2 12 68 https://globalhealthchronicles.org/files/original/54a001c3adbdad32e563666a7e044879.jpg eca63236a0238d140a941f47d4589827 https://globalhealthchronicles.org/files/original/cf36c4cf42ab778f098348ab7657d124.pdf 87532066f4be21f88ff723979948bbb8 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 Mark Rosenberg with Interviewer Dr David Sencer Transcribed: January 26, 2009 | Duration: 0:40:25 David Sencer: I am David Sencer. I am interviewing Dr. Mark Rosenberg. We're on the stage at CDC: April 3, 2008. Dr. Rosenberg has been informed that he is being filmed and audioed and has signed a release for us. So we'll start. Tell me a little bit about your early days. Mark Rosenberg: I grew up in a family that was committed to social service and community action: health, medicine, public welfare, and I had a father who was very interested and active in his unions. He was in a good union, the International Typographical Union, and didn't go to college until he put all his kids through college, and my mother was a physician and she practiced for 61 years in Montclair, New Jersey, the town where we grew up, and she did some very good things, socially active things in New Jersey. She was the first physician ever to see black people as patients in her office. She volunteered for Planned Parenthood and she was the physician at Montclair State College for about 35 years and maintained a private practice for a long time. I think she was a very important influence. I'd like to think that I made a rational choice to go into medicine for reasons X, Y and Z, but I think probably trailing her around for a long time, seeing what she did, and having that kind of spillover, being exposed to how much she valued what she did, probably influenced me to go into medicine. I went into medicine I guess after college, I went to medical school and was always still interested in public service and during medical school, took time off to go study Government and Public Policy at the Kennedy School for the first year that it never had a combined MD/MPP program. So I went there, spent a couple of years there and then did an internship, and a residency and then I had signed up for a draft deferment, but the draft had ended before I went, and came to CDC because it was something I wanted to do. It seemed like an interesting way to learn about Public Health and came here and was in the Enteric Diseases Branch for two years with a very, very good crew of people, and it was an exciting branch. We had lots of outbreaks. We had salmonella, shigella, botulism, waterborne diseases, and the opportunity came up to go work on smallpox in India and it seemed like a fascinating chance to do something very different from enteric diseases in the United States, so I signed up to go off to India. I did not have any idea what to expect. David Sencer: What was your first impression of India? Mark Rosenberg: I thought I had stepped into the set of a movie, a movie that started 2000 years ago and was an unbelievable mix of people. I went to West Bengal and we were around Calcutta and spent a lot of time in Calcutta, and I just thought that it was a fascinating city, and an incredible place, the mix of people, people driving in cars and people living on the streets. The other thing, I've always been interested in photography and I decided then to do a lot of photography in India and I just remembered the scenes of incredibly beautiful brown bodies throughout the States. I mean, people in the fields, working in the sun and starting to sweat, people getting up in the morning on the streets as the sun started to go up, living on the streets, but living very clean lives, bathing, living, feeding, raising families while living on the streets. Visually, it was an incredible place to be. David Sencer: Was all of your time in India spent in West Bengal? Mark Rosenberg: Just about-the time working was in West Bengal, but then at the end I took an extra month and went with Jill who was to become my wife and we traveled around to more of the standard tourist places. We went to Delhi, we went to the Taj Mahal, we went to the Ganges, we went to Asan; we went to Darjeeling, Nepal, Katmandu. We traveled a fair amount. David Sencer: Was there much smallpox in Calcutta when you were there? Mark Rosenberg: Unfortunately, there was none that I could find. When we got there in 1976, we were searching for cases and that was basically the work that I did during the day and evenings. We went around; a team with myself, the driver and an interpreter, looking for cases of smallpox and we put out rewards, but the cases that were reported to us were really chickenpox at that time, and the reward started going up and up and up, and we didn't find a single case of smallpox. It made me feel like we were kind of in a second wave and I wished I had been there when there was smallpox because we were kind of the clean-up crew. David Sencer: Were you there on your own or were there other people from CDC and WHO? Mark Rosenberg: There were other people from CDC who went over with me at about the same time. Dick Jackson, I remember went at the same time, then we ended up back at CDC. We both left for awhile after our EIS time and then came back to CDC and serve there at the same time. So there were several people from CDC. David Sencer: Was he in West Bengal or no? Mark Rosenberg: I don't think Dick was in West Bengal. David Sencer: But you were there alone? Mark Rosenberg: No. There was someone from Czechoslovakia, Fred Bagar [inaudible0:06:41] and he was there. He was an older person who had served as a Community or State Epidemiologist in Czechoslovakia and then had come back to do this service, so we were there together, and saw each other when we came back to the city. We spent most of our time in the - suburbs isn't the right term, but outside of Calcutta, in the very small villages, driving around routinely, but also then taking detours where there was a report of a case, we'd go check it out. David Sencer: Who handled your administrative details? Mark Rosenberg: There was someone assigned from WHO and I don't remember the name of the person, but someone in Calcutta itself. David Sencer: Bill Foege had left India by then? Mark Rosenberg: I think he did. I think he was ordered back by someone - or no, he wasn't ordered back, he came back against orders- that's right. That was the amazing story that Bill had left. So I didn't really encounter Bill in India at the time that we were there. The person