo- Dioulassou, which was where the African/French regional health operation was located. Other parts of the country that I visited depended upon where there were outbreaks or where the teams were working. Travel slowed down some in the rainy season. Chillag: What were the biggest rewards of the work for you? White: I think part of it was realizing that there were opportunities to make a difference. We had conversations about this even during the course of the training in Atlanta. That, if we were successful in eradicating smallpox and controlling measles (measles had a 20%- 25% mortality rate then), what was going to happen in those countries? We weren't doing anything to change the economy; there wasn't necessarily anything else that we were doing that was going to change the larger health structure. And so from a philosophical point of view, one of the questions we asked ourselves in late-night conversations with wine and cheese was basically: What were we accomplishing? And I think we accomplished something for the United States in that it took away an infectious disease that could have come here. But the real question was: What was the real benefit in the areas in Africa that we were working in? I think some of the techniques that we taught folks about disease follow-up, learning about putting in place some modest epidemiology and epidemiologic approaches in surveillance and assessment of coverage, stayed with some of the teams. So I think we contributed to their having a better understanding of those things. But the ultimate, I think, was just the psychic kick of being able to demonstrate to myself that I could able to learn to function in a different culture, learn to function in a different language, and learn to be leading a team in accomplishing things. I wonder, frankly, with today's instant communication, whether or not the freedom that we had to go ahead and make decisions and take action would be allowed under today's circumstances. There were times when I was out in the field and I would come back and I would find a cable asking for one thing, and then 3 days later there was another cable countermanding that request, and then another cable saying, "Forget those two. They're not important." Today, if you had wireless access or a cell phone and a satellite communication or anything else, somebody would want instant response to things that may interfere with what really needed to be done . Being on the ground and being able to make the decision with the available information was key. The other thing that in some ways shaped my experience there was the fact that our son was discovered to have an illness when we were there, and the nature of his illness was congenital. It was Hirschsprung's disease, and that meant that he had a section in his colon that needed to be resected. This condition is usually discovered within the first few weeks of life, with newborns. In his case, it wasn't discovered until later, and so there were constant questions about whether or not there were parasites infecting him or something else causing his symptoms. And that caused a significant amount of stress for my wife and for me because you don't like to see your kid in pain and discomfort. And when his colon got enlarged, he had to have frequent enemas and other procedures to disimpact him, and they just weren't very satisfactory, and it was a difficult way for a child to live. The dilemma occurred when the State Department physician, who was the first one who came up with a best assessment as to what was wrong, determined that it wasn't a reason for medical evacuation because it was a condition that was congenital in nature and should have been fixed before we were overseas. That, on the face of it, seemed preposterous. The folks like George Lythcott and others in the regional office backed the decision to allow my wife and son to leave the country on early R&amp;R; (rest &amp; recreation) to Germany. There, at Landstuhl in Frankfurt, they did a full evaluation; they weren't quite sure that what they saw was correct and sent them stateside. So I wound up being in- country probably about 4-6 months by myself while they were in Germany, then in the States, going through all of the diagnostic procedures as to what was really happening because it wasn't clear. Finally, Children's Hospital in Boston recognized the condition and corrected it. The other difficulty incurred by that situation was that some challenges were made to the State Department on its decision, not by me but by my brother, who was a physician in the States. He sort stirred up some shit-excuse the Spanish. The State Department got very huffy and essentially at one point made a note to the record that described my then-wife as a morale problem, and they would not allow her to return to post. The reason for that was that there were a few other Foreign Service officers at post who also had very young children, and they had seen circumstances in which they had seen a mother with a child who was somewhere around the same age as theirs who was not dealt with fairly, in their mind, by the State Department. The parents raised all kind of hell with the Ambassador, who just got all very huffy about the decision. The State Department rallied around itself and said that its decision was correct and there was no way to reverse it. So that changed the circumstances in terms of whether or not my wife was ever going to be allowed back in-country. She had been designated as persona non grata by the Ambassador and therefore DOS. And so that pretty much ended my career in terms of being part of the international group. From the CDC perspective, there were other opportunities to go overseas. One of them was Afghanistan at that point, which was not a likely choice, given the fact that I wanted to spend some time with my spouse and kids, and Afghanistan was not a post where that was going to happen. Chillag: So, one of the questions that we ask sort of follows from this in a different way: How did your experience working on smallpox affect the rest of your career and your life? White: It's a good question because one of the things that I saw coming back stateside, I think there was a lot of preparation done for us going overseas. There was a lot of instruction about things that you hope never happen to you and infectious diseases that you hopefully never come in contact with, around anti- malarials and getting your kids to take the meds; information about the smallpox program, and USAID relationships, and all of those things. When I came back stateside, I was dealing with relocating my family stateside, and the East Coast seemed to be the place. And since I had spent time in New York City before then, getting relocated in New York made some sense. The domestic side of the CDC operation had little, in my estimation, appreciation or understanding, at least from the perspective of what Operations Officers learned to do overseas. And questions around promotion, questions around understanding of those things, and, at least in my experience coming back, were not well understood by the domestic operations side of CDC. When I came back, they sort of grudgingly accepted me into the tuberculosis program in New York. But it wasn't clear, at least at that point, that the experience overseas translated into a kind of integrated career pattern within CDC. I would say the other thing, just from a personal point of view, that pissed me off even when I joined the tuberculosis program is that, what I was looking for was an opportunity to get into graduate school so I could get at least a master's level, beyond where I was, in public administration or public health. NYU [New York University] at that point offered the program. When I requested CDC to pay the tuition, that I was going to be going to school in the evening, so there was no time away from work, they denied it because they weren't certain that I had career potential within CDC. So I then went to work for the Office of Economic Opportunity and worked in community health centers and a variety of other kinds of things. I stayed in public service until sometime in the early '80s. When Joe Califano was Secretary of Health, Education and Welfare, I was the point person on his office for the Childhood Immunization Program. That caused some folks at CDC to be anxious because there had previously been somebody from CDC based in Washington who was heading that up. I wasn't at CDC then-I was in the other part of the Public Health Service-and there was a concern that I harbored ill feelings towards CDC, and I didn't. I mean, I just realized that they were going one way and I was going another way, and that was fine. I think that as far as I was concerned, I learned a number of things when I worked with CDC. I had a great experience from a personal perspective overseas in learning that I could go ahead and make decisions, and I could make decisions in complicated political and other environments that made sense, and I don't regret that experience at all. I don't. In terms of my kids and as far as what their perspective on all of this is, they purport to remember their time overseas. My daughter was 10 months old when she