1 12 68 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/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 https://globalhealthchronicles.org/files/original/3d8f9959ed1caa24dd35a0f53c1de03b.JPG dadcdab1227b920a9105b656fe9c6c36 https://globalhealthchronicles.org/files/original/5128da3b3614d2e157f6a0e19d143385.pdf 0fb616a6958502f13832fcec31a0c944 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 Dr. Christopher D'Amanda about his experiences in the West African Smallpox Eradication Project. The interview is being conducted at the Centers for Disease Control and Prevention in Atlanta, Georgia, on July 13, 2006. This is a part of the activities for the 40th reunion of the West Africa Smallpox Eradication Project. The interviewer is Victoria Harden. Harden: Dr. D'Amanda, you were born on July 14, Bastille Day, in 1934. I would like you to describe briefly your childhood, pre-college education, influential family and friends, if you would be so kind. D'Amanda: May I begin by saying I prefer, if it's all right with the project, to just call me Chris, or Christopher. Harden: That is fine. D'Amanda: Yes, July 14 was the day that my mother described as her day of liberation, so it wasn't only the Bastille that was taken care of. And that was in Rochester, New York. I was in school there, at a co-ed country day school, until the 7th grade, when my parents decided I should go to Exeter. So I went to Phillips Exeter Academy for 4 years. And then, in those years it was very easy-in fact, the Exeter senior classes were told this-that if you wanted to go to any college in the country, even if you were not in the top 75%, you could go to any college without applying to more than one. So Exeter seemed to be a precursor, in my mind, to Harvard. Then I went to Harvard for 4 years, where I majored in English. Harden: I'm fascinated by how somebody majoring in English literature then decided to go to medical school, so can you slow down and tell me here? D'Amanda: Well, the sequence really began in my father's family, where we would repair every Sunday for supper or luncheon cooked by his mother, and her 5 children, one of whom was my father. Her other son was a doctor. And her daughters had married doctors. So I grew up in a family of physicians, even though my father was a lawyer. And my older brother had already claimed, as the older (as I've learned later in my role as a family therapist), he'd already claimed law as his future. So I declared for medicine, following in some ways Papa's injunction that D'Amandas never worked for anybody. They were their own bosses. Little did I know that that was a little bit illusory. We all have bosses, one way or another, even in medicine. But anyway, we all have bosses. Harden: Indeed. D'Amanda: So as far as I was concerned, I was destined to be a physician. My choosing English, and all the humanities I could at Harvard, was in full recognition that once I got to medical school I'd have no time-or at least, I didn't know that I would have time- to read history, enjoy music. I started playing the piano when I was at Harvard. I took 6 courses every semester, even though we were only required to take 4, just because I wanted to get my fill of everything I could. And then, after that, after Harvard, I went to medical school at the State University of New York in Buffalo. Harden: And would you comment on any influential teachers at Harvard or in medical school that helped direct you towards thoughts of public health? D'Amanda: Well, we'll get to why I got here, but it was totally serendipitous, if you will, or fortuitous. Both of them were very positive moments, but not by design. When I first arrived at the medical school, my dean told me that I needed to work very differently at the University of Buffalo School of Medicine than I had at Harvard, in the sense that, it was very clear, looking at my transcript, that I could get As when I wanted to, but if I wasn't interested in a class, I would get a C. And he said, "Here, you have to do all the work we tell you to do because we want everybody to excel, and we want everybody to pass the medical boards." So a large part of their teaching was designed toward doing. The testing, anyway, was designed to replicate a large part of the medical boards which consisted of multiple-choice questions, which I've never enjoyed, and still don't. I prefer essays, and thinking a little bit, rather than having a thought done for me. In any event, that was the medical school experience. There were some wonderful professors there, particularly one in. in pathology,. Cornell Terplin [ph.]. Back at Harvard. Oh, I guess the tutor at Elliott House, where I lived, was a seminal person in my experience there, in retrospect, as he told me that Harvard was a molecular society. Now, I didn't quite know what that meant, but then he explained. Everybody at Harvard is, at least in those days and probably still (I just came from my 50th reunion there, a couple of months ago) is so busy doing their own world. They're like atoms, spinning in their own spaces, and they bump up against each other from time to time. But don't expect enduring friendships or things to grow out of the Harvard experience, was his way of defining it. And that wasn't particularly true for me because I did find friends there, but actually, in retrospect, the friends whom I still have are the friends that I made at Exeter, 3 or 4 years before I got to Harvard. The experience for me at Harvard was probably, at least in my mind, better capsulated by the excitement, the intellectual stimulation, and the fact that I was taking a graduate course in my first year because I could do it. I mean, I was allowed to do it, put it that way. It was just endlessly enthralling. But it was also sufficiently intellectual that by the time I got to my senior year I knew damn well I had to leave because it just didn't seem like a real world to me. I had an instinct that there was something else besides Harvard out there, but there was no way to enjoy it at Harvard. I have always been the second child, the explorer, the traveler (which is also part of family therapy: tradition of birth order). Anyway, I left very gladly. I left Cambridge and I left Boston, and went back to upstate New York. Harden: When you finished medical school, in 1966, obviously the Vietnam War was going on, and the military always needs physicians. But you joined the Public Health Service and came to CDC. Now, you said it was a serendipitous experience. You want to walk me through this? D'Amanda: I stayed in Buffalo to do my internship in medicine, and then chose to do a full medical residency with 2 years, and then stayed on a third year as chief resident. And during those years, I had a hand in teaching and being aware of research activities, journal articles, and so on. I envisaged myself becoming a full-time academic researcher in some ivory tower someplace. However, the draft still loomed. So I had a good friend who knew about the Centers for Disease Control, and I was interested in statistics as a way of sort of separating the wheat from the chaff in so much of the stuff that was being published in journals. Too much of it was anecdotal and not enough well-designed so that you could produce some kind of conclusion that might bear benefit in the practice of medicine. In any event, I came down to CDC to see if I could enroll in the EIS [Epidemic Intelligence Service] program. But when I got here, I was older than most of the people who were being recruited, having finished not only my internship, but my residency. A lot of the other doctors, my peers in the program, had just finished an internship. Secondly, I was bilingual in French and... from earlier travels I'd done in Europe, and training I'd had as a schoolboy in Rochester. So somehow that word got to D.A. [Donald A. Henderson], and D.A. came over and basically hijacked me out of EIS, and put me in the smallpox program. And I thought, what a wonderful opportunity. Here it is, I'm going to get to Africa, where I've never been, much as I had traveled before in other parts of the world. I was going to get to really perfect my French because it was clearly destined that I was going to a francophone country. And thirdly, I was not serving in the military, except in this wonderful sort of almost Gilbert and Sullivan way. My title was Lieutenant Commander, JG. But clearly I never had a uniform, never learned to salute. But because the Public Health Service had started with the Navy, taking care of the sailors who were getting sick on their early transatlantic voyages, the Public Health has always used naval military designations. So that was the serendipity. That was chance. Harden: So this is 1966, and you were taken out of the full EIS program, but they were training... D'Amanda: Oh, yeah, we still did the biostatistics course, we did all the other things. But then, one of the things that amazed me, we had a special program that went on for some time, learning how to take apart a Dodge truck and put it together again. Not part of the usual epidemiologic training, I'm sure. And I learned to do that. I'm not a mechanical genius, by any means, but in one of the letters I wrote at the time, I was describing that we all had to learn how to take the Ped-O-Jet apart and put that together. That was a piece of cake compared to a large motor vehicle. But it was stuff that I learned to do, and in fact was able to train people to do before my operations officer got to Ouagadougou in Africa. And it certainly helped me in when we had une panne, which means to have an accident, a breakdown. Harden: But you did have an operations officer supporting you? You didn't have to do both roles by yourself? D'Amanda: No. That was the design. It's one of the designs I'd hoped would follow me when I came back to work in America 4 years later: the balance between an administrative person and a physician, a medical person. But it doesn't work outside of this environment. Harden: Why is that? D'Amanda: I think it's because the administrators are too hungry. They don't want to share the glory. Put it this way: When I went to work in Philadelphia, after I'd come back here, I had talked to the director of the program that I was being hired into as the Chief Medical Officer for Drug and Alcohol Services in Philadelphia. And I described this. He had been a Peace Corps director. And he assured me that, yes, we would be a team, and so on and so forth. Well, that wasn't the way it worked out. He clearly wanted to be