who was in charge was a French person who was assigned by WHO. David Sencer: Nicole. Mark Rosenberg: I think so. David Sencer: Grasset. Mark Rosenberg: Yes; and [pause] no - Bill had been there; and I didn't really get to know Bill until we came back and then he was - there was a Preventive Medicine Residency Head back here, so what Dave worked with Bill on was back here, at the case of Crater Lake. We worked that up into a teaching case for Preventive Medicine Residence, but unfortunately, he wasn't in India when I was there. I'm sure you have this story about Bill's departure from there, but it's one that impresses me. One of the things that we work on now is the issue of collaboration and coalitions, and we've looked at lots of coalitions in global health, looking for the elements that make them work: When are they successful, when are they not? What you need to think about when first putting them together? How do you frame that last mile? What do you set as your goal? Because the most important element in any successful coalition is framing that last mile in a way that everyone develops this shared goal; and that is an overriding goal and a motivating goal to keep you together. So we've studied a lot of coalitions in global health because as it turns out, even though there are many coalitions formed, very few of them succeed. So one of the stories that we talked about is what's necessary for a good leader to be an effective leader of a coalition; and one of the things that you need is really this quality of ego submersion. You need to be willing to step back and let your partners stand in the spotlight and get the attention, get the publicity, let them get the credit. I don't think there's ever been anyone as good as Bill in doing that; and the story that always impresses me whenever I think of this notion of ego submersion is Bill going to India, when he was sent there by you to work and to apply the containment theory and as I heard it, Bill decided that several months before the last case was eradicated in India, he would come back home; and he could come back home because the containment theory, even though it was questioned at times and almost reversed by the Minister of Health, they were able to continue it long enough to see it succeed; and within a very short period of time, less than two years, the cases started to fall very close to zero. When Bill saw that they were going to eradicate the last case maybe six months later, he called you, his boss at CDC and said I'm coming home and I'm bringing my family home; and he told me you told him, "You can't come home. You've got to stay. Don't you realize that what's going to happen in six months is some historic landmark that's never been matched in the annals of Public Health? They're going to go from 83,000 cases down to zero in two years and this is going to be a momentous day. You've got to stay there for this." And Bill said, "No. I'm coming home and my family's coming home because if I'm still here when this last case is eradicated, then all the credit is going to go to the foreigners. It's going to go to the Americans-and this is something that's got to be credited to the Indians. They did it. They made it happen; and if I'm here, they won't get the credit that they need. I'm coming home." And you said, "No. You're not." He said, "Yes, I am." He packed up, he put his family together and they left India and they came home. They weren't able to get into their home because the keys that were sent to him to get in were not the right keys to get in, but he came home. He packed up and left. That was an extraordinary thing, but I've never come across an example of ego submersion that's so complete and so universal in everything he does. Still-in everything he does. David Sencer: What effect on your life did your short term in India have? Mark Rosenberg: I think I'm just learning the ways that it had an effect on my life. It gave me an experience in global health that complemented what was mostly a domestic outbreak investigation that I had. I don't think there was ever any question in my mind even when I was doing outbreak investigations as an EIS Officer. There was no question that I wanted to stay with public health and would stay with public health. But I think this really solidified it. It was just - it was going into another world. I mean, stepping off the plane out of the modern world, into the world that was 2000 years old and unchanged; and you could step onto a street where there were cows and elephants, people walking, people sleeping, people selling, people eating and bathing, and shaving on the street in a scene that was unchanged for hundreds and hundreds of years. To have witnessed that and to have been there was an amazing, amazing experience. It made me see that there's not just one world, but there are multiple worlds that exist at the same time, and I don't think there's any place as rich as India. Even today, you see multiple worlds existing side by side, people being shaved in the middle of a street that's now a major road around the modern city of Delhi. People living their lives somewhat oblivious to the motorized traffic that goes by and to the people who go by in Mercedes, and to the people who are doing business in high skyscrapers, but multiple worlds living together at the same time. I think you need to understand that if you're really going to work in global health, that there are multiple worlds where people live and are born and get sick and die, in parallel universes at the same time. But it was an amazing impact on me. I went on to go back - we went back from Atlanta up to Boston. I'd signed up to do a Fellowship in Infectious Diseases at Mass General, but I decided that I had done a lot of photography in India and wanted to do more photography; and so, deferred this fellowship in infectious diseases and ended up spending a couple of years, working on a photographic documentary of patients and illness, trying to show what it was like to be sick. I knew what it was like to be sick, but during this experience I realized that being a doctor is a separate world from being the patient. It's like these separate worlds that existed in India. The same thing exists here and doctors think they know the world of patients, but doctors know the world of doctors. They know sickness from the perspective of the doctor, not from the perspective of the patient. So I spent some time doing this photographic documentary and spent hours and