left Upper Volta, yet she still seems to have memories of that. I don't know if it's from family conversations or whatever. But both my son and daughter have spent a fair amount of time traveling internationally or working internationally and living internationally. My younger son, who wasn't even part of the group at that point, also has worked and lived internationally. In fact, my daughter lived about 8 years in Russia, and my son for 9 years. In fact, he's back there with his wife and daughter now. So I think they grew from that experience. You know, people perceive themselves as being more international in how they see the world. Chillag: I suspect you've touched on some of the things that would be the answer to this question, but if you had been in charge of the program as a whole, what would you have changed in terms of the approach or any dimensions of it? White: This was really CDC's first effort in international public health in any major way. I think the training of folks leaving country was pretty reasonably well done. I think training people about how to reenter and how to interact with folks domestically was not as well integrated as it could have been. Maybe it's changed now and maybe the career paths and the way that one can take a look at things are better thought of and better defined. Chillag: At what point did you think smallpox could actually be eradicated? White: Well, I think it was pretty clear. I mean, I never thought when I went to work for the syphilis eradication program, that syphilis was going to be eradicated, particularly given what I saw in New York, and at that point homosexuality was so hidden it was unbelievable, in '62 and '63. But I thought that given the availability of vaccine, if we could figure out the cold-chain issues, if we could figure out the trainings of teams and the distribution and early knowledge of what one could learn about managing the containment of smallpox outbreaks, smallpox could clearly be eradicated. The strategies were modified over time, and the availability of the bifurcated needle and better vaccines and all the rest of that really helped, but I think it really was in many ways sort of a simple disease to eradicate. That's why, frankly, I couldn't understand the hysteria around scurrying around and looking for millions of doses of smallpox vaccine that went on in the Tommy Thompson era. It just struck me as really stupid public health and a waste of monies and dollars. But I don't feel strongly about it. Chillag: Do you remember hearing about the last case of smallpox and how you felt? White: Yes. In my career I've been involved in eradicating syphilis and eradicating poverty, and the only thing I've ever been successful in eradicating was smallpox. It's not the only thing that I'm proud of, but having been part of the group of people who were able to contribute in some way to that, yeah, I think it's an impressive thing. My godson is getting married tomorrow, and the real question was whether or not I was going to come down for any part of this reunion. So we came down today, and we're going to go back up early tomorrow morning for the wedding. But it was important to see folks who were here and also just to reconnect with some people who were part of something I think that was a very interesting and I think a significant effort in public health. The other thing that I will say that has been a point of unhappiness for me in the last several years is the erosion of CDC as an agency that is seen as a significant presence in public health. I worked in Massachusetts for the Department of Public Health up there, and they don't look to CDC for direction and guidance. I think the agency, over a period of time, has become increasingly politicized in the appointments of its directors and its missions. I think some of that's been allowed by Congress, and a lot of that's been allowed by the secretaries. I think that that's unfortunate. Now it's even worse because it's happening at NIH [National Institutes of Health]. But it's an unfortunate legacy in the last 15 years or so in terms of what's gone on with CDC. Seeing Tommy Thompson out on television talking about anthrax, I just wanted to reach deeply into my throat and retch on the floor. The man had no reason to be that. You needed a scientist out there talking about that and reassuring people of what was going on. Chillag: And you feel that was very different at the time you were with CDC? White: Yes. I think that there were people here who were connected to the science. I don't care if it was Alex Langmuir, when he set up the EIS [Epidemic Intelligence Service] or Carl Tyler, when he was there and I was working with the Family Planning Program. They came to agreement on things that they could contribute to and make life better in the delivery of reproductive health services. I mean that the Reagan era began to deviate from science in the area of reproductive health, and I think it continued a little bit in Bush one and I think it's gotten worse in Bush two. And public health science is just not here. Chillag: So, is there anything else you want people to know for posterity about your experiences? White: Yes. I was 26, 27 years old at the time, and I was in an environment in which I was perceived as being in charge of a significant part of the development of a public health program in a country, and that was pretty heady stuff. We were the folks that people came to when the new Peace Corps group was coming to town because we were really the first American presence in that country that had gone outside of the major parts of the city. And when the Peace Corps came, I think that our presence there made that more accepting. And as long as you made it clear to folks that we didn't work for the CIA, I think it was ultimately fun. Chillag: Thank you very much. It's been a pleasure. # # # </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/309983164&amp;color=ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false" frameborder="no" scrolling="no" width="100%" height="166"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource sound recording - nonmusical interviews Date A point or period of time associated with an event in the lifecycle of the resource 2006-07-14 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/1591f emory:1591f Subject The topic of the resource Smallpox Eradication USAID WHO CDC Operations Officer Format The file format, physical medium, or dimensions of the resource 389484144 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Chillag, Kata (Interviewer); CDC; Anthropologist White, William (Interviewee); CDC; Operations Officer Contributor An entity responsible for making contributions to the resource Reunion of West and Central Africa Smallpox workers (2006 : Atlanta, Georgia) Title A name given to the resource WHITE, BILL Description An account of the resource Bill White was an Operations Officer assigned to Upper Volta (Burkina Faso). Bill describes his work in Upper Volta, the complexities of daily life, his son's illness, and negotiating CDC infrastructure once he returned to the United States. Bill reflects on the impact living abroad had on his children and the role of CDC today in public health. Language A language of the resource English https://globalhealthchronicles.org/files/original/52e3a6012227df4737362c23378943c1.jpg f7d78b88df4e468df04a13d6b5b8f263 https://globalhealthchronicles.org/files/original/6fdf939dd6d1e87749f04827b6d25b6b.pdf 56ec1ccdb453f5b28d463fc0b50e594d Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> This is an interview with Ernestine Hopkins on July 14, 2006, at the Centers for Disease Control and Prevention in Atlanta, Georgia, about her involvement with the West African Smallpox Eradication Program. This interview is being conducted as part of a reunion marking the 40th anniversary of the launch of the program. The interviewer is Kata Chillag. Chillag: I'm going to ask you to broadly describe your relationship to the West African Smallpox Eradication Program. I know it was as a spouse. Hopkins: We came over to West Africa in October 1967. We were part of the second wave to come over. My husband was in charge of the Smallpox Eradication Program in Sierra Leone, and I believe it was the country with the highest rate of smallpox cases in West Africa. I guess my role was basically to support my husband. I had worked up until then, but I wasn't able to work there, so I ended up traveling with him out into the villages. Our weekly schedule was basically 3 or 4 days living in the villages and then coming back to a wonderful apartment on the weekends. Chillag: So you were in the capital? Hopkins: We lived in the capital, but we traveled out in the villages during the week. Chillag: And where did you stay when you were in the villages? Hopkins: We usually stayed in government rest houses. Some of them were OK, but many were mud huts. For me, one problem was the heat, and of course there was no air-conditioning out in the villages. A second problem was that often the houses had been closed up for long periods of time, which allowed bugs to accumulate. And a third problem was that very little electricity was available. So