the major person, and it was a major administrative job, just like smallpox was. But there were clearly a lot of clinical, medical issues to be addressed, in terms of providing service. Philadelphia at that time was the 4th largest city in the country. We had 14 different treatment programs; we had 10 methadone programs. I mean, addiction is a medical disability or a medical problem. In any event, I made do by inventing things for myself. That's how I got to do a lot research for the people in Washington. But this model that exists here is very special. And I don't know whether you saw it at the NIH [National Institutes of Health], but it's a wonderful give-and-take because clearly the administrator has his or her areas of expertise and implementation and experience, just as a good doctor does. Harden: No, I did not see it at NIH, and that's why I have found it so interesting, the 2 working together . . . D'Amanda: None of us can know as much as we need to know. No single person. Harden: Yes. D'Amanda: But when you get into a complex project or major issues of administrative health programs...One of the things I did in Philadelphia was to start an Employee Assistance Program for the City of Philadelphia employees. I figured if we were taking care of the citizens of the city, we ought to try and figure out how to take care of our own because the statistics were clearly the same: 10%-15% of the people in any work force are involved, either actively or just recovering from, some form of addictive disorder. So anyway, I started this program. I had the city administrator working with me, as well as the union person. Because city employees, of course, were all union, and it was very clear from the model that I'd learned employee assistance from, that if you didn't involve the union, they would never cooperate with administration, and vice versa. So I got to be the middle person as the doctor, saying, "Look. This man has just driven a truck of hundreds of thousands of dollars worth of equipment, nearly off a bridge"-which was one of the headlines that occurred at one point when I was doing this-because he was drunk. But he was also a member of the union. So if the administration had tried to fire him, the union would have put up a battle. And if the union tried to brush it under the carpet, the city would have said, this doesn't work. So anyway, employee assistance was a beautiful way to give everybody a piece of the pie. And my job was, first of all, to train administrators to not be diagnosticians, just to pay attention to the job that needed to be done, and if somebody wasn't doing their job, they just had to report that, period. And then to get the union people to trust me enough to say that, even though I belong to administration, I'm not selling you out. I'm here to keep your voting member alive and well. So it worked, very well. The model is a tremendous model. It came out of the Cornell School of Labor and Management. A guy named Harrison Trice. Harden: Let's transport that back to Niger, now. Tell me how you conceptualized what you had to do and worked with your operations officer to do it. D'Amanda: Niger was a special project that we all shared, doing an assessment of neighboring countries. My countries were Ivory Coast and Upper Volta (now Burkina Faso). My home was in Ouagadougou, which is the capital of Burkina Faso. Harden: So perhaps we should start with Upper Volta and Ivory Coast? Okay. Sorry. D'Amanda: No problem. Well, one of the things I learned very quickly was, because I'm blue-eyed and white-skinned but happened to be bilingual, I was frequently taken to be a French person. And I learned very quickly that all the French carried a very significant and generally pejorative aura because they were the colonial powers. And they were still interfering with the local African people too much with their autonomy or their hoped for or desired autonomy in whatever francophone countries that I went to. So I learned very quickly to identify myself as an American, and of course that was very popular because Kennedy was President, and everybody loved Kennedy and loved the Americans. The second thing I learned very quickly was I had access with my OOs [operations officers]-a brilliant guy named Bill White [William J. White, Jr.], in Upper Volta, and then Tom Leonard [Thomas A. Leonard], and then Bob Hogan [Robert C. Hogan]. They were just special, wonderful human beings, as well as highly skilled technical people. I had to learn to be patient. Because even if I declared myself an American, it didn't mean that that would work all the time, and it didn't mean that it worked right away. So for the first year in Ouagadougou, I can remember still having to learn to wait for 3 hours to get to see the Minister of Health, whom I needed to see to discuss the program. And so I used to bring books and I used to read, and I used to get restless. But I also reminded myself that I was a guest; this was their country. They could treat me any way they wished. But after about a year of what I now think of as eating humble pie, so to speak, then I got to be able to get in ahead of people. I used to say to the Ivorians, as well as to the Voltaic, "You know, I'm being paid by America, but I'm not working for America. I'm working for your country." And that was the way we felt. That's the way I felt. And it was important as I see the practice of medicine now, and certainly family therapy, you don't tell people what to do. You ask the questions, you learn the ways, and then help them make decisions. So it was not in any way dictatorial, "we know better than you." The difficult part was, in some ways, working with the French, especially the man I worked with in Ouagadougou. There was a fair amount of disregard between the French and the Americans anyway, at least the French didn't like the Americans very much in those days. I'm not sure they're that much more comfortable with us now. But in any event, Colonel Sansarricq's first words to me were, "You know, D'Amanda, I don't know why you Americans think you can get rid of smallpox in 5 years. You know, we French have been here for 30 years, and this disease is not going to go away just because you came here." But that was another lesson I learned. We can segue up to Niger at this point because I was involved with the actual campaign in Ivory Coast and Upper Volta, in terms of the up- front sort of dealing with the higher-ups in the health administration. I'm an internist, and trained, as we all were, to identify smallpox, to determine whether an illness really was smallpox or not. The longer we were there, smallpox was getting less and less common. I ended up seeing about a hundred people with smallpox in Upper Volta. But near the end of my stay, most of the time, people who did not know the distinguishing characteristics thought that a lot of the old, but most of the young, people who had these particular kinds of rashes had smallpox, when in fact they had chickenpox. Harden: People have talked to me a little bit about differential diagnosis, but nobody has actually gone into detail. Can you? D'Amanda: Sure. First of all, smallpox is what's called an exanthem. It affects the skin. Virus affects basically lining, or squamous, cells. Squamous cells are on our skin, but they also line all our insides. They line our gut, they get modified in various specific ways. But, for instance, one of the common problems with measles patients is that they get otitis media; they lose their hearing. One of the worst things that happens to children who have measles and are nursing is that the whole lining of their mouths and their intestinal tract get these lesions on them, so they can't swallow; they can't even nurse. They get chronic diarrhea. That's how so many of them die. Or they get bronchitis. Again, these same cells are being infected with the same virus. So the distinguishing characteristic to do the differential diagnosis is really on the skin. And also time course of the illness. Each disease has what I call choreography, which is one of the words I use to define the withdrawal symptoms of various drugs that people take in the street. The time course, the process of smallpox, is 3 weeks long. And the lesions are in specific locations on the body. Harden: As opposed to chicken pox. D'Amanda: Chickenpox is sort of a flood of these same-looking lesions. On a black-skinned person, they're called taches blanches, white spots. Because as they erupt, they look like little blisters or pustules; but when they become scars, the black melanin hasn't gotten to that space; in fact, it's new tissue and it may never be replaced. In fact, that's how we do the assessment: we look for the white spots, the taches blanches. But the white spots have to be in different locations, and the patients have to have been sick for a different period of time. So that was a differential diagnosis. Harden: Someone spoke about a different smell for smallpox. Does this mean anything to you? D'Amanda: Not one I remember. It may have been, but I used those measures that I just described for you. I did not use my nose. Harden: All right. You were going to talk a little more now about the Niger assessment. Would you? D'Amanda: Okay. Our primary job was to make sure that we vaccinated at least 94% of the people with smallpox vaccine. Smallpox, like all infectious diseases, has something called herd immunity, meaning that you don't have to really cover every individual with whatever vaccine or inoculation to get immunity for the population. The only reason smallpox was eradicable was because the virus only lived in human cells. So it was known from work done here, before we even got out to West Africa, that if we got 90% of the population immunized, the virus couldn't survive. So our job was to first of all organize people in the various campements de marché [ph.], in whatever way we would bring them together to get them all inoculated with the Ped-O-Jet. And then going away and get the country done, within the 3-year period. We thought we could do the same thing with measles but that was an error. We thought measles infected children who were 5 or 6, when they first went to school. We did not understand that the epidemiology is a crowding phenomenon. And the crowding phenomenon in West Africa is going to marché. (market). Infants are carried on their mother's back. So as soon as they are born, they're introduced to the markets of whatever region they're in. And they get exposed. So in fact, the measles virus was transmitted