days and weeks and months with the patient seeing their story and taking photographs, and interviewing them to put together their stories. Again, that was a transformative experience for me. It was an amazing experience; and I really realized that I didn't have the faintest idea of what it was like to be a patient. I didn't even know that I didn't know what it was like to be a patient, and this experience really showed me that other world. It was also an amazing experience. David Sencer: Did you hear Anne Fadiman[0:16:17] when she was here? Mark Rosenberg: I didn't hear her. I was sorry to have missed her, but I think she tells the story in an amazing way. David Sencer: One of the things that I remember is, she said, "You don't catch a disease. The disease catches you." She was advocating - one of the things that she advocated was that every chart should have a picture on the cover of the family. Mark Rosenberg: [Pause] - That is a powerful voice. David Sencer: Yes. Mark Rosenberg: You know, for the patient. David Sencer: Is there anything else about smallpox you'd like to say? Mark Rosenberg: I'd like to say that this revisiting it for this 30th Anniversary of the eradication has been a wonderful thing. It made me realize what a significant event it was; and again, the idea that we could eradicate a disease has certainly affected a lot of the other work that we do. I work now at the Taskforce for Child Survival and Development, the taskforce that was started by Bill Foege when he left CDC and we work on a number of diseases where we're aiming for - if not complete eradication, at least elimination as a Public Health problem or eradication of one aspect of the disease. So we work on river blindness and there's been tremendous progress. We've delivered over 700 million treatments of Mectizan for river blindness. We're embarking on a program where we're treating intestinal infections, intestinal parasitic infections in young children probably is the most widespread infectious disease of children in every place in the world. There are probably two billion people at risk for these intestinal parasites. I think in all the work that we do, we're inspired by the idea of eradication, and by the possibility of eradication. I think we think very differently about eradication, knowing that it was done and it has been done even in diseases that are not infectious diseases. The latest example is an area of road traffic injuries, but most people think of road traffic injuries as accidents, things that just have to happen, and in fact, road traffic injuries are an epidemic. They're an epidemic beyond people's ability to imagine, but there are more than 1.2 million road traffic deaths every year. For every death, there are between 20 and 50 serious injuries; and the predictions are that, if we don't do anything about this problem, most of which exist in the developing world. It's 85-90% in low and middle income countries. If we don't do anything to speed their ability to address the problem and turn this around, and if it takes them as long as it took us as being the United States, the U.K. or New Zealand, Australia. If it takes them as long as it took us then we will loose 100 million lives to road traffic injuries. We have the tools to prevent it. We have the equivalent of vaccines for road traffic injuries right now, but it's a horrible epidemic that's coming. For many people, they don't pay much attention to this. They say these are just accidents, they are just part of modern day life and it's this fatalism that's so bad and that keeps it going. But in Sweden - in Sweden, a group of dedicated people said, "We can eradicate road traffic deaths. We don't have to have any of them at all. We can completely eradicate this problem and wipe it out." They said, "We can do the same thing to road traffic injuries that was done for smallpox. We can eradicate it." They started talking about this about 30 years ago, and when they started talking about it, people just laughed and said, "You're crazy." As you add more cars, as more people start driving, you build more roads. The number is going to go up. Inevitably, it'll go up; and they said: it's not inevitable that we can eradicate this. They started working to build safer roads. For example: they took out red light intersections and put in traffic circles. They told me, "Red light intersections cause deaths. How? Because what happens when you get to a yellow light? When the light turns yellow, many people speed up; you cause a high speed collision and that high speed collision is fatal, and red lights actually kill people." So they took all of these red light intersections out and they put in traffic circles, and the death rate came down by 90%-ninety percent. That's as effective as our very best interventions in public health or global health. It's as effective as our best vaccines. So step by step, they built safer roads; they put barriers down the middle that also brought the rates down by 70-80%. They built safer cars, Sweden is famous for that and they made people obey speeding and drinking and driving laws; and by doing that, they brought their death rate down incredibly low. They started with a focus on children and 30 years ago there were probably about 137 children who died in the road traffic crashes; gradually came down 135, 131, 127. Three years ago, there were 11. Two years ago, there was just one death of a child in the road traffic crashes. Vision Zero is what they called this campaign and it's inspired by smallpox and they're going to eradicate road traffic deaths. I think this is going to inspire the world to start to turn this down. Three days ago, we were at the UN; the general assembly met and it met just on the topic of road traffic deaths. This epidemic now is really bad. The global burden of disease from road traffic deaths is greater than malaria and it's greater than TB, greater than both of those, and the general assembly met and they passed a resolution that for the first time ever, there will be a UN Global Ministerial Conference on this issue. It's going to come to light, and this notion of Vision Zero that you can eradicate road traffic deaths is going to drive this Ministerial Conference, and it's going to drive the world to change-that comes from smallpox. It's a lesson learned from smallpox. They wouldn't have been so brazen. They never would've thought of the idea of eradication, had it not been for the success of smallpox. So I think we often think: How has it affected our notion of infectious diseases? It's gotten well beyond infectious disease and this whole notion of Vision Zero really owes a big debt of gratitude to the eradication of smallpox. I think it has affected our thinking; it has affected our approach and hopefully it will affect what we can deliver for the good of mankind. David Sencer: Thank you. If we could just switch gears for a minute: Do you want to take five minutes and tell us about St. Helen? Mark Rosenberg: St. Helen? I didn't - Crater Lake or St. Helen? David Sencer: Crater Lake, rather. Mark Rosenberg: Crater Lake. Yes, [pause]. David Sencer: This is for the other archives. Mark Rosenberg: Okay. So I don't have to tie it into smallpox eradication? Crater Lake was an incredible adventure. We got a call one day in the Enteric Diseases Branch that Jean Gangarossa[0:24:29] and Mike Merson who were our supervisors and they said that a lot of people were getting sick at this park in Crater Lake, Oregon; and they think maybe there's a problem there. They're not sure, but maybe it's a problem that CDC ought to help them with. So the Preventive Medicine Resident was sent out there to do a quick and dirty survey to find if there really were people still getting sick and was it widespread. This Preventive Medicine President named Jeff Koplan, did this quick and dirty survey and then we had a conference call back in the Enteric Diseases Branch. Everyone huddled around the phone while Jeff said: yes; it had an attack rate that seems among the staff to be well over 80% and that on tour buses, people were still getting sick after going to the park. They had no idea what was causing it, but could we send someone out from Enteric Diseases and could we do an epidemic aid investigation. So I got sent out the next day. I flew out. I had to fly first to San Francisco then Crater Lake, a National Park. It's a 200-square-acre track that has the main point of interest as an extinct volcanic crater that's been filled completely with water. This lake is 2,000 feet deep and it's billed as the world's cleanest water, and it's billed as one of the Seven Wonders of the World, Crater Lake. So I got sent out to Crater Lake because something was wrong. I got to San Francisco but I missed the connection. I left home, probably at about 5:00 a.m. to get to the airport here. I missed the connection there, then waited around five hours in San Francisco, flew up to, I think Medford, Oregon, and then rented a car. This was now late at night - very late at night and I had to drive through woods and through forestland for about four more hours, finally arriving at Crater Lake at about 2:00 a.m. Eastern Time; and when I got there and everyone was sitting around: the Youth Conservation Corps, Jeff Koplan; people were sitting there and I was more than ready for bed, but they showed me some reports of the water and I looked at these reports of very high coliform content and then they said, "What do you think about this?" I guess I told them what I thought about that. Then the next day, we got up early. It was still all covered in snow, because even though it was in July, the snow doesn't melt except for a very short period, at the end of July and August. So we started out and because of these high attack rates, we thought this was waterborne, but we couldn't prove it. So we set out collecting some water samples. We tried to look at the water delivery system in the park. They said, "You don't have to worry about the water because this is the cleanest water in the world and this water comes from a deep underground well- it's got to be clean. It can't be the water." Well we were nervous because everyone on the park's staff was sick. The Park Superintendent had been sick for so long, he'd lost 35 pounds. Everyone in his family was sick. The attack rate among the staff was over 80%; among the Youth Conservation Corps it was almost 100% attack of a disease characterized - people were throwing up, vomiting and then they had sustained diarrhea, and the Park Superintendent, until two days ago, hadn't even thought this was a problem. He thought, Ah! 35 pounds of weight loss, three weeks of diarrhea, my whole family is sick. It's just the bug. This is the flu bug. In fact, the person who ran the concession at Crater Lake told them, "This is just the flu. This is what comes every year. It's nothing. You don't have to look into this." In fact, he had told all his employees to keep working; and so the Chef was sick, had this vomiting illness, but he kept a little bucket on the stove where when he got sick, he could use his bucket, and the owner of the concession had told everyone, "Just keep working. You know, if you have really horrible diarrhea or if you're vomiting, carry a bottle of Pepto-Bismol around with you and sweak[inaudible0:29:00] that as you go. After a day, the snow started to melt so we could start to get some water samples and see that the sewer system had been jerry- rigged and water was going up to the area near the lake with no chlorine in it. So we sent some more samples to be analyzed. It turned out, these also came back highly contaminated and people were still getting sick. We did some quick and dirty surveys; and by the end of the next day, we had rough estimates that there were 3,000 visitors a day to the park and that about 70- 80% of them were still getting sick. So we spoke to our bosses back here at CDC. We said, "We think you ought to close the park." They said, "On what basis do you propose closing the park?" And we said, "It's a very high attack rate. It's a very serious illness. There are old people who come here. If they get sick and dehydrated, they could die. We think we ought to close the park, and we think there's nothing else that explains this high attack rate: that is food and waterborne and we think it's the water, but we'll get the evidence." Our bosses said, "No. You need to keep the park open. You need to collect evidence. You just have convenient samples of people calling in from the buses and tours who come, and you need to keep checking." And they said, "Besides, how'd you know it's the water? Maybe this is some mosquito-borne illness. But we have never heard of a mosquito-borne illness that causes this level of attacks in diarrhea, but we kept working. The snow kept melting and the next day, I was doing rectal swabs because we had to get cultures, bacterial cultures to look for the culprit, and I think I had finished about 230 rectal