we had to put a coin in a meter, which produced light for about 10 minutes. So it was very difficult for me in the beginning. It was my first trip out of the United States. Chillag: Oh, yes. I was going to ask. Hopkins: So it was a very interesting experience and I'm very happy I had it. Chillag: Before you went, what were your expectations of what it was going to be like? Hopkins: Actually, it was pretty much like what I had expected. The only difference was that the capital cities were more developed than I had anticipated. They were very similar to those I'd visited in Caribbean countries, such as Puerto Rico and the Bahamas. So the capitals were fine, but as soon as we left the boundaries of the capitals, we were kind of in the bush. But overall, it was very much like what I had expected. Chillag: How long were you there? Hopkins: We spent 2 years in Sierra Leone. We were in India for about 3 months with the same program. And then we were in East Africa for a few weeks during Don's [Donald R. Hopkins] residency. Chillag: How did you feel when you found out you were going to Sierra Leone? Hopkins: Well, I had been hoping we would to be assigned to a French- speaking country so that I could learn to speak French. I have to say the first few months were really difficult for me because of the climate, but not for Don. Don's from Miami, so I think the climate was pretty similar, so it didn't bother him so much. The first 3 months were very difficult because we didn't have an apartment and we lived at a hotel. After we got our apartment, we began to travel to the villages more frequently. There, we met many Peace Corps volunteers, who helped the program by alerting the health offices of smallpox cases they had seen. So after the first 3 months, the experience was just wonderful. Chillag: What were some of the cultural challenges that you encountered? Hopkins: Well, actually, everything was a challenge. But for me, a major challenge was having people who did the cooking and cleaning for us and the lack of privacy. Another was that we had to be very careful with food (disinfecting all vegetables) and water (boiling and filtering). Most of the Sierra Leoneans we met socially had studied in the States, so I can't say that there was a big cultural difference there. Chillag: You mentioned that you had worked before, but you couldn't work there. How was that? Hopkins: For me, that was the most difficult part of the experience because I had worked my way through college. So I had always been very busy, and suddenly, there was no work. I was told that I couldn't work there because I would be taking a job from a Sierra Leonean. There was an institute for the blind in Freetown, where I'd hoped to volunteer, but I could not. So I decided to travel with Don, even though I had no particular interest in public health. Many of the wives had children. I believe Ilze [Ilze Henderson] and I were the only spouses who did not have children, so we were able to travel with our husbands. In retrospect, I think my experiences when traveling with Don proved to be invaluable. And I began to enjoy it very much, particularly during our second year there. Chillag: So, what was a typical day like when you were out in the field, in the bush? Hopkins: Well, on a typical day we would travel to different villages. The roads were terrible in Sierra Leone, so, for example, going from Freetown to Bo, the second largest city in Sierra Leone, took about 3 hours in a Land Rover-on a very rough road. So we were kind of bumping along until we got to a village after 3-4 hours. Eating while on the road was another problem. We ate mostly bananas. Basically our diet consisted of Coca-Cola, nuts and maybe a piece of cheese, and, of course, bananas. The villages were very interesting to me and I saw a lot of smallpox. Overall, my African experience was a fantastic educational experience for me and I would have been happy to have had another assignment there. But we had to return to the United States so that Don could complete his residency. After completing his residency and earning an MPH, the political and social climate in America had changed and there was not another opportunity for us to go back to Africa. Chillag: You mentioned about people with smallpox in the villages. What was that like? Hopkins: Well, I wasn't worried about getting smallpox because I had been vaccinated. I often saw people who had smallpox pustules, but they often didn't appear to be very ill. But, I distinctly remember a little boy who was covered with smallpox pustules and his eyes were swollen. He was about 4 or 5 years old, and he looked so miserable because he had to stand up in front of a doctor so that he could be examined. Every inch of his skin was covered with pustules; even his eyes were swollen and closed. He stood so still and silent. This was very painful for me to see. Chillag: What do you think were the biggest challenges for your husband in doing the work? Hopkins: I think the large number of cases was a major challenge because Sierra Leone had the highest incidence of smallpox of any country in the program. I also think the time frame was a concern because Don wanted to eradicate smallpox during his 2- year assignment in Sierra Leone. So I would say that the time frame and the number of cases were the 2 biggest challenges for him there. Chillag: And you said you followed him most of the time. Were you separated at other times, or you were with him the whole time? Hopkins: I was with him all the time. I don't think we were ever separated in West Africa, except when he went to the office. Chillag: You mentioned that, out in the village, you were in the rest houses, which were often mud huts. Did you have any experiences that are very striking to you? Hopkins: Oh yes. One of the government rest houses had apparently been closed up for some time. We had traveled from early morning, and it was quite dark outside, so I would assume it was about 9:00 PM when we arrived at the rest house. In order to have light inside, we had to insert a coin into the electricity meter, which would provide electricity for 10 or 12 minutes. So we put a coin in and opened the door, and all of a sudden I heard these bodies falling on the floor from the walls. There were huge cockroaches covering the walls, and they were dropping from the walls to the floor. Some of the locals sprayed inside the room and swept up the dead bugs; there were hundreds of them. On another occasion, after conscientiously attaching my bed netting around the bed, I fell asleep. During the night I felt something crawling on my hand. I saw the largest cockroach crawling on my hand inside the mosquito net. I screamed and woke Don up. I think the size of the bug even bothered him. All of the experiences which were difficult for me were related to bugs. For Don, I believe the most difficult were related to the few snakes we saw there. Chillag: Were there any difficult experiences with people? Hopkins: No, none at all. The people there were really wonderful, both those with the embassy and the locals that we met. I was very young then; I was 23. There were a lot of young people, under age 30, who had studied in the States and now worked in businesses in Freetown, so I had only positive experiences with the people there. Living there was a very good experience for me. Chillag: So, what were the most rewarding parts of it? Hopkins: The fact that Sierra Leone did get rid of the smallpox. And for me, I began to become a little bit more interested in languages. I've always had an interest in Spanish, but never French. After visiting some of the francophone countries, I became very interested in French language and culture, and later earned an MA [Master of Arts] degree in French. Chillag: So, clearly, this experience has affected your life in that way. Are there any other ways that participating in this program has affected your life? Hopkins: Oh, it's made me generally more interested in people from different cultures. I don't think I would have had that interest had I not been involved with Smallpox Eradication Program. Chillag: Well, thinking back to that time, if you had been in charge of the program, what practical or technical aspects would you have done differently to prepare people like you, couples like you, who went over to live? Hopkins: I think it's very important to protect your health, particularly regarding water and food. I don't think the medical facilities are ideal, even today. Additionally, in order to get a better idea of what it would be like to live in a village, I would recommend speaking with a Peace Corps volunteer about his or her experiences living in that area. But I think people learn as they live in an environment. Chillag: So, at what point did you think smallpox could actually be eradicated? Hopkins: From the start, because I believed my husband. I knew nothing about it, but I just knew that he was very good at what he was doing, and I just believed everything he said in those days. Not anymore. But I believed him, and I was very young, so he must have known. So it was that simple. Chillag: So, how do you feel about having been part of something so . . .? Hopkins: It's amazing to me that it turned out to be so wonderful. I thought once smallpox had been eradicated from Africa, no one would care that it had been eradicated. But smallpox now represents the first disease eradicated from the world, and I played a part. But it was a great time! Chillag: Does Don talk about it a lot? Hopkins: Oh, he still talks about it, but he's now trying to eradicate another disease, Guinea worm. So I think he's very excited about that disease now. But I believe the idea that Guinea worm disease could be eradicated was based on his work with the smallpox program. Don is very proud of the time that he spent with the Smallpox Eradication Program. Chillag: It sounds like it affected him. Hopkins: Yes. He wrote a book called Princes and Peasants: Smallpox in History. It came out in 1983, and was nominated for a Pulitzer in the history of medicine category. It was out of print for a while, but the University of Chicago republished it about 3 years ago, with a slightly changed title. It's now called, The Greatest Killer: Smallpox in History. For those interested in medicine or history, I think it's a great book. It shows how smallpox influenced history among both royalty and peasants. So Don was able to write a historical account of smallpox disease. Chillag: Very interesting. Do you have anything else to add? Do you want people to know for posterity about this experience? Hopkins: No, I don't believe so. Chillag: Well, thank you very much. Hopkins: Thank you. # # # </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310126372%3Fsecret_token%3Ds-F609W&amp;color=ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false" frameborder="no" scrolling="no" width="100%" height="166"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource sound recording - nonmusical interviews Date A point or period of time associated with an event in the lifecycle of the resource 2006-07-14 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/158kj emory:158kj Subject The topic of the resource CDC Smallpox Eradication USAID WHO Life as expatriate wife Format The file format, physical medium, or dimensions of the resource 322884912 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Chillag, Kata (Interviewer); CDC; Anthropologist Hopkins, Ernestine (Interviewee); CDC; Wife of Medical Epidemologist Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of West and Central Africa Smallpox workers (2006 : Atlanta, Georgia) Title A name given to the resource HOPKINS, ERNESTINE Description An account of the resource Ernestine Hopkins, wife of Don Hopkins, who was the Medical Epidemiologist for the Smallpox Eradication Program in Sierra Leone. Ernie talks of traveling with her husband to the field during the week, adjusting to life in Sierra Leone, meeting people with smallpox in the villages, and the ways in which the experience has impacted her life. Language A language of the resource English https://globalhealthchronicles.org/files/original/cd9c59fc10df93186b073c1dd81353c8.jpg 15e7980cb2e517147851d6f369f1ec15 https://globalhealthchronicles.org/files/original/bc601c6c4356d4b94779f5ad0a296678.pdf 28d5b36c8168e32d6428726a82d6450d Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> Interview Dr. Davida Coady with Interviewer Chris Vaniser Transcribed: January 2009 | Duration: 0:33:21 Chris Vaniser: This is an interview with Davida Coady on July 11, 2008 at the Centers for Disease Control and Prevention in Atlanta, Georgia about her role in the Smallpox Eradication Project. The interviewer is Chris Vaniser. With this interview we are helping to capture for future generations the memories of participants and their families involved in eradicating smallpox. This is an incredibly important and historic achievement and we want to hear about your experience. I have some questions to guide you, but please feel free to recount any special stories or anecdotes that you remember about events or people. The legal agreement you signed says that you are donating the oral history to the U.S. Federal Government and it will be in the public domain. For the record, could you please state your full name and that you know you are being recorded. Davida Coady: Davida Coady, and yes I realize I am being recorded. Chris Vaniser: Thank you again for coming and sharing your memories about the Smallpox Eradication Project or Program. I guess to start, if you could talk a little bit about your early days before going on to college and if you knew what you wanted to do with your life, or what you wanted to be when you grew up; and share a little bit of that information with us. Davida Coady: I grew up in Berkeley, California in a family, none of whom had graduated from High School previously. I was fortunate enough though to be living in Berkeley, it had some good role models and decided that I wanted to something worthwhile with my life. I met two women doctors, pediatricians, running a camp for diabetic children and I decided that I would try to go to medical school and I did so. I read about Dr. Tom Dooley and his work in Southeast Asia, and I decided I wanted to spend part of my life in the Third World and went to medical school with that idea. Chris Vaniser: Were you thinking of being more of a clinician? Davida Coady: I was thinking more about being a clinician. I went to Columbia Medical School and of the acceptances I got, I chose that school because they had an elected[inaudible0:02:49] in Liberia in the fourth year, and I went there and I made a decision that I would definitely go into pediatrics. I also realized that I really loved working in a third world country. I think up until that point I had kind of a moderate complex. I thought I was going to die young of malaria or something, but it hadn't occurred to me really that I would enjoy being in the third world and working in places where you could be innovative and where people really needed you, where the young people; people who were being trained as nurses would be so eager to learn, and any time that you would spend with them, they would pick your brain about everything you knew, and I saw lots of people getting well. I also became aware of the need for Public Health. So during my Pediatric Internship and Residency at UCLA I found time to go to Mexico and then to Guatemala where I met Dr. Thomas Weller from the Harvard School of Public Health and I talked to him about career development and he persuaded me that I needed an MPH if I really wanted to work in Prevention which I certainly did by that point. So I went to the Harvard School of Public Health and then jumped into Third World work from there. Chris Vaniser: So where did you go then after Harvard? Davida Coady: I went first to Nigeria, only I was in the part that was then called Biafra. I was there obviously during the Nigerian civil war. I worked with a small relief agency run by Normal Cousins inside of Biafra and got out the night that the country collapsed. I was sent back to Nigeria on a Government assignment shortly thereafter as part of the relief efforts for what had been the former Biafran enclave and it was there I got really acquainted with Bill Foege and Stan Foster and people who became my heroes, my mentors, my gurus; and I became so interested in smallpox campaign. I then went to work at the Peace Corps, first as their Acting Medical Director and then as a Health Programmer and it was during that time that I met D.A. Henderson and he became one of my big heroes in life and I was involved in the Peace Corps involvement in smallpox at that point. Then later on I left the Peace Corps, I went to UCLA to teach and I went to Bangladesh after their revolution and was working there when I ran into Dr. Henderson in the airport in Dhaka. Actually he was getting off a plane and I was getting on a plane. He said "Hey Bill Foege is in India and he is looking for people to work on smallpox on three-month assignments;" and I said "Oh wow, I am interested!" and the next day I got a telegram from Bill Foege asking me to come to Delhi and talk about it which I did and - Chris Vaniser: Where were you based with at the time? You were with the Peace Corps at that time? Davida Coady: No, I was still - I had gone to UCLA at that point to be an academic, but I am not an academic, I don't like it. I like teaching, but I didn't like the rest of it, and by that time I was a part time academic, but mainly working on my own. For years then I taught one or two Quarters a year at UCLA and did international work the rest of the time. Chris Vaniser: So you got this telegram from Bill Foege asking you to come and talk to him in Delhi? Davida Coady: In Delhi-and I was actually on my way home and I did; and I arranged to go back a few weeks later. I was getting married at that point and my husband - I thought it would be much easier to work out in the Boonies in India with a partner, and he was interested and we went back to India; Bill sent us to Gorakhpur. So I was the first woman field epidemiologist and there were a number who followed me. They were watching me very closely and - you know, it was a real highlight of my life, it was just such a wonderful thing to be part of. I've been part of lots of different