very, very rapidly, and there was no way we could cycle in the 3-year time to get all the new children being born. So measles became actually a sticking point because in some of the African countries, especially places like Ivory Coast, smallpox had virtually vanished before we even arrived. There were a few cases, but they were imported cases, usually from Upper Volta because so many of the men from Upper Volta had to come south to find work. There was very little employment in countries like Niger or Upper Volta, and they lived by subsistence farming. So they'd go south to get money. But they'd also bring disease with them. Harden: So some of the countries were not supportive, then [of the smallpox effort]? D'Amanda: Well, that had to do a large part with how they were beholden to the French, their agent technique [ph.] who were French. Some of them were upset that we weren't eradicating measles. We'd set out to do that. That was part of our title: Smallpox/Measles Eradication. We did it with smallpox, but we in no way did it with measles, and so they were disappointed. There were a few slings and arrows thrown at us, but we had to do a mea culpa, or effectively so, that we didn't understand that the crowding phenomenon [that we assumed] had occurred in this country at the age of 5 or 6 and which would have given our cycle of 3 years ample time to vaccinate everybody, simply didn't work in the developing world. And so we did the best we could. Harden: In the forward to your journal in Niger, you stated that after being in Africa for a while, "The stranger begins to long for the leisure that cannot be had here, and he knows, even as he does so, that he has become a devotee of the special non-leisure that is Africa." Would you comment on living in Africa? D'Amanda: Well, it has to begin with us. It has to begin with the enthusiasm and the excitement we felt. We've talked about it a couple of times already here, in this reunion. It was really a new adventure for all of us. It was a new program for the country. It had extraordinary benefit in the potential to think that we could be helping so many people in such a distant place live, survive. So we were all fired up. And some of us enjoyed the clique of the American, sort of ambassadorial, residence and everybody of that sort. But most of us had to be out in the field, and we got to know the countries we were in well. I certainly got to know Upper Volta as well as anybody who was living in the capital because I was traveling all over the place. But in that process, you begin to realize that there's very little rest for these people. Subsistence farming is a cruel fate, and nature is there at every beck and call, either with too much water or not enough, either with seeds that can germinate or can't. There were very few animals in my area, so that there was no loss from predation. But it was just nature. And so people are always trying to take care of themselves, to get enough food just to survive. And then that's part of the traveling: people from Niger would travel through Upper Volta to go down to Ivory Coast, just to look for work. And I became aware of this energy that was often physical, was certainly mental. And it's not to say that there weren't warm, wonderful family units. And the camp, the compounds that we visited and the ones that I got to know in Ouagadougou and would be invited into for evening tea, were special, warm, loving places. But the real world was much harsher. That's what I was trying to get at: the fact that, in any developed country and certainly in America, we have the time to put punctuation marks. The time to take a break. Read a book. Watch TV. Listen to a concert. But that can't happen there. Harden: The program obviously had a major impact on you and the rest of your life. Would you comment on this and on the idealism of the '60s? D'Amanda: Let me deal with the first question. I never thought of myself as belonging. In fact, one of my regrets was that I was so busy in medical school that I didn't get into the idealism of the '60s. I mean, much of the Vietnam War went by me like that because I was too busy focusing. Harden: But on the other hand, you could have just come back and gone into private practice and made lots of money, and ignored the rest of the world. This is the kind of thing I'm thinking. D'Amanda: Oh, okay. Harden: It sounds to me, from what I've read, that you were very much committed to these people, and that they grew on you a lot. D'Amanda: Yes, they did. And the exposure to them. The simplicity and the dignity and the integrity. And I've learned the same with the poor people I work with now, from the inner city of Philadelphia, many of whom have not had much education. Literacy was, I thought, the way to get ahead in life. I had no idea, until I went to Africa, that literacy had nothing to do with wisdom. We met lots of very wise men and women there who couldn't read, couldn't write. But they were wise in life. Did I come out of Harvard, thinking that was possible? Not at all. In any event, it was possible, and my goal of becoming an academic doctor in some ivory tower was totally blown. One of the things that Sencer [David J. Sencer] asked us to do [to prepare for this interview] addresses that particular question. This was my number-one response: altered career plan and life: From academic medicine in an ivory tower, to addiction medicine in the trenches with citizens victimized by poverty, racism, and bigotry. Because that's what we've got here. We don't have subsistence farming, but we have people who are diminished in their value, and certainly in their ability to lead quality lives by a lot of "isms." And so, that's what, in the largest sense, those 3 years meant for me. Working with poor people, and, certainly in the northeast part of America, working with blacks, was not anything I had any experience with. We had had a black cook in the house I grew up in, and that was about my extent. I had read about the Black Panthers, and I had read about the freedom movements of various groups, and the "Black is beautiful" concept that was being promoted in the '60s. I knew that Stokely Carmichael had taken refuge in, or been offered asylum (I'm not sure what the proper phrase should be) in Guinea, and was a guest of the president, Sékou Touré. So I had friends in the airlines business, a wonderful... Vert Comboree, an absolutely statuesque, brilliant, and very, very intelligent and wonderful woman. And I asked her if she knew anybody who knew Stokely. Oh, she said, "I do. Because I'm a friend of the president's." Vert was a friend of virtually every man of power, as far as I was concerned. And whether she was courtesan or not didn't make any difference. She was just a very special human being. So anyway, she set up an interview. So I flew to Conakry and took a cab to the president's compound, a section of which he'd given over to Stokely. And I had a wonderful 3-hour talk with him. Strange, Caucasian- American, walking into this compound. . .I don't know whether he knew I was coming or not. I have no idea. In any event, one of the things he said, which was very, very special to me, was "Don't try and do things for black people in America." In other words, "Don't do a Teddy Roosevelt." He did use that phrase. Don't carry any big sticks on their behalf. He said (again, I'm having to paraphrase my own recollection, but basically, he said), "If you can open a door, that's fine. They may choose to go through it or not. But that's their business, not your business." Harden: Bill Cosby would tell them to walk through it. D'Amanda: Well, Bill Cosby's a newer generation. Harden: Right. D'Amanda: And one that has some legitimacy, I guess a lot, with the people who want to believe that they would or should. But a lot of people don't buy that. Harden: There must be a thousand stories that you have from your experiences over there. Is there anything that just impresses you that you'd like to get on the record here? D'Amanda: One of my difficulties, I guess, in the life I've led, is that I am enough in the moment so that even though I've got a reasonable mind, I tend to forget moments. The memories that I could share at this moment are the friendships and the excitement of being on the move. That's why I took that little caper in Nigeria, even though I was supposed to only be working in Niger. And I loved the excitement. What stories, what stories... Part of being bilingual in Abidjan, which was a much more sophisticated city than Ouagadougou, meant that I got to know people at the university. One friend of mine and I used to give great parties. Dominique would know various restaurants that would be available, and we would know lots of people at the various embassies, and so we had these wonderful, sort of all- night dancing, drinking, fun parties, in Abidjan. On the work side, I would say that the most important piece for me was something I've already alluded to, which was, you don't walk with a big stick. You listen, and you are patient. You observe, and you figure out where the hook is, to use a family therapy term-how to get in. Because you've got to work on somebody else's territory, as well as your own, to influence change. And change is why I went into family therapy. I'll share a story to give you a perspective of part of what made Africa so useful for me, and part of why it was such a powerful experience. My first day in family therapy, there were 12 of us in the class. The supervisor was going around, asking each one of us why we had come. When she got to me, I said, without even thinking, it was totally reflexive, "I want to be free." And I'd be damned if I knew what I meant. Well, part of Africa was being free from here, my particular family of origin, the issues that my parents had, that my brother and I sort of united to be safe and separate from. There was a lot coming in, in family dynamics, that in quite significant ways, affected who I was, and I knew that. Just like I had the instinct that Harvard wasn't the real world. I didn't know what the hell it was, but I knew that I wasn't participating, and that's one of the things that Africa let me do. It's probably why I was so active. I had another fleeting thought. . .There are wonderful raconteurs that I have listened to. One of my favorite delights listening to Bob Hogan, who unfortunately isn't here. He could tell stories beautifully. Part of the issue of being over there, especially in Abidjan, was to go to the Fourth of July ambassadorial