swabs. I was ready for a break and Jeff Koplan called me up. He said, "You've got to come out here and look at this." The snow had melted and they found a sewer that had been blocked and it had all backed up and the sewage looked like it was running downhill towards the stream. We put some fluorescence dye up behind the sewage to see if there was contamination from the sewage into the drinking water, then we used fluorescence because just one part per million would show up under ultraviolet light; and we thought no one would be bothered by seeing this in the drinking water, but we could see if the water got contaminated. But it turned out that the drinking water was this little surface stream. The surface stream was just downhill from where the sewage was backed up. So if you can imagine, bright fluorescent green sewage flowing down the snow-covered hill into the drinking water, turning the water green. This was incredibly heavy contamination and we decided at that point that - and this is the drinking water for the whole park. People would come to the park. There was no other source of water. We thought we could bring in bottled water, but that would take days to bring it in. So we thought that the park really needed to be closed down. So we started issuing signs and putting them around, "Don't Drink the Water. Don't Touch the Drinking Water. It's Not Safe for Anything Except for Flushing Toilets." We went to the concessionaire, we said, "Don't share food to the people who are here because you are going to serve food cooked with contaminated water. You're going to serve on plates that have been washed in contaminated water. Don't do it." He said, "I've got to serve them breakfast. I've got to serve them breakfast." Then we said, "Okay. Then serve potato chips and things that come in bags, but nothing cooked." He served breakfast the way he usually does with oatmeal made with this crate water, with eggs made with this crate water, on plates cleaned with this crate water, but we had a conference call, there had never been a case of a National Park being shut down due to illness in the history. So we had to figure out how do you close a National Park that had never been shut? And so CDC didn't have the ability to declare it shut, but CDC dealt with the Bureau of the Interior and they finally got permission to shut down this park, and it was shutdown that next day. It was the first time in history that a National Park had been shutdown due to illness. The park was closed and they had this massive cleanup job. Massive because all the water, all the pipes were contaminated basically by sewage, and then the drinking water, if you let it settle, you could see particulate sewage in the water. After several weeks the park was re-opened and people went back. There were sporadic cases of continuing illness, but we went back to investigate that. It turned out that that was just sporadic illness and the water was clean; there is no more waterborne disease: and we thought, Thank goodness. Thank goodness we're finished. This was one big outbreak. Then, I think a few weeks later you, Dave, came into my office with your sleeves rolled up and you were carrying a letter. You said - so I was this EIS Officer, still pretty intimidated by what went on - and this was a letter; and I think it was from Congress and it was saying that; "There's going to be a congressional investigation of whether or not there was a cover-up at Crater Lake. They said, "Would you please explain, Dr. Rosenberg for the record, if what you said when you first arrived there that night when they showed you these water samples, would you explain if you really said this; and if you said it, why didn't you close the park as soon as you got there?" And it said, "This is what you're quoted as saying Dr. Rosenberg; when you got there that night and you were shown the water samples, you said, 'You've been drinking pure shit.' If you said that, why didn't you close the park right away?" So this became a long series. We had to prepare - it wasn't clear to me how you respond to that kind of letter. You were very cool. You were very calm. I would've thought that if I had one of my low level employees saying this kind of thing, and on the Congressional record, that I would've gotten rid of him post haste. But you were very patient. You said, "We're going to prepare a response. We'll figure this out. We'll figure the right way to respond." And we did. Then we testified. There was a Congressional hearing out there in Medford, Oregon, and we went and we testified, and I still have the Congressional record from that hearing because the first three pages are solely devoted to whether or not, Dr. Rosenberg actually said, "You've been drinking pure shit." Three (3) pages of Congressional record; and the Superintendent of the park was very sympathetic; he said, "Dr. Rosenberg never would have said that. He must've said: You've been drinking animal waste." Then someone else asked him, "How would he know it was animal waste instead of human?" I'm sure I said what I was accused of saying. I was tired. I was exhausted. I thought I was talking to friends, but that became a teaching case of Crater Lake and there are lots of lessons to be learned, both how we handled it and what you might expect. David Sencer: After that, your name was Shit? Mark Rosenberg: It was and in certain places, it still is. But we survived. David Sencer: Those were my - [crosstalk 0:37:24] Mark Rosenberg: Let me just add. I think for me, I always knew that the Director of CDC, when I was there as the EIS Officer, was special, because you would always come around - we were in the Enteric Diseases branch and you would always come around the day before the MNWR was coming out. We have lots of stories about whether it's Salmonella outbreaks, church picnics, eating contaminated food, and there's always something in Enteric Diseases Branch coming out in the MNWR; and you always came by. You always came by with your shirt sleeves rolled up and you would sit down with us and go over it and ask us some questions about it, and you cared about what we were doing. You spoke to us and we were EIS Officers, and you were the Director of CDC and you came by, totally without pretense, without arrogance, just to sit down with us with your shirt sleeves rolled up, and that had an incredible impact. Not just on me, on all the EIS Officers. You knew them. You spoke to them. You deigned [0:38:28] to have contact with them. It was an