Public Health initiatives of one kind or another, but this was something that was so clear that you could see the results. So we put a 1000 miles a week on our Land Rover, a lot of it on dirt roads going around to the villages in India and many villages there, in those Northern districts of the Uttar Pradesh, they had never seen a white woman. In fact they had really never had any women visitors and all kind of rumors would go around the villages about who I was. The one I liked best was that occasionally the rumor would go round that I was Indira Gandhi and so I - that was kind of fun; and I would tell them that I was not, but I - Chris Vaniser: How long did you go over for? What was your - ? Davida Coady: I think we were there for a three month assignment and then we were extended for several months after that and then we went back to Los Angeles for a couple of months, and then went back for a second assignment, and the second assignment was in West Bengal. I had asked particularly to go to Calcutta, I love Calcutta, and so we were based in Calcutta in charge of the four districts to the North and the East, East - No I am sorry, it was actually the North and the West of Calcutta and then when Calcutta - when West Bengal was free of smallpox we were transferred to Bangladesh. Chris Vaniser: Going back to Gorakhpur again, which was your first assignment in India and your first smallpox assignment, can you tell me a little bit about your team that you worked with? Davida Coady: We had an Indian doctor, Dr. Rao[inaudible name0:10:14], who was from South India who worked with us, and he kind of took two of the districts and I took two of the districts. We had a wonderful paramedical assistant and a driver who we became very close to; and we went touring around the countryside. I think one of the things that I did was I realized that the people working on it in the villages, the doctors, the health workers; they had no idea when I got there that this was part of an international effort. So I managed to get a map of the State of Uttar Pradesh, and another map of India, and another map of the world. These were not easy to come by in Gorakhpur, but I got them. Now we would take them around to the districts and we'd go through and I'd show them what they were part of, and hundreds of people would gather around and listen to this and they would get so excited and then when I'd go back weeks later or months later, they'd say what is happening now in Ethiopia. Are we going to beat Bihar, are we gong to beat Bangladesh or are we going to beat Ethiopia in eradicating smallpox; and they'd get so excited and the quality of work would improve tremendously. Chris Vaniser: How were you received as a Caucasian woman working in that area of India, which I am sure that most of the physicians you were dealing with, I assume, were male? Davida Coady: Right. Chris Vaniser: At least most of the other people. Davida Coady: I think fairly well-very well in fact. I think in India there were no problems really. You know, I dressed appropriately and all, and got my legs covered and all those things, and in Bangladesh it was a little harder. If I went somewhere without my husband, people would say well bring your husband next time, and they didn't my traveling without him, and we'd often split up and did different parts of the work. But in India there was none of that. There was a village character in one of the villages who wrote a song about me and evidently the chorus - he was a man suffering from tertiary syphilis and was quite crazy - the chorus was translated to me saying: "Dr. and Mrs. Coady is a wonderful doctor, she's the best doctor in the whole world because she carries herself like a doctor and she acts like a doctor." So I thought that was very, very nice. Chris Vaniser: Very nice-Yeah respectful. Did you have any special challenges or events that happened when you were in that Northern part of India that kind of stand out as very memorable events during the smallpox? Davida Coady: Just that it was terribly, terribly hot. We were there in the pre-monsoon season and I don't remember anything really frightening. Our driver and medical assistant, and many other people were very kind of cautious when we first got there and they - the person before us had made an error in trying to vaccinate a woman - this is a male epidemiologist - without her permission and the villagers had come very close to throwing him down the well. So they told me, they lectured me, but after about a week they said, "It is fine. We know you are not going to cause any problems like that." But that always made me just a little bit wary. One thing we noticed was a - my having worked in Africa before where people loved to get immunizations and loved to get vaccinated; was that the Indians, they wanted some conversation before they were vaccinated. They wanted an explanation and their views of the goddess and her role in all this varied really from village to village, and sometimes - in one village they wanted us to come back next Tuesday because that's what the goddess wanted us to do instead of vaccinating people then. I think we finally agreed to do that, it was just easier, but many times they would say, "No, the goddess doesn't want us vaccinated;" and we'd sit down and go through all the explanations and just at the point when we were convinced they were never going to let us vaccinate anyone, they'd say, okay now we understand that it's a disease and it's not a goddess and please vaccinate us." I remember one elderly man, he said, "No, I don't want to be vaccinated because I'm getting ready to go to God;" and my husband looked him right in the eye and said, "I really think God would like you better vaccinated;" and I was just thinking "Oh my!" And the man said "Oh, alright fine," and he said, "Please, please vaccinate me." So a lot of it was just listening and realizing that nothing worked fast in India. Chris Vaniser: Now did you speak Hindi or did you have a translator with you? Davida Coady: We had a translator. Our paramedical assistant was our translator. I learnt a little bit of Hindi and just enough to get around, just a little to ask where ask directions and where people were, and of course the word for smallpox was Bashanto[0:16:56] which is also the word for springtime; and I relied a little bit less on my Hindi after one of our fellow epidemiologists, a man from France whose name I forget; he got very good at Hindi, but he spent a long time, he had a sprained ankle at the time, walking to a village looking for - he'd asked if there was any Bashanto and everybody said: yes, yes. "Where is the person with smallpox?" And after he walked a long, long distance he finally found this man out on the field. It turned out that the man's name was Bashanto. So I was [crosstalk0:17:57] Chris Vaniser: A little bit more [crosstalk 0:17:56] after that about your Hindi. Was your husband a physician as well, or in the health field? Davida Coady: No, my husband at that time was not, he was not a - Chris Vaniser: But he was - he sounds like part of the team? Davida Coady: Yeah, he helped. Chris Vaniser: In terms of going out and- Davida Coady: He liked to write and he was collecting information and stories. Chris Vaniser: Interesting. So then it sounds like soon after that you went to Calcutta? Was that the same trip? Davida Coady: Right, we came back to the United States for a couple of months and then we went back and went to Calcutta. Chris Vaniser: How did that differ from Gorakhpur? Davida Coady: Well, we were in the city and Bengal was much more sophisticated, and there was much less smallpox. I saw hundreds and hundreds of cases of smallpox in Uttar Pradesh and many, many ...[inaudible0:18:58]. We were doing the last of it and the reward was being offered by that time and the amount of the reward was going up, and we went around to different groups asking them to help us. One of the interesting things was, we went to see Mother Teresa to see if she would have her nuns help us in looking for and reporting any smallpox; and Mother Teresa like she always did - I went back and worked for her later actually - she turned it around on us and she got us to agree to bring our staff on our day off and vaccinate everybody in her feeding lines; and our driver and our paramedical assistant were just so thrilled to meet her and to be part of that, they took their day off too, and we did that, so that was kind of fun. Chris Vaniser: Did she also agree to have her nuns help with identifying any cases and reporting them? Davida Coady: Yes, yes they did. I can remember that they did. But then in those times we spent a lot of our time with people coming to us, being brought to us with everything from scabies to chicken pox to hives, with people trying to tell us it was smallpox and they wanted the reward. So I spent an awful lot of my time saying no that was not smallpox; and it was interesting, one man particularly who came to us; and I still have his little advertisement. He was an Ayurvedic Doctor of some kind and he had a little advertisement which I have still, with a picture that he'd drawn of somebody with smallpox and he introduced