celebrations. You just talked to people you don't know and wandered around talking. And at one of them, I got into conversation with this fellow, who wanted to know how many people I knew in the government. He dropped some names. Did I know them? Yes, I knew them because I'd had to work with them and discuss things. A long story short, he began to ask me whether I would be willing to record my conversations with these people. I said, "What would I do that for?" "Oh," he said, "Well, there are people in America who would be interested." Well, it didn't take me long to figure out that he was a CIA [Central Intelligence Agency] operative, and he was trying to recruit me. And I just sort of stood back after a couple of minutes of this conversation. He even got to the point of saying, "Well, we know what you're doing here in Abidjan, and we could make it uncomfortable for you." I said, "What the hell do you mean? I don't play cops and robbers." And I was so fascinated by the way the system apparently works. I have heard this subsequently. There are people who collect data., conversations. And they reel them off into these recorders, and then somebody, somewhere, tries to fit them all together. I suppose that's a large part of what our "war on terrorism" was all about. Anyway, that was a story that made me understand, again, so powerfully, as so many other things in Africa did, that I just don't fit into any of those kinds of skullduggery cowboy stories. Cops and robbers is not my style. Harden: Before we stop, is there anything else about the program that you would like to talk about? D'Amanda: I guess I'd like to hope is that there are other programs like it in the future-where there's a mission that is humanitarian, requires scientific and administrative know-how, and can move ahead and get things accomplished. I've not been in the public health world, other than looking at addiction sometimes as a public health process and as a behavioral disorder. But I know there's a lot to do. And this country does have inordinate resources. I think we lack the will, too often. But this organization, 40 years ago, didn't. And I think that that's a tradition that could be remembered with benefit to everyone, including CDC. Harden: Thank you so much. </pre> Player html for embedded player to stream video content <iframe src="https://www.youtube.com/embed/_D4wKxBp6nk" 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 2006-07-13 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/15ntn emory:15ntn Subject The topic of the resource CDC Smallpox Eradication USAID WHO Relations with French Format The file format, physical medium, or dimensions of the resource 9519840000 bytes video/x-dv Creator An entity primarily responsible for making the resource Harden, Victoria (Interviewer) D'Amanda, Christopher (Interviewee); CDC; Epidemiologist Contributor An entity responsible for making contributions to the resource Centers for Disease Control Title A name given to the resource D'AMANDA, CHRISTOPHER Description An account of the resource Dr. Chistopher D'Amanda, a CDC epidemiologist assigned to Upper Volta (Burkina Faso) with responsibility for Niger and Cote D'Ivoire describes relationships with the French and the host countries as well as relating the relationship of the epidemiologist and Operations Officer in the field. Dr. D'Amanda also describes a cross border excursion to Nigeria following a smallpox outbreak. Language A language of the resource English https://globalhealthchronicles.org/files/original/e932ec991a971bb835ae7c64d48d263c.jpg b33f46374fd454c54a209a8c3a6b5ae5 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 DAVIS, CORNELIA https://globalhealthchronicles.org/files/original/213f5650e0e68ce9accd73ea9daabd51.jpg 0e769dca97282eeb2118832945a3f673 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 DAVIS, CORNELIA 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 <br /><iframe width="100%" height="100%" id="iframe" name="viewer" src="https://globalhealthchronicles.org/ohms-viewer/viewer.php?cachefile=2023.300.093.xml" 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/. Title A name given to the resource DAVIS, CORNELIA Coverage The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant youtube https://globalhealthchronicles.org/files/original/2efbfa1d712cc9a76a90691e56b3c24e.JPG c36322f058fa72125c459a2a0213fa5c https://globalhealthchronicles.org/files/original/51a892069f7b2a40da44fc734946c8a0.pdf 918d761c76aa457f69d77cb5705359cd 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. Keywords https://youtu.be/htSQgU-L36E Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/htSQgU-L36E" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="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/. Title A name given to the resource DRESCHER, JOHN Date A point or period of time associated with an event in the lifecycle of the resource 2008-04-01 Subject The topic of the resource smallpox eradication program WHO (World Health Organization) Public Health Advisors U. S. Public Health Service Description An account of the resource John Drescher assigned to Niger in the Smallpox Eradication Program and later Gaya, Bihar, India talks about his experiences during those assignments. Interviewed by David Sencer Creator An entity primarily responsible for making the resource Interviewer: David Sencer Source A related resource from which the described resource is derived David J. Sencer CDC Museum https://globalhealthchronicles.org/files/original/a14efb4876e19798ed4188337823e916.JPG 135e6ef2baee7c0adf478b944437aaf3 https://globalhealthchronicles.org/files/original/2004fffab008be1051279b90bc2a4356.pdf 99ab9a0ed4c6bcf117145ae31a0fad4c 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> Conversation Dr. William Foege &amp; Dr. William Foege Transcribed: January 30, 2009 | Duration 0:41:22 A Conversation between Dr Mahendra Dutta &amp; Dr William Foege Introduction Today is the 9th of July, 2008. This is a taping as part of the Continuing Series of all Histories of Smallpox Eradication Program. Today Dr. William Foege and Dr. Mahendra Dutta are going to have a conversation. Both of them know that this is being taped and they've signed permission for us to tape and to use it in appropriate manners. Dr. William Foege: Okay. Mahendra, 30-plus years ago, we spent so much time together working on smallpox, but I never asked you, how did you happen to get into the program? Did you volunteer? Was this dictated? Dr.Mahendra Dutta: Yes, I did volunteer. I had returned from my training in Epidemiology for nearly 9 months back to the office where I worked with the Director General of Health Services and the campaign was being mounted and they needed more people to help in the campaign, and that's how I volunteered. Dr. William Foege: Ah, ah. So you did volunteer. Now, we've often talked about the top group of people. You, M.I.D Sharma, C.K Rao, Pidish, and so forth, an extraordinary team, but how did it happen that they came together, because I don't think you could have found a better group of people if you'd searched the world. How did that happen? Dr Mahendra Dutta: There was a continuous process of selection. People at the helm of affairs in the Ministry of Health, technocrats, were getting involved and those who could not perform they were quitting also. So ultimately the fittest survived. So that's how you saw them all together. Dr. William Foege: Ah! So this was evolution. Okay-Survival of the fittest. Now there was a person I was very fond of early on in the program who was running the program in Bihar. I totally missed the fact that he was extracting funds from us at an alarming rate. How did you pick that up and how did you handle it? Dr Mahendra Dutta: I got involved with the program in February when Dr. Dish[inaudible name0:02:49] asked me to visit and see how things are moving there because he was not comfortable. Dr. William Foege: This was February 1974? Dr Mahendra Dutta: February 1974, and in this visit, when I reached, I went to a district, Munger, there is a district by that name, where I spent a week seeing how things are happening. The reports we were receiving were that people do not accept vaccination; and when I went there I was surprised. Every morning we went to villages, we had a team of 20 people to vaccinate with us, and one after another village where we went, people were pleading to get vaccinated; and the stories that we got were: so many died in this village, people were really alarmed. They wanted vaccination, then the civil surgeon, the head of the health administration of the district was hostile to Dr. Sinha and he narrated me all those stories, how he is employing over and above the normal staff, some extra workers, and virtually paying them 1/5th or 1/6th of the money that they are supposed to get and the remaining is being pocketed. So this was corroborated by another colleague who had worked with me earlier who was my other class fellow in the public health training, and he corroborated that this is actually happening. I finally met the Health Commissioner at a very personal level in a club and told him. He said that this is no news to him. So then everybody knew-so I said then, "What to do." The gentleman said, "Well! I am not heading the health services. It is a technocrat there. He has to come. I am a bureaucrat. Then only, I will step in." It went on like this, till fortunately, let me say, may be you are aware, in 1974 May, there was a nuclear explosion in India. Dr. William Foege: I remember that! Dr Mahendra Dutta: Pokharan, and after Pokhran, the Newsweek in its front page carried a report, "Another Explosion in India" and this was the smallpox explosion in Bihar, when you will recollect that in our May search, we discovered over 8,500 new outbreaks with 11,000 cases. So - Dr. William Foege: In one week, 11,000 cases - if I can just interject here - The previous Fall, D.A Henderson had asked me, "What's the largest number of cases you will find in any State in a week in India?" And we actually took this quite seriously, and we concluded that it would be less than1,000 cases. So we suggested that they use 3 digits for their computer programming. D.A- always suspicious of us; added 4 digits, and then we had to call and say, we've had 11,000-plus cases in one week, in one State, and so even the computers were not cooperating anymore. Okay, so go ahead - then May of 1974... Dr MahendraDutta: Yeah, then the stage came that the government of India and the State Government, they all got