amazing and wonderful thing. Then when this letter came from Crater Lake where you came and you sat down with me and you had that letter, I thought I would've been fired on the spot; and instead, you said, "Let's figure out how we're going to respond to this." And it was together. Let's figure out together how we deal with this. I thought, "What an amazing man?" What an amazing man you were? You remained so and you still are, but that was certainly a formative experience for me; an amazing experience and a wonderful experience. David Sencer: Just one of those things at CDC-Just another day. Mark Rosenberg: It wasn't just one of those things. Not at all! There are some things small that happens everyday, but something really, really important. I think as an EIS Officer, one of the things you learn is how to bear yourself and how to conduct yourself in this world and with your colleagues and in your business, and I think if you're lucky - if you're lucky, you get to connect with mentors who are an example that's always held out there. I always remember a book by William Golding, the author of "Lord of the Flies" and in his book, he said that, "Our lives are constructed out of bricks and we build our lives one brick at a time. But the bricks aren't the ideas. The bricks with which we construct our lives are people. They're the people that we meet." You've been a brick for me, a very important brick, a very important part of my life, and an amazing thing and I am so ever grateful that I had the chance to work with you. David Sencer: You were one of the products of Montclair, New Jersey, that wasn't cheaper by the dozen. Mark Rosenberg: Well, thanks. David Sencer: Thank you, Mark. Mark Rosenberg: Thanks, Dave. [End of audio - 0:40:24] </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/6tqcIUqtGxs" 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 2008-07-29 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/15pd3 emory:15pd3 Format The file format, physical medium, or dimensions of the resource 8724720000 bytes video/x-dv Creator An entity primarily responsible for making the resource Rosenberg, Mark (Interviewee); cdc Sencer, David (Interviewer) 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 ROSENBERG, MARK L. Description An account of the resource Dr. Mark Rosenberg served as an field epidemiologist in India with the Smallpox Eradication Program. Subject The topic of the resource oral history Language A language of the resource English https://globalhealthchronicles.org/files/original/d6d8f6e0a7baee2ec152e3d916cdd917.jpg 9c82c9143b5028c1060873b6bb60a25f https://globalhealthchronicles.org/files/original/14c20f3205f97b3b2a9a23136d88498e.pdf 271551e47c57078b6293465233fdef7c 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: Vince Radke Audio File Transcribed: January 29, 2009 Interviewer: I'm Dave Sensor and I'm interviewing Vince Radke. Vince is an employee of CDC. It's April 1st, 2008. We're interviewing at CDC in the afternoon and Vince realizes that he's being photographed and recorded and he's signed the permit. First Vince in ten minutes or less... Interviewee: Okay. Interviewer: ...tell me about your early years. Interviewee: Okay, Dr. Sensor. Early years born and raised in Detroit, Michigan. Did my undergraduate at Michigan State University in biology and... Interviewer: Too bad. Interviewee: Too - yeah I know. Well, you know, these graduates from Michigan, you know. I always got to put up with them. But then after that - well while I was at Michigan State I put an application into the peace corps and about a year later I get a call from a gentleman and he said, "Vince would you come to Philadelphia? We'd like to tell you a little bit about Ethiopia and a little bit about smallpox." And I said, "Oh that would be great." Well the next thing I did, made a beeline for the library and got all the books I could on Ethiopia and tried to find out what smallpox was. To make a long story short, came down to CDC in nineteen seventy. They were having a training program for two weeks for the peace corps volunteers who were going to be going over to Ethiopia. So, the best, the best by far training I have ever had in my entire life was those two weeks here at CDC in smallpox. I had some great, great instructors. D.A. Henderson was one of them, Bill Fergie and others. It was just, just a fantastic time. Right after that then we flew off to Ethiopia and for the next three and a half years I worked in the smallpox eradication program there in Kaffa Province. Interviewer: What had you been doing before Ethiopia and after college? Interviewee: Well, right - I came in right in out of college. That summer is when I went to - I had just graduated from Michigan State. That was the summer of nineteen seventy and the - that July we were in Philadelphia for the first interview and then the summer I spent visiting some friends in Michigan. And then a call came in September to come down for the training at CDC and this was September/October of nineteen seventy. And then we were here for two weeks for that training in smallpox eradication and then we hoped the plane to New York and changed planes there and on our way to Ethiopia. And for the next three and a half years that's what I did. The two, it was only a two year original commitment but we were - I enjoyed the work. It was tough but I enjoyed the work so they asked me if I would stay for another year and I said yeah I'll stay for another year and then stayed for six months beyond that. And then came back and then I knew that I needed to get some more education. So I started at the University of Pittsburgh to get my masters degree in public health and while there I was contacted by D.A. Henderson and he said, "Vince we could use some help in Bangladesh for a short while." And I said, "D.A. I'd love to come," and so made arrangements and for six months I worked in the smallpox eradication in Bangladesh. Interviewer: In Ethiopia what were your main responsibilities? Interviewee: In Ethiopia we, my partner Mark Strosberg and I -- also a peace corps volunteer -- were assigned to Kaffa Province. That's in the southwestern part of Ethiopia and we were there to find cases of smallpox and vaccinate. We were told originally when we saw the reports that the number of cases of smallpox in Ethiopia, couple of hundred a year. I think the year before we arrived they reported like seven hundred cases. Dr. Sensor I think within the first couple of weeks we were there we had