himself as a specialist in smallpox from a part of our district, North of Calcutta, and he had a man whose scabs were just falling off, or just forming I guess; and we said, "Why didn't you bring him sooner," and he said, "Because he just ran out of money," and we said, "Well, explain this." He said, "You see I charge people when they come with the fever, I charge them and they pay, I have a medicine to make the rash break out, I have a medicine to make the macules..." - He knew the terms - "...the macules form into papules, and the papules form into pustules, and then for the scabs to form, and then for the scabs to fall off and for the scars to go away. They come back and I sell them each of these medicines. But he has run out of money, so I came to get the reward." Then we talked with him further and he was able to tell us every case of smallpox, maybe then 25, 30 cases in that district, in that outbreak over the past two or three months, and he was able to tell us everyone of them and who got it from who and it corresponded exactly to the reports that we had gotten from the health workers. So he knew the whole thing. Chris Vaniser: But of course, he didn't have the vaccine. He was missing that part he had medicine to make - Davida Coady: He had no interest in the vaccine. Chris Vaniser: That's right; it destroyed his business I guess. Davida Coady: Right. Chris Vaniser: How did you find the conditions? Davida Coady: They were difficult. Gorakhpur: it was hard to eat; we ate at the hotel where we stayed which was - and then later we found a Chinese restaurant, but we didn't find that for about a month, and we ate at the hotel and everything was so terribly, terribly hot. I am used to hot food, but this was really, really hot. So we would just try things. Of course, we couldn't read the menu so we would point to things on other people's plates and they would get those for us, and it was challenging, but we were young. Life was easier in Calcutta, there was indoor plumbing and - Chris Vaniser: When you traveled up in Gorakhpur, were you out overnight sometimes in the neighboring districts? Davida Coady: No, we were always able to get back when we were in Gorakhpur. In Calcutta we did, we had these four districts; we'd stay in the districts, we found places to stay. In Gorakhpur we never - [crosstalk 0:24:17]. Chris Vaniser: It was always maybe a long day trip, but you would always get back. How about any problems with getting safe food, safe water? Davida Coady: We would find that we'd buy bottled water and Coca Cola, and I think there was one time when we bought some cokes and it was adulterated and we all got very sick. Chris Vaniser: Any other events that stand out from your time in India? Now you came back to the States before going back to Calcutta and then [crosstalk0:25:01] from Bangladesh also? Davida Coady: Then we went directly from Calcutta to Bangladesh. I know it was before Christmas because we spent Christmas in Bangladesh. Chris Vaniser: Then, how was that in comparison to India? Davida Coady: It was very different. In Bangladesh they didn't have the structure. In India they had the structure, these Health Centers and there was always somebody who was in charge that you could work with and some of them were wonderful and some of them were not at all interested; but at least there was a structure. In Bangladesh we were in the North in Saidpur, which is a larger Bihari City and which was good because they spoke Urdu which I could understand; I never really got hold of the Bengali language at all, and the Urdu I could understand from the Hindi that I knew. There was no structure, we just had to do the work and hire the vaccinators and find the epidemics and it was much harder and you had the feeling that you weren't teaching that much. You were just trying to get the cases and get the work done. Chris Vaniser: When you say you had do the work, it was actually you and your team that was more - not the Bengalis that were there as counterparts? Davida Coady: Right. We didn't really have counterparts, we had vaccinators that we trained and hired to work for us. Chris Vaniser: What year was that, when you were in Bangladesh? Davida Coady: That would have been '75; in late December '74 and then into '75. Chris Vaniser: So I guess - it sounds like you also had just an incredible time as part of the Smallpox Program and you had brought to it lot of experience, international experience, specially from Africa and other places, Guatemala and other international locations that you had worked in. How did the smallpox experience affect your future career and your involvement in Public Health? Davida Coady: I became very, very convinced that the idea of eradicating infectious diseases was very doable and feasible and helpful and everything right about it; and I have been very disappointed that other diseases have not been eradicated. I thought surely the lessons would be learned. We had this wonderful seminar this morning that I thought surely guinea worm and polio and measles and some of the others would be gone by now with the lessons we learned, and I think people made such valiant efforts to promote the principles. Dr. Henderson and Dr. Foege, Dr. Foster; and all of them; they had such a wonderful plan to really use all these principles to eradicate other diseases and it's been very disappointing that there wasn't the political will and the finances - the political will to do it. Chris Vaniser: [cosstalk0:29:05] the difference perhaps? Davida Coady: Yeah; and I think the idea that an international effort like that could work, has kept me going through some hard times and some of the battles I fought are harder than that and you have more foes, there weren't too many people against smallpox eradication. There were a few people who made money off smallpox. I remember one very overweight politician in India railing at me one day, when we drove up with the smallpox vaccines - with the smallpox van; and he said then: Why don't we foreigners and smallpox people go home and let our people die of smallpox before they starve to death from overpopulation; and this man was fat and he was eating a plate of food, and he was one of the few people I ever met that said: eradication of smallpox is not a good thing to do. It just seemed so clear; one of the battles that I fight today in my hometown in Berkeley, is we are fighting the tobacco industry very hard and the pharmaceutical industry and the illegal drug industry; and I work in the addiction field now and you have these giants, the Alcoholic Beverage Industry and the Tobacco Industry, and all the rest, are such hard foes that I look longingly at the time when I was fighting smallpox which didn't have those big interests against you. Chris Vaniser: [crosstalk 0:31:01] with lots of money to - Davida Coady: But it has given me - I had training in epidemiology, but the smallpox work gave me the field experience to see what epidemiology could really do, and it of course greatly influenced my teaching at UCLA - but really the way I look at everything. I am in the addiction field now because I looked around my own community with the tools I learned as an epidemiologist and said: The biggest cause of homelessness and crime and misery and violence and child abuse in my community is the substance abuse, which is not being treated. So that's why I made that decision. Chris Vaniser: That's a pretty big decision to have ended up - it sounds like you had spent time in international health and trained as a pediatrician. Correct? Davida Coady: Right. Chris Vaniser: And now you are working in smoking and addiction control because of lessons learned through the smallpox eradication. Davida Coady: Right. Chris Vaniser: Well, thank you very much again for sharing your stories. This sounds like it must have just been - again an incredible experience. Davida Coady: It was a peak experience; it is something that I just wouldn't trade for anything. I am just so happy I was part of that. Chris Vaniser: And it sounds like you made quite a few friends along the way that are legends in their own right in the area of Public Health and - Davida Coady: I did. Chris Vaniser: Not just smallpox, but Public Health in general. Davida Coady: Right; and I just loved India and Bangladesh, but particularly India. I loved working there. I loved the people. I love to look now at pictures of Indians and see that nobody under 30 has got smallpox scars. That just chokes me up. Chris Vaniser: There's nothing else that you can really say that of-that has been so eradicated and know that you had a part in all of that. It was just a huge accomplishment. Thank you again. Davida Coady: Thank you. [End of audio - 0:33:21] </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/ZazTD1mKMlY" frameborder="0" allowfullscreen></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource interviews motion pictures moving image Date A point or period of time associated with an event in the lifecycle of the resource 2008-07-11 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16rfh emory:16rfh Format The file format, physical medium, or dimensions of the resource 7197240000 bytes video/x-dv Creator