really startled because a lot of journalists who had come to Rajasthan to cover the nuclear explosion, they moved into Bihar and started reporting. Now at that point of time, we were asked by the Health Commissioner there who was the chief bureaucrat in the Health Service. Earlier he took the stand that the Technical Head should come to me but now he himself went to the political head and told him that this is the problem that they want the Program Manager Dr. Sinha to be moved out; and then he was - a substitute was selected by consensus. He was a very good person. Everybody felt that he was going to deliver, and he moved in and then things moved. So after that, we had very fast track movements on the program. Dr. William Foege: I want to come back to this, but this has always been an example to me of an outsider not able to see what was actually happening and an insider understanding immediately what was happening. What else did I miss? Dr Mahendra Dutta: Well, you didn't miss much because even in this case, I recall you were believing that smallpox will definitely go sooner or later. I wanted it to be sooner. Dr. William Foege: Yes, Dr Mahendra Dutta: That's about the only difference of you. Dr. William Foege: So the reporters came to India, they did their reporting on the nuclear test and now looking for other stories, suddenly this becomes a very good story. Smallpox is out of control and they have no background to know that this is partly due to the improvement of the program and surveillance was improving and there were a lot of people now on the problem, but it caused Parliament to make life miserable for you because everyday they were asking for explanations; and how important was that in diverting people from smallpox eradication to answering Parliament? Dr Mahendra Dutta: Well, the group of workers who were handling at the National level for the Parliament was only being fed by the peripheral workers. We were not disturbed much in the field. In fact, we were helped by this lot of reporters coming in and giving the stories. It was a helpful thing because the Government at that time asked us to request whatever we needed more and we increased our efforts far more then. Dr. William Foege: What was Karan Singh's, the Minister of Health, what was his approach to all of that bad news? Dr Mahendra Dutta: Oh! He was the real support. He recognized that the disease is being tackled in other States and it was only the problem of inactivity in Bihar, that's why they were lagging behind. So he himself visited later in Bihar and emphasized that we put in more efforts and things were already showing up, and very soon things will be completed. In fact, we recollect that he all along was a big moral support. Dr. William Foege: So, at the very top, you had all the support you needed. If you go down a layer, to the Director General of Health Services, to Dr. J.B Srivastav, what was his role at this time? Dr Mahendra Dutta: Unfortunately he belonged to the group of unbelievers. There were people, I believe in every country, who did not believe that Smallpox can be eradicated vis-à-vis the others. He belonged to the other group and he was always pessimistic about our claims of eradicating it very soon. So all I recollect is that I had a very good liaison with him and he, several times, enquired of me, "Is it real what you are reporting-so good a progress in so short a time?" So that was the main thing he would always accept when I say so and I recollect when later we were so close to the endpoint and we were going in for announcing a reward for a case. The minister was to make that announcement on July 1, 1974. He was asking, "Isn't it too early to make such an announcement?" And I said, "Well the amount of money and effort we are putting in each day, I shall be so happy that if I can have all the remaining few hundred cases discovered by this reward and it will save a lot of money and time." It was a matter of chance that not a single case was found and we didn't have to pay a single reward but Dr. Srivastav had apparently not been at the most peripheral level, in the field level; that is why he couldn't appreciate how thoroughly the things were happening. Dr. William Foege: How powerful was his pessimism in influencing the Minister of Health of Bihar when they wanted to change back to mass vaccination. Dr Mahendra Dutta: He came to Patna on the asking of the Minister of Health and addressed the civil surgeons and at this meeting he pleaded that the ultimate solution of the problem would be covering backlog of mass primary vaccinations; children who have never been vaccinated. Unfortunately, the minister took it very seriously and wrote to Dr. Karan Singh, the Indian Minister for Health that your Director General has requested that we should cover the backlog of primary vaccinations, children who have never been vaccinated. He asked for money; vaccine and bifurcated needles for vaccination to harness a new organization, the block level health staff to complete it. Because Dr. Srivastav said he is not against the firefighting efforts that are being carried out. So Dr. Srivastav's comments were sought about the statement that he made and I recollect that Dr. Srivastav was uncomfortable how to respond to it and he asked me, I had to go back from Patna and I said there is an anomaly. They too are saying the same thing; that first we bring the disease to zero level and thereafter we can concentrate on the backlog of primary vaccinations which we never needed there, probably; and it was completed without the backlog. Nobody needed it. Dr. William Foege: Now you talked about the believers and the unbelievers. Do you recall the day you became a believer? Dr Mahendra Dutta: I recall the day when the non-believers were shunted out. I was responsible myself. Several of my Indian colleagues who came to work in Bihar with me in the initial discussions, they belonged to that thinking, though they were working and I pleaded with them, if you don't believe, probably, morally, you should not agree to do it. Couple of them did go back instantly, because unless you have a conviction that you can achieve, then you are not doing it. Dr. William Foege: The National Institute of Communicable Diseases put a lot of effort into this program. Did they take great pride at it when it succeeded; and did it make a difference in the way the Government of India supported NICD. Dr Mahendra Dutta: Oh! Tremendously; I believe they are surviving on the laurels of achievement of smallpox even today. That's the biggest thing they did. Of course, they did a couple of other good things after that but smallpox is a feather in their cap. Dr. William Foege: There were very many foreign workers and often times coming for three months and then leaving, and that's the most difficult, to get people acclimated in 3 months to get some productive work out of them and then have them leave. What were, from your point of view, the biggest problems of having these foreign workers in India? Dr Mahendra Dutta: Well, I recollect when they landed in Patna, they volunteered, many of them came through CDC, and when they arrived in Patna, they were very enthusiastic in performing. At the same time, probably, they have never worked in a developing country before. So they were also apprehensive. What we did was that upon their arrival, besides the technical briefing, a sociologist was made to speak with them; and this session attracted them the most. They had so many things to ask the sociologist. Probably, this was the longest session in the briefing in Patna, three to four hours, and they were told about the communities in India, how they operate and how they live together. So that helped them to know quickly, in the filed, how to perform. I recollect that the work to be done was so much that many of them did long extended hours of the day in the field. From morning till late evening, and we were always telling them that in the summer months, you should not be out in the peak hours in the noon but they were defying it also in the enthusiasm that they must complete the work before they leave. Fortunately, some of them, and they were good, those some of them; they asked for extending their period of stay so that before they leave they could see things happening and I recollect at least, a couple of them, Steve Jones and David Hyman; they were later on moved to Bangladesh but they stayed for about five months in India. So that was their enthusiasm to show the results. The small mistake that happened in the beginning, a couple of them arrived with their better-halves and they couldn't perform because field conditions in India were not so conducive for their wives to stay alone; and they did not perform well in the field, and subsequently we had to advice that anybody coming here must come without their spouse. Dr. William Foege: So you worked them so hard maybe 90 days was as long as they could actually take. We wore them out. Have you ever thought pf what were the biggest mistakes that were made in the program. If you were doing it all over again, what would you avoid doing? Dr Mahendra Dutta: I don't see back, anything wrong, the only thing that for this short program, as I said, it lasted hardly an year or so, and there were other programs that suffered because everybody was occupied with this program, but we had to pursue with those programs. I recollect that Family Planning was our biggest competitor as a program, and time and again, the people in the family planning were disturbed but we had to tell them that ours was going to last a few more months, and later on we can join with you in the program. Dr. William Foege: That brings up the question; if the National Institute of Communicable Diseases took great pride in this, did Family Planning take pride in the contribution they made-because it was an enormous contribution? Dr Mahendra Dutta: Well, maybe that was only after April or sometime in 1975 that the Family Planning was given a top priority during the emergency era in India. Before that, they had certain target approach and that's why they were more eager to perform and let not their workers be diverted to help in smallpox. Because in the smallpox, we involved every month, for a week all health workers for the search and that's what was disturbing them but seeing the results, they also agreed that we are doing some job and let it be finished. Dr. William Foege: You mention that it was in truth a very short program, at the time it seemed to go on forever. But it