over a thousand cases of smallpox. We would contact, go to schools, go to market areas in Kaffa Province and we'd ask, show pictures of small pox and we would be inundated with people saying in their village or in their areas there was smallpox. And so we picked a couple of villages and I went one way and Mark went the other way. And so we were looking for cases of smallpox, recording them, we'd record each of the cases of smallpox, we'd record the number of people that we would vaccinate, names of the villages and then from there we would get reports that would take us on to the next village and every - inevitably we found some smallpox. So for the next about three years I did that. Interviewer: Was the work environment in Ethiopia a good one? Interviewee: It was good. We were - we had great cooperation all along the line from the Ministry of Health in Ethiopia, also the World Health Organization. Our two smallpox people there from WHO were Ciro de Quadros, Dr. Ciro de Quadros and Dr. Kurt Weithaler. They led the program. You were - I was assigned to the Ministry of Health and you had an official government car and that helped very much. We went out to the Provinces and met with the governor and the local officials. They gave us good cooperation down there. Sometimes they would supply us with a guide and a translator even though they trained the peace corps in the local language in Ethiopia or the government language which was Amharic. In Ethiopia you have seventy different languages and two hundred dialects. So each time you would go cross another mountain range or move into another area you would be in a totally different language and so we had to have a translator with us and a guide. So the government officials were very, very helpful in doing that. Interviewer: Were you married when you were there? Interviewee: No I wasn't. I didn't get married until I finished in Bangladesh. Came back from Bangladesh in the end of seventy six and then met my wife at the University of Pittsburgh and then got married in August of seventy seven and then shortly after that went to Kenya to work on the smallpox eradication program. That was the last stages where we were trying to document that there were zero cases in Kenya. Interviewer: While you were in Ethiopia what was the most gratifying thing? Interviewee: Oh wow. That's a tough question because there was - Dr. Sensor there were a lot of gratifying times. To pick one. To me I remember one village I had been in Ethiopia and there was a number of cases of smallpox already in the village. Some children had had smallpox and we vaccinated and got good coverage, good cooperation from the local chief in the area and we felt we had a good job. And so we left that area and then moved on, on to another area. I went back a couple of months after and I was coming down the road one day and here was this chief that I had met a couple of months before. And he got off his mule and he came up to me and he said, "Thank you very much and thank Haille Sellasse for bringing you because you had saved much suffering for the children by giving them the vaccination." So that made me feel great and just knowing that we were beginning to stop this transmission. That was gratifying that indeed this plan that had been worked out it was working now, it was working and there were less and less cases as we went through the years. It was very gratifying. There was one time I had been out for about three months or so and I had reported - in a two week period I had reported over a thousand cases of smallpox I had recorded. It was just incredible and I remember talking to D.A. Henderson and he had said that at that time those two weeks that I had reported he said, "You and Mark Strosberg and the others that were working in Ethiopia at that time in Kaffa Province," said, "you had 10% of all the cases of smallpox for that period of time," so that was another gratifying moment. Interviewer: In some countries it's alleged that undue force was used to vaccinate people. Was that ever an issue in Ethiopia? Interviewee: No for the most part. I remember a few occasions when we'd be in the market vaccinating. We'd go to the market. Usually these markets they had once a week in an area so Wednesday was their market day and we knew this. So we'd go there into the market area and we'd do a couple of things. One we'd ask for cases of smallpox and the other one was that we would set up a vaccination for those that wanted it. Sometimes the local person in charge, the chief or whatever, wanted to make sure that everybody got vaccinated so they would drag some of the people to us to get vaccinated. So in that sense that was - but it was very, it was very rare. I think it was more often that if people didn't want to get the vaccination we didn't force it on them. And we knew just the methodology that we didn't need to vaccinate everybody. We knew if we got the majority of the contacts that we could break that transmission and indeed that was the case. So it really wasn't necessary for us to do that. I know all the volunteers that I worked with in Ethiopia, whether it was in Bangladesh I mean we never forced people to be vaccinated. Interviewer: Was there a big contingent of volunteers? Interviewee: In Ethiopia I think there were thirteen or fourteen of us that went over in the first group of peace corps volunteers and then every other year cause we were on a two year cycle, another group of peace corps volunteers would come in to replace those that were going. In the second and third year we got some other additional international volunteers. Some of them from Japan, some of them from Australia. We had volunteers there also. We had quite an international group of people in Ethiopia and Bangladesh from I would say twenty, thirty different countries. It was great to see the cooperation and working with all those different people. It was really great. Enjoyed it. Interviewer: Do you remember the name of the Director of the Ethiopian smallpox program? Interviewee: Well that was - the Director for the program he was an Austrian and that was Dr. Kurt Weithaler. Interviewer: The Ethiopian one. Interviewee: Oh, the Ethiopian. I can't remember Dr. Sensor. I worked with - you know the Ethiopians that I remember are the ones that I worked with. The sanitarians, the dressers that were down in Kaffa Province. Interviewer: The Director of the program was the director of the control of diarrheal disease in nineteen eighty seven after the