An entity primarily responsible for making the resource Zahbhiser, Chris (Interviewer); CDC Coady, Davida (Interviewee) Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of Southeast Asia and East Africa Smallpox Workers (2008 : Atlanta, Georgia) Title A name given to the resource COADY, DAVIDA Description An account of the resource Dr. Davida Coady was a field epidemiologist working in the Smallpox Eradication Program in India from 1974-1975 Subject The topic of the resource Smallpox Eradication Epidemiologist Language A language of the resource English https://globalhealthchronicles.org/files/original/363d193ed536cb7836b61897f0a6c8ca.jpg 30104dee25ce624dad29f9c8a5729104 https://globalhealthchronicles.org/files/original/df674b895b797ba76665c753c25d89f0.pdf 7ed6a30202a54ab0c63e89057679dbc7 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> Interview Mr. Peter Crippen | with two Interviewers [unnamed] Transcribed from audio: January 29 2009 | Duration 0:22:41 Interviewer1: This is an interview with Dr. Crippen, April 2, 2008 at the CDC in Atlanta. I guess we will start where you'd just do an introduction. Who you are and how you became involved with Public Health and smallpox, and why you became involved with it? Peter Crippen: Okay. First of all, it's Mr. Crippen. Interviewer1: Mr. Crippen. Okay. Peter Crippen: And who I am is a Public Health Advisor, that's for those of us who are public health advisers, that says a lot. Right now, I'm still with CDC, I've been with them for more than 40 years. I was in the Peace Corps in Thailand right out of college, right out of bachelor's degree, and didn't have anything to do with public health. I was a teacher, but when it became time to come home, I needed a job and there were a lot of postings that came through for Peace Corps volunteers who were about to return. Most of them were teaching jobs and I wasn't interested in a teaching job, and the only other one that seemed interesting was being what we used to call VD-a VD investigator. So that sounded interesting to me, and I applied for it and I was interviewed and got the job. It was very easy at that time frankly. If you had a bachelor's degree in almost anything whatsoever, they would hire you and you could walk, you know; you could get a job as, what became, Public Health Advisers. At that time, we were not public health advisers; we were what was then called, Cooperative Employees, which meant that they could fire us at will for the first year or so. But after a year, we became Public Health Advisers. I started out in Chicago and then went to Detroit; and when I was in Detroit there were opportunities to go to West Africa for the Smallpox Program which interested me a great deal. From my Peace Corps experience I hadn't been to Africa, but I knew what it was like to work in a third world country if you will, and it sounded fascinating. So I applied for that and I was selected and went to Nigeria. What had just recently been Biafra, the war was over, but just recently over. That would've been in 1970, and we stayed there for two years in the Eastern part of Nigeria in Calabar and Enugu. Enugu was the capital of Biafra at one time, and I saw a lot of interesting things. I saw monkey pox for instance which was misdiagnosed as smallpox at the beginning, but what I did not see in 1970 was smallpox. There wasn't any in 1970 in Nigeria; and we looked very hard. We didn't know that there wasn't any. Everybody assumed that it was mostly gone, but people wanted to be sure that it was really gone, so we looked very hard and we found monkey pox. We did some good things, it was combined with the measles control program and we did a lot of measles vaccination, saved I think a lot of children's lives with measles vaccine. But I didn't see any smallpox which kind of nagged at me. So we came back after a few years, 1972, went back to Chicago this time with the Immunization Program and routines went on, had children, things like that, like people do. Then heard about the opportunity to go to Bangladesh and so I threw my name in the ring again for a temporary duty assignment to Bangladesh, and I was selected. I think I was the first public health adviser to go to Bangladesh. Before that, I think it was all physicians who were there. Immediately following me was Jean Roy. I don't know if you've interviewed him yet, but I'm sure you will, if you haven't. But he, I think was the second public health adviser in Bangladesh. So we flew over on the plane to New Delhi with Mike Lane who, if you haven't interviewed, I'm sure you will, and we stayed in New Delhi for a couple of days, had dinner at Bill Foege's house; and Mike Lane stayed in India. He was working in India. I got on the plane to go to Dhaka and arrived sick as a dog in Dhaka, interviewed with Nick Ward who was a British epidemiologist who is very famous in smallpox circles and I worked with him again in WHO in Alexandria, the Eastern Mediterranean Regional Office a few years down the road. We were working on diarrhea and acute respiratory infections. In any case, Nick Ward was there in Bangladesh. Stan Foster was essentially - Nick and Stan; I'm not sure who was on top, but Stan was certainly the American in charge although I think Nick might have been overall in charge of the WHO project. The other person of note was Stan Music who later on established some of the field epidemiology training programs at CDC; and Stan Music gave me some medical advice which was basically, drink a lot of water and get some sleep, it would feel better in the morning, here're some aspirin. Eventually I did feel better; a couple of days later I was out in the field, and at that time we spent, I think, 20 days in the field straight, and then five days back in Dhaka. So they just put me in a land rover, and off we went out to my station which was Faridpur. Nothing much to recommend Faridpur to anybody; by road, by land rover, it was about four hours from Dhaka. It was a long drive, not very far, but it took a long time to get there. Met the team, and I thought I knew what I was supposed to do. I'd been briefed. I knew what I was supposed to do, I was supposed to find smallpox. You know, go out with the team and search and follow-up rumors and vaccinate around the cases that we find. Do forward tracing, and that was the big thing that time. Not to look back to where it had come from but to look forward as to where the disease might have gone. Find the close contacts and see where they may have gone and then go to that place and see if anything had happened there. It didn't take long for me to see my first case of smallpox in Bangladesh. I think that first trip out, I saw my first case and she was dead. I remember the man - a woman about I don't know, a young woman 18, 19, something like that, and we said we heard there were smallpox here and he said, "Yes," and I said, "Is anybody here with smallpox?" He said, "Yes here." He pulls back a blanket and there is this corpse of this young woman there and it certainly looked like smallpox to me. Finally, I had seen my first case. I was hoping it would not be a dead case the first one that I saw but there she was. That was the beginning; we saw many cases after that. Thankfully many of them were still alive. It became clear that it's not really easy to catch smallpox. You really have to be in the same house with somebody who has it. Close within the same hut, and sleeping in the same place, eating in the same place, living in the same place, and then it's relatively easy to catch it; but outside of that kind of closed environment, we, I at least, didn't see much transmission in market places or buses or things like that or casual contact. So I stayed there not quite three months, more than two months, less than three. Others were staying there from January 1974 to I think early March of 1974; then I came back to routine in Chicago. Going around to catholic schools and making sure everybody had their shots. That was my job. The way I got into it was a fascination with working overseas, it just never left me; I've stayed in it one way or another since that time, and the public health aspect is certainly rewarding. You see fewer bodies when you left than when you arrived, so that's one way of measuring success. Interviewer2: What was your first thought when you arrived in Bangladesh? Peter Crippen: Well, it is not really different from some things as I had seen in Southeast Asia, but I guess my first thoughts were that I was too sick to do anything. But I was glad that I knew Stan and so I felt things would probably be alright as long as Stan was around there giving me some advice. When I was back in Dakha out of the field, I stayed at Stan's house so it was kind of a - and of course he had his whole family there, had all his kids and his wife so it was a nice way to be in the field with essentially nothing, you know, and then to come back and be in a family atmosphere before you went out again. I was trying to think before coming, how - right now we communicate all the time, people have Blackberries and cell phones; and I can't remember that we communicated at all when we were in the field. We were there, that's it, and nobody