only took us three months to sort of come up with the system, another four months to perfect the system and then, India went from the highest rates in May of 1974 to zero twelve months later. No place else in the world was the change so fast, so dramatic, it's amazing in retrospect to even look at that. But then you went on from India to work in Ethiopia. Compare the two programs. Dr Mahendra Dutta: Things were very different in Indian program. We did not have the difficult terrain working conditions in the field. In Ethiopia, the communications in the field was so difficult, and here I recollect when at the end phases, every case occurring in Bihar, I personally went to that village, I could reach in less than 24 hours. But this could not happen over there. They needed a much prolonged sustained effort, and I was part of it that was done from moving from one district to another so that you make one area free. There, the people also do not move so much as they do in India; because here in the Indian program, fortunately, when our efforts were at the peak that was the lean season for transmission. The disease was expected to come down with the onset of monsoons but our efforts were peaking up further. So that's how we could come over so soon. Because around October-November, when the rains cease and people started moving about again, we were left with very few cases; 150 odd villages where the disease was present, and I recollect later in July, we had some junior teams, mobile teams, we stationed a team in every outbreak and these young doctors who were coming as medical interns, they performed so well because they were all trained, they were all relied upon, they were amazed at what kind of faith we were placing upon them. I recollect those who were bearded Sikh gentlemen, when I met them in the field, they removed their beard; I have no time to wash every day; and those who didn't have the beard, they were having beard, I have no time to shave everyday. So those young people changed the whole complex. Then we introduced the strategy of guarding the case which was paying dividend that the case would not be allowed to spread the disease to another place, around the clock, 8 hour shifts, watch guards were placed, watch guard supervisor was placed. The family was compensated that they can't go out for work. So therefore we will pay rent for the house where our guards will stay; so all these strategies helped in achieving a very fast disappearance of the disease. Dr. William Foege: Its nice, 33 years after the last case, to hear you talk about it and still have the enthusiasm that you had 33 years ago. What is it though that you would like to tell to young public health workers that you've learned from this experience that you hope you can pass on. Dr Mahendra Dutta: All I could say in brief was that in public health, community approach, your conviction, your devotion and team effort, that's what matters the most. The entire team of workers national, international, higher, lower level functionaries, they all worked like a very close team; and that's what I can believe public health team-effort approach-is pride. Dr. William Foege: I agree with you. I think that's the lesson of smallpox in India; that the team worked as a unit. It was a coalition in truth, and people lost their national identities... Dr Mahendra Dutta: Absolutely, absolutely. Dr. William Foege: ...their personal identities and it seems as though we made decisions based on everyone agreeing, I can't remember that we ever took a vote or had really strong disagreements. So it seems to me that it was a coalition that was quite unique. Now, I worry that we have lost the words now of people like M.I.D Sharma. You talked to him a great deal after smallpox eradication and I don't know if you have any message that you would like to pass on from MID Sharma or Dr. Pidish, or some of the other people who we don't have a chance to question. Dr Mahendra Dutta: I was meeting them till/[while] they were alive, and my only understanding was that they felt that the success story of smallpox eradication was also an achievement which gave them satisfaction in their life, and the only thing which I felt they wanted the young generation to follow or emulate what they saw was, the same thing as I said earlier, that devoted efforts, team efforts always mattered in community health work. Dr. William Foege: Years later, I had lunch with Dr. Pidish and he said something similar, that it was quite different to be on an Indian team than to be on an international team working on an Indian problem, and he said to me at that time that, "If you come back to India, I will come out of retirement," we will do this again. Dr Mahendra Dutta: I would say the same. Working with you was a real pleasure. Dr. William Foege: Thank you. How did you get into public health though? Dr Mahendra Dutta: That was a very different story. My father was a Public Health Physician. Dr. William Foege: I know, the Rockefeller Foundation sponsored him. Dr Mahendra Dutta: Yes, he was a Rockefeller Fellow and right from when I graduated from the medical school, I made the choice that I am going to study in the School of Public Health. I didn't waste any time. Very next year, I joined the School of Public Health. Dr. William Foege: Where? Dr Mahendra Dutta: In Calcutta in India, and then pursued the career through married[inaudible0:28:34] life, and I have no regrets. Dr. William Foege: And what did you do after smallpox eradication? Dr Mahendra Dutta: Oh! After smallpox I worked with the Municipal Corporation of the City of Delhi. I was their Chief Health Officer for a few years. Dr. William Foege: Your father had done the same thing? Dr Mahendra Dutta: Oh, he'd done the same thing too, and then I was the Chief Epidemiologist of the NICD for a three-year period, and finally I was the Deputy Director General for the public health work in the Ministry of Health, and looking back I feel very happy that I worked in these positions and got a satisfaction. Dr. William Foege: But there is something genetic here also. Talk about your son. Dr Mahendra Dutta: Oh, he chose it himself, that he wants to also be a Public Health Physician. He came to the U.S. He was a bit disgusted about the policies of reservation for certain backward classes, and he said that he may not get the opportunity in India to work in the specific field where he wishes to work, and he will choose to go to public health work and go to U.S. for training. So I said, "If you wish to go, its up to you." So he is working here. Dr. William Foege: Three weeks ago, I was at my final meeting at the Rockefeller Foundation and I was asked to speak to the staff, and I said: when people ask me what the Rockefeller Foundation has done, I resist talking about the Green Revolution, or the Yellow Fever Vaccine, or the Hookworm Program; I said-I talk about the scholarships that they gave to people around the world, and I talked about your father getting one of those to study public health and that for three generations, this investment by the Rockefeller Foundation has continued to pay off. I mean, it's just a wonderful story. Dr Mahendra Dutta: Very nice of you to say that. My father has left behind his writings of life and he feels the same, that I received the training in public through the Rockefeller Program and I owed a lot to repay it, and I have repaid it because my son followed the same, my grandson followed the same. So that's the same way he thought. Dr. William Foege: In India, how do we improve the number of people going into public health? You've done it. You've found it to be a very enjoyable satisfying profession. How do we increase the number of people doing this? Dr Mahendra Dutta: It has been a dilemma for all the years but I don't know how, but things appear to be going haywire now. More and more people are interested in public health. It's a big change happening in recent years, and I recollect that four years ago, a Foundation with the collaboration from the Harvard University was established to raise Public Health Schools in India - establish new Schools of Public. Medical Research Council also following the same example, they are also supporting establishment of new schools of public health; and the young doctors are also getting more interested in pursuing Public Health as careers. Unfortunately, so far the Governmental System doesn't create more opportunities or caters for public health people. But I am sure there are two ways of doing it. One is that you train the people and there will be careers coming up, the other way is you create careers and then you find shortage and then people will be trained. So apparently we are going the other way round. People will get trained and opportunities will be created to meet those demands. Already several programs, National [inaudible0:33:06] Programs have started creating posts for public health physicians at district levels and lower. So that approach probably is going to be there. Dr. William Foege: I think we are seeing a renaissance of global health interest in recent years and I am just pleased that we both lived long enough to see what's going to be a great change in the future. Dr Mahendra Dutta: I wish too. Dr. William Foege: Are there stories or things that you want to say about the Smallpox Eradication Program because, you know, we may never get an opportunity like this again to talk about it. Are there things that you want to make sure that people hear? Dr Mahendra Dutta: We have said a lot but the only thing I'll add will be that in achieving success, besides technical things, there is also an element of administrative tact, I would call it; whether you say diplomacy in the modified terms but we, people in public health, should use this more often and after all you have to work with your own team, and also this is the team in our system: there is a bureaucracy, there is a political leadership. So you have to work along with them and carry them with you. Dr. William Foege: I hope to make that point at our reunion that behind every public health decision, there is a political decision... Dr Mahendra Dutta: True. Dr. William Foege: ...and that we end up trying to educate politicians but it's a very labor-intensive sort of thing to do because the politicians keep turning over; that they have a limited time in office and that I now miss no opportunity to try to get public health people to go into politics. It seems to be a shortcut, more efficient, if we can get more public health people to actually become politicians. Dr Mahendra Dutta: I wish it happens in my country too. At the moment, we are facing a dilemma because more and more politicians are coming from another group, the group which is rather not desirable but they are the people who flout laws and more and more of them are entering into politics. A separate stream has come. Formerly, most politicians were coming over from categories like rich people, business people, like accepted heads of the communities. Now some bad elements have started infiltrating into politics. Dr. William Foege: We are years ahead of you. Dr Mahendra Dutta: It is worrying, not me, but it is worrying the Indian Government itself; how to get rid of these elements in the politics. Anyway, it's not for me to too much comment on that. Dr. William Foege: But that seems to be a chronic problem in many countries. Let me ask you one final question and that is, the remarkable contribution made by TATA for the Smallpox Eradication Program where you had a private corporation agree to work under Government rules and to use the same approaches and so forth. It now has happened with other corporations, MURK with what they have done with River Blindness and Glaxo Smith-Kline with lymphatic psoriasis and so forth, but that was a very early example of what TATA did. Has this continued? Do you have private, public collaboration in health programs from that TATA experience? Dr Mahendra Dutta: All I would say is that per force, we had to go for that collaboration because the Southern Bihar lacked adequate infrastructure of health from the Government side and TATA has had a very good infrastructure in that region. They have their [inaudible0:37:35] and coal fields and factories all over- spread. Therefore we approached them and they readily agreed because they were working with the people there where it was benefitting. I have seen that now it has become a Governmental Policy in recent years to accept that kind of - because the medical care itself is going to the private sector more and more; and government is only obliged to deliver public health service to the community; the preventive medical care, and in these efforts, they know that we cannot invest so much, so they are seeking collaborations from non-governmental agencies including the private sector. Dr. William Foege: Well, this has been great fun to get together again after - we have done it before, but till now at 33 years to talk a little bit about this, and I will say this on Saturday, but I want to be sure that it gets recorded now. How wonderful it was to work with you, what a hard field worker you are, that you never shied away from doing anything that needed to be done in the field, and you were just the epitome of deliberate approaches to solving problems, rather than getting excited when things went wrong, you would sit down and ask how do we solve this problem and so it was great to work with you then, and it's great to hear you reminiscence now. Dr Mahendra Dutta: I am also pleased that I'd worked with you, and in fact I learnt also a lot of things, but basically, as I said, our team-approach was the most successful approach. Dr. William Foege: Great-good. Thank you. Question from Audience: May I ask one question? Did he play jokes on you? Dr Mahendra Dutta: He played rings because whenever he had nothing - rather, he had something in his brain lurking to solve, he would have a set of rings how to unfold them. But I don't think Bill was that kind of person. He was a serious person. The best thing I recollect is he was a very good assessor. He could assess how people are performing and that's what we got from him; his personal assessment of people who were coordinating, who could survive. Dr. William Foege: But the ring story reminds me of an absolutely true story; where we were going to a meeting where another person had absolutely different ideas than I did, and I knew that because we discussed it quite often; and it was a 2-day meeting. It was early in the first meeting when I took off my puzzle ring and let it fall apart, and I just said, "Oh could you put this back together? He had had a puzzle ring as a child and he said sure. He spent the next six hours on this puzzle ring. He even missed the discussion of the issue that I was worried about where he would bring up the other side. We were passed on other things before he realized that the puzzle ring had kept him occupied. *** Thank both of you. [End of audio] </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/pc6RzIlxjKg" 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/. Title A name given to the resource DUTTA M. WITH FOEGE W. Description An account of the resource A Conversation between Dr. Mahendra Dutta and Dr. William Foege, two of the key people in the smallpox eradication program in India. Dr. Mahendra Dutta, former New Delhi, India Health Commissioner Dr. William Foege, former CDC Director Source A related resource from which the described resource is derived The David J. Sencer CDC Museum at the U. S. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333 www.cdc.gov/museum Date A point or period of time associated with an event in the lifecycle of the resource July 10, 2008 Format The file format, physical medium, or dimensions of the resource 8928960000 bytes video/x-dv Language A language of the resource English Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16rk2 emory:16rk2 https://globalhealthchronicles.org/files/original/15cff6897b42722de6d85ec8ddd53485.jpg 96f9857b18795fa6e75ffee8451b5e43 https://globalhealthchronicles.org/files/original/3f591a9f59cfa5f845cac4a292f46849.pdf cbe8473a9db438866875ed8550f218c2 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 Audio File: Dawn Eidelman Audio File Transcribed: January 23, 2008 Interviewer: This is just formality. Now I'm David Sensor. I'm interviewing Dawn Eidelman on the third of April, two thousand and eight at CDC. Dawn knows that she is being taped and has signed permission. How old were you when you went to Africa? Interviewee: When we went to Africa I was five years old so I started my formal schooling in Lome, Togo at L'ecole de la Marina, not speaking a word of French on day one and it was a rather traumatic first day of school. I about half way through the day had to use the facilities but didn't know how to ask. They figured out what I needed but then when they showed me the facilities I had no idea how to use the drain in the ground. So luckily we had a long school day and a long lunch and I went home for lunch and my ingenious mother noticed that I had an outfit that was almost identical, persuaded me that nobody would know the difference. I went back for the afternoon and she clued me in how to use the little drain in the ground and astonishingly within a month I was starting to understand the French. They only white kid in the class, pigtails, we had the little inkwells in the desk and by the end kindergarten my father was I think a little bit jealous that my French was pretty solid and quite effortlessly. So, in my line of work now I'm a huge advocate of total immersion for English acquisition. I don't believe in segregating students for a lingual education because I know that children are really like sponges. Interviewer: How long were you in school in Togo? Interviewee: In Togo I was there through middle of the third grade. So kindergarten first and second, at L'ecole de la Marina, French system but African private school. Third grade was an interesting experience. The first half of the year we were still in Lome and the first house that we had lived in, the bottom floor - excuse me - the bottom floor had become Boutique Togo Agogo and the top floor our school house for the American kids. And we used Calvert which is still in existence now for distance learning and one or two of the moms who had teaching experience facilitated. And we had assembly in the living room and the two bedrooms were I think the odd grades and the even grades. So we did distance learning in an American program and that's when I first started formal studies of English. Interviewer: In addition to learning about how to use the toilette what are some of your other interesting experiences in your formative years? Interviewee: So many. As I shared on the way over here I really did not like the Sunday ritual of having to take Aralen. It was really nasty and bitter and ugh I just couldn't abide it. So, I didn't take it on a couple of occasions and I became quite ill with malaria and I remember that fever and sitting in the tub taking baths, trying to get that fever to break. That one is definitely a distinct memory. It was actually an idyllic childhood. We didn't have TV. I had a record player and a few records and I know those lyrics to this day backward, forward, inside out. Just a couple of toys and what that really did was promote a comfort level with time in solitude, time for recollection, time to develop an expansive imagination and I regret that more children don't have that experience in childhood now because I think it's very important for really becoming who you're capable of becoming. Having some quiet time and not being programmed all the time with activities. And we had a lot of really cool pets. A family of bush babies, we had a parrot, feisty Senegalese parrot Bud who came back to the States with my mum and lived another twenty years or so in captivity and remained feisty all the way. We also had a podo and that was quite the dramatic story and a small python. We kept mice in a cage. Every Sunday after waffles and Aralen we would in the afternoon watch the python devour a mouse. That's what we did for kicks. Some men came to paint our ceiling fans, let the mice out of the cage. One of the mice bit the podo and the podo was probably our closest family pet. She would pluck out my dad's chest hairs when he was taking a nap. She got into my mum's birth control pills. Very, very intimate family member and so it was really tragic when she got rabies and she also bit my mother. So the whole family went through the rabies series and I remember Dr. Henn would clean up the syringes and obviously get rid of the needles and everything and make them suitable for water fights so my brother Dave and I would have water fights. But Christmas that year we had a rabies shot because we were going through the series at that point. So memories of pets and lazy days, a lot of reading, listening to music, very few toys but the ones we had we really cherished. Halloween was fun. We