essentially knew where we were, and I don't remember getting instructions from anybody or inquiries from anybody. We just did what we did; we kept records of things that we were suppose to keep and we came back and during those five days, we shared what had happened; but in between, there was nothing. There was no contact whatsoever that I can remember. Most of Bangladesh is water. Water with a little bit of ground in between and that's the why the people make their living, is fishing and rice-But in any case, we would take the land rover to Faridpur town and then from there we usually go by speed boat some place, named or unnamed, and then get out of the boat and walk. We would walk for hours to wherever it was you were going, to some small village where there was a rumor of something happening. So the boat was very important and the land rover less important and walking was extremely important because that was the only way you got to know where you were going. But I remember on time, we were in the boat and our driver wasn't the best I guess, a boat driver. Anyway he hit another boat and we all- myself and the team member that was with me anyway, fell out of the boat from the crash. This is a Ganges, a tributary of the Ganges. I lost my glasses and my wallet was wet and all that stuff; and the team member that was with me, he broke his arm. I didn't break anything but I lost my glasses. I had sunglasses with me but that kind of thing, if it were to happened now in some place, I mean, there would be all kinds of support and running back and getting things repaired. There was nothing, I mean you'd just put on your sunglasses and keep on going until you are back in Dakha, where you can get some things repaired and get something done. Now that I think about it, it's pretty amazing there weren't more injuries than there were. There weren't things happening that couldn't be retrieved, maybe there were, maybe you'll find out about them but I never heard about them and we just seemed to do it. Interviewer2: How old were you? Peter Crippen: Well that was 1972, no '74, I was born on 1942 so what is that, it's 34. Yeah-what's 42 from 74? Whatever that is that's how old I was. I wasn't a kid. My second son had just been born in October or September of 1973. So he was less than six months old when I went and my wife was not thrilled although she understood, I mean, she had been with me in Nigeria and I think she understood that, the call of the pox or whatever, I don't know. Interviewer1: What would you say was the most frustrating part of your job while you were there? Peter Crippen: My favorite what? Interviewer1: Most frustrating part. Peter Crippen: The most frustrating part? Ah boy! Part of it was interference, there wasn't a lot of it but there were some. The person in charge of that area under the British system is called a civil surgeon and he was a little unusual. Of course they were all Bengali, that was the ethnic group and they should've all been Muslim because of the partition in 1947 and that's why Bangladesh had been East Pakistan, and then in 1971 became Bangladesh. Well this is 1974 so it wasn't that long that they had been independent. They were still using the British system and the civil surgeon was a Hindu and everybody I worked with was Muslim but he was a very high class kind of self-important person as some people tend to be, and there were of course goods that came in to support the program, among which were motorcycles that came in to be used by the teams for going around searching and things. He sort of appropriated one for his son and I took it as part of my responsibility to disappropriate it, but it was clear that you can't offend this man because he controls everything. He controls the petrol I'd use in the land rover. He controls all of the personnel that are on your team, I mean, you can't do anything without him so we just had a little conversation and I just had to let him know that I was aware of the fact that there should have been 20 and there's only 19 motorcycles; you know, that his son just happens to have a new motorcycle. So this would be embarrassing if it became well known and surely he understood that within a month or so after the newness had all worn off, we might be able to use his son's motorcycle for what it was intended for, sort of a veiled threat, if you will, of embarrassment. Nobody likes to be embarrassed like that. So we got it back eventually but that kind of thing can be frustrating because you know - you can't be quite as upfront as you would like to be, or as Americans tend to be about some things, you have to work within the culture as it stands and within the personalities that you're confronted with, you know. I guess that not really frustrating, it's part of the job, it's what you learn how to do if you want to get things done. Interviewer1: So from between the time you left for Bangladesh and the time you came back, how do you think that you changed as a person and as a public health worker? Peter Crippen: Well in terms of public health, I think I learned how to get along in another environment. I had been in other environments before but each new place you go to teaches you something specifically for Bangladesh, I'm not really sure but it certainly enforces, or reinforces your ability to be flexible, to take things as they come and to work within the constraints that you are given and to just try to do the best you can with what you're given and keep on going. So those skills I think they are valuable wherever you happen to work. As a person, I'm not really sure how it changed me. I'm sure it must have and I guess I may be more resilient than I had been. I don't think I was any smarter but I think I knew how to bounce back better anywhere. Interviewer2: How many other assignments overseas did you have? Peter Crippen: Oh gee! A lot-in terms of temporary duties, after that I was with yellow fever in Gambia with Tom Monahaff[inaudible name0:19:36] and others. I did something again with Nick Ward in Indonesia for WHO for looking at their immunization program in Indonesia and went both to Indonesia and to Bangkok to look at the - and then I was with WHO for six and a half years in Alexandria office which is now in Cairo, as I said for diarrheal disease and acute respiratory infections; and then I went from that office to Hanoi for HIV-AIDS and spent a year and a half in Hanoi. Then came back to CDC and went to the Western Pacific for three years. There were six US jurisdictions in the Western Pacific: three countries and three territories. Came back to headquarters and there was a Global AIDS Program, and I don't know how many countries in South East Asia and West Africa, South Africa and Central America, Brazil, and now I'm with the Emerging Infections Program and with them I've been to China and to Kenya. So once you get the bug, you sort of keep it I guess, and if you know of any other opportunities, I'm ready. Interviewer2: Any words of advice you'd like to give? Peter Crippen: I guess my only advice would be that CDC needs to keep doing this sort of thing and needs to keep up its reputation as a world leader in global health. People around the world, as you know, Dr. Sencer, I mean you came to - when I was in Alexandra, you came as a consultant to-was it Yemen or Qatar or some place anyway because I don't remember why which country it was-but they wanted somebody to come who could give them advice about their public health system. Well that sort of thing happens all the time; sometimes if it is high level advice like that, or if it's very nitty-gritty: What do we do now? This is a disaster-and the world looks to CDC to be able to provide that kind of expertise and the only way you develop that kind of expertise is by doing it, by continuing to do it and having your personnel used to performing the job in an odd place with little or no assistance. Interviewer2: Thank you Peter. Peter Crippen: You're very welcome. [End of audio - 0:22:41] </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/iChsdh1PVag" frameborder="0" allowfullscreen></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource interviews motion pictures moving image Date A point or period of time associated with an event in the lifecycle of the resource 2008-04-02 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16rsw emory:16rsw Subject The topic of the resource WHO CDC CDC Smallpox Eradication USAID Smallpox Eradication Format The file format, physical medium, or dimensions of the resource 4897200000 bytes video/x-dv Creator An entity primarily responsible for making the resource Crippen, Peter (Interviewee) Unknown Interviewer, (Interviewer 1) Dr. David Sencer, (Interviewer 2) Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of Southeast Asia and East Africa Smallpox Workers (2008 : Atlanta, Georgia) Title A name given to the resource CRIPPEN, PETER Description An account of the resource Peter Crippen describes is life and career leading to his assignment to Bangladesh to work on the smallpox eradication program. Prior to that he had been in Nigeria at the end of the smallpox eradication program there. Language A language of the resource English