would -they thought that we were absolutely nuts. My mum was a really fun hostess and I remember one year we put sheets over the clothes line to make a tunnel of terror and we dressed up in all kind of different costumes that our tailor made for us and wondered what the crazy Americans were up to. I remember some rollicking fun. There was some great adult parties and they never seemed to mind that we were kind of milling around. Interviewer: I remember visiting your house. It was probably in seventy, no sixty eight, and George (Lithket) and Don Millar and I we were making our big tour of Africa. It was a very pleasant evening I remember. What was your feeling about life in - of other people in Africa? Interviewee: Of the Africans or the other Americans? Interviewer: Africans. Interviewee: Interesting again from a child's perspective. I did have an awareness of being very privileged and I remember one day standing out on the balcony with my doll and looking across the street at an African girl who was about the same age who was also holding up her doll. And just noting the disparity in the quality of the houses that we were living in and feeling that somehow that wasn't fair but I loved the experience of going to L'ecole de la Marina and I think that too has had a profound impact on my world view as an adult. A lot of what I do professionally is - most of our charter schools that we start up and manage are in the inner city and Inc. magazine has something called Inner City 100 the fastest growing companies that serve, that revitalize, generate jobs for, really enhance inner city populations in the U.S. and our company for three years in a row was in the top five. So the need is really great in neighborhoods where children live poverty. And so much of what I feel really deeply about is not prejudging what children are capable of accomplishing and really holding a high standard and a high expectation for everyone and rising to the occasion as adults to serve that need. And a lot of it I think goes back to how I felt on that first day of school looking around me at the all these kids, African kids who understood everything that was going on in French. I didn't understand a word. It was a hugely humbling experience and I think that that childhood experience and being a minority having - really I recall that it was just a very happy culture. It was a wonderful time in life and I think that that had an impact on the way I see these children in the U.S. living in poverty and not all of them. We serve children in affluent neighborhoods too but I think that even as a child I was keenly aware coming back to the States in seventy two how marginalized African Americans were in this country and just being astonished by that because I'd really idealized the States living overseas and it was - it was a surprise. Interviewer: Were you stationed in any of the other countries in Africa? Interviewee: We were in Nigeria for a year and we lived in Kaduna in the Hogan's house after they moved out. That was - it was a huge cavernous house great for telling ghost stories. There were parts of the house we never even went into and that was during the civil war so we stayed very close to home. There we ended up going to a Catholic school, Sacred Heart and that's when I had my encounter with British education and it really for years I had some issues with my spelling as a result. But it was - Nigeria was a positive experience for my brother and me as children but unfortunately that was the time that my parents' marriage was starting to come apart. So that was for them I don't think nearly as positive as Togo had been. Interviewer: You were in a Muslim culture in Kaduna. Interviewee: Hmm. Interviewer: Did that hinge upon you in any way? Interviewee: Not in a way that I can recall. I don't really - maybe it had to do with the fact that we were going to a Catholic school but I think I was a little bit oblivious to that because it was never much of an issue with my parents and I don't think that that really registered. Interviewer: I would think that the environment in Togo was a much happier environment then? Interviewee: It really was. It was just such as positive place and really all the other expats there that we met I loved the peace corps volunteers for years as a kid that I aspired to serving in the peace corps and it just - it was a great culture. Wonderful gatherings, great music. The music too that my parents had on the reel to reel tapes that we played over and over again. The top one hundred hits of nineteen sixty six Bob Dylan, Blood Sweat and Tears, Beach Boys, but they made for some really wonderful gatherings. Interviewer: You spent some time in Bangladesh with you father? Interviewee: We did. My brother and I spent about half of the summer. The year must have been seventy five and we went to Bangladesh first and stayed in (Aham) and he was wrapping up some work and then we went together to Nepal and stayed in Dave Newberry's house in Kathmandu and we went to India and we were in New Delhi almost the whole time we were there. We did a couple of side trips. I think my brother and I went to see the Taj Mahal one day and we spent a week on a houseboat in Kashmir as well and that was an interesting experience because the only meat that one could eat there was lamb. So we either ate lamb or things cooked in lamb's grease. The left an impression too. French toast in lamb's grease. Interviewer: Do you still like lamb? Interviewee: I really don't. Not so much, not if it's gamey. Interviewer: And I think that's - to me that's one of the problems with lamb today is not gamey enough. You hardly know you're eating it. Were you in Bangladesh long enough to have any feeling for the country? Interviewee: I remember the crushing poverty of the country and seeing a body on the street and I couldn't discern if the person was sleeping or dead. It was, I was just really aware of the poverty and it was also so incredibly muggy. That also left quite the impression. Almost hard to breathe there and in India and you know this was in the back half of the summer so it was incredibly hot and humid. No I just - I remember Bangladesh as being - and I was a little older too. I was fourteen when we visited Dad that summer so I was very aware of children living in poverty and begging and you know missing limbs. It was very hard especially coming from living in the States for a few years then, living a very comfortable middle class lifestyle and then experiencing the poverty was - it was a lot more shocking at that point. Interviewer: Is there anything else about your experiences that you would like to get on the record? Interviewee: Yeah. I think what's really most remarkable to me about those years besides the fact that it was truly an idyllic childhood and a time to be able to enjoy family, friends, gathering, time for reflection, time to really, to read, to sing, to get to know a few texts really, really well because there weren't a lot of other distractions. And I'm very proud of having been a part of smallpox eradication as a child experiencing that because it was such an amazing endeavor and I remember upstairs in the bar you know the house in Lome dad kept scabs in the freezer of the things of that - we just never went into that refrigerator. It was also a bar. We weren't supposed to be there but I remember even at the time - I remember even at the time being very proud of the work that my dad was doing and really liking the people he was working with and finding it really interesting to hear the stories of when he was breaking bread with the chief of the village and trying to negotiate access to the veiled women so that he could vaccinate them. I loved the time that I got to spend with both of my parents with that lifestyle. Dad and I used to play chess all the time and that was a lot of fun and we spoke French together and that was enjoyable. From my perspective today it's - I'm very proud to have been a part of something so historic and huge and I loved doing the reunion a couple of years ago. The reflections about how the young doctors and - what were they called? The operations... Interviewer: Operations officers. Interviewee: Officers, operations officers, really in many ways didn't know what they didn't know. That's something as an entrepreneur that I can really appreciate and it's something that I think it's what's truly remarkable about this global endeavor that was really impressive [inaudible 19.40] at the time. Sometimes not knowing what you don't know, not knowing the magnitude of the project that you're taking on is a blessing and thank goodness, thank goodness we had courageous, bold, ambitious, tenacious, brilliant, dedicated people who with all those qualities didn't know what they didn't know and they kept at it and they chased this disease from the face of the earth. Interviewer: And most of them were very kind people. Interviewee: Absolutely. Absolutely so. It was, it was a great community to be part of and I remember that vividly even as a child. These were - several of these folks I called uncle for years to come and even at the time I knew that it was special and we were part of something that we could be proud of. Interviewer: Thank you. </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/jdlLEyID2OI" 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 2008-04-03 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/15jnn emory:15jnn Subject The topic of the resource CDC Smallpox Eradication USAID WHO Life as expatriate child Format The file format, physical medium, or dimensions of the resource 4466760000 bytes video/x-dv Creator An entity primarily responsible for making the resource Sencer, David (Interviewer); CDC Eidelman, Dawn (Interviewee) Contributor An entity responsible for making contributions to the resource Centers for Disease Control Title A name given to the resource EIDELMAN, DAWN Description An account of the resource Dawn Eidelman, daughter of Andy Agle, who served as an Operations Officer in Togo and later in Southeast Asia. Dawn begins by recounting her first day at a French school in Lome, Togo at age 5, coming down with malaria, their unusual household pets, celebrating holidays while living abroad, as well as realizing disparities of wealth as a child. Later Dawn accompanied her father on smallpox eradication work trips in Bangladesh, India, and Nepal. Dawn expresses her pride in being a member of the of the Smallpox Eradication Program community. Language A language of the resource English