government had changed and it was unhappy situation. Interviewee: Yeah, it was, it was. I talked and maintained a lot of my contacts over the years in Ethiopia and almost to the person they expressed the time after Haille Sellasse as a bad time, as a bad time, yeah. Interviewer: How long were you in Bangladesh? Interviewee: I was in Bangladesh for about six/seven months from April until November and I think that was seventy five or seventy six. I can't remember now. Interviewer: You were there as a peace corps volunteer? Interviewee: No, I was WHO short term consultant. Interviewer: WHO then. Interviewee: Yeah, at that time, yeah. D.A. Henderson said to me at the time, he says, "Vince," he says, "Yeah, if you're coming I'll tell you basically we're going to give you $50 a day," and at that time I thought man that's all the money in the world. So and - but more so than that just to get a chance of getting back to the smallpox program you know. Interviewer: Where were you in Bangladesh? Interviewee: I was in Sylhet district. When I got there at the airport, Stan Foster, Dr. Foster was there and he met us. First of all we went to the office and then he took us to this house they had. I think they bought the house and it was for the consultants that were coming over to work on the smallpox program. And we had I think two days of orientation and then they - he says, "Okay you're in charge on Sylhet district." And so went up to Sylhet district and worked there for the entire time except for those occasional times we'd come back to Dhaka for a meeting or something. A couple of interesting stories there. Since you were in charge of the entire smallpox program in Sylhet district, you'd have to pay the vaccinators and translators and other people that would help you in the smallpox program and we had to pay them. So we'd come down to Dhaka, we'd have our monthly meeting or every couple of months we'd have a meeting and the other thing was to collect - get the money so when we go back we could pay the people for the work that they had done. Well the denomination in Bangladesh was taka and I forget what the amount was. I think it was like fourteen or fifteen taka to the dollar or something like that. So I'd have this suitcase of money okay and I probably had sixty or seventy taka in it and I'd feel so uneasy with the suitcase of money, throw it in the Land Rover and drive up to Sylhet district with all this money. And I couldn't wait to pay the people so I could get rid of all these thousands and thousands of taka that I had to operate the program but... Interviewer: And [inaudible 16.00] Diego was back in Dhaka worrying about the receipts. Interviewee: Right, absolutely. Receipt for everything. I mean you signed your life away you know, even though at times having the Bangladesh money, the taka there it sometimes was like monopoly money. I didn't really think it was real but I did want to get rid of it because I knew - for them it was very important, you know for the vaccinators and the other people that were giving us a hand. Well, a couple - I could tell you [inaudible 16.29] there are a couple of other stories here. Interviewer: Go on. Interviewee: One story which I'll never forget. I'd been in Bangladesh for a couple of months already and they had this - one of the problems we had was we of course had to document that there was zero cases. So any time we'd get a case of rash we'd try to collect this specimen, get a scab specimen from abrasions, send it off to the lab but we would still do containment even though clinically it might be chickenpox and not smallpox. We'd do containment cause we wanted to be sure. So we'd have to do that containment until we got the lab report back. Well, they had come on with a new test, a rapid test for smallpox which we thought was great because we wouldn't have to do the containment for so long. And so I collected a couple of specimen, sent them down to Dhaka for testing and they came back positive for smallpox and I said well there's no way that this is smallpox. I said this was chickenpox. These were two chickenpox cases. So I called up Stan, Dr. Foster and I said, "Stan," I said, "I'm sorry but they screwed up with the lab here okay." And I said, "These are not cases of smallpox, these are chickenpox." He goes, "Well," he says, "See if you can get some other scabs and ship them down but still do the containment." So I did and then a couple of weeks later had another case of reported rash, did the same thing and it came back positive again for smallpox. So I called up Stan again and I said, "Stan this test is no good. I mean we're getting false positives here. I mean I can't - these are clinically, these are not smallpox cases." He goes, "Yeah," he says, "Yeah we've been having some discussions about that here." He says, "But I want you to continue to what you want, to continue to collect the specimens and send them down." So I thought to myself you know what I'm going to send him some specimens but they're not going to be scabs of chickenpox or whatever. What I went ahead and did was to vaccinate myself with the smallpox vaccine. Once I got a scab - I vaccinated myself a couple of times in the arm and I collected those scabs from the vaccine and I put those in the container and falsified the records and sent them down to Stan Foster and they came back positive okay for variola virus. And I said, "Stan," I says, "You know that's vaccinia virus." I said, "That's what's on there." And he goes, "Okay Vince." He says, "I knew you were up to something because when you falsified that report the name that you put on there was a very common Bangladeshi name and I just knew that wasn't the true case." So later on that test indeed was no longer used so we went back to the old testing methods. The other story in Bangladesh that was, that I'll always remember was my last case of smallpox in Bangladesh. We had gotten a report that there was a person with smallpox on a public launch. This was a boat that would go from village to village in Bangladesh up the river and we heard reports that this person had gotten off this launch at about three or four different villages okay, but in one of the villages he had spent overnight. So we went out and visited all those villages where we had gotten reports where he had stopped especially the village where he had stopped overnight to visit. Well it turned out that the people that he was visiting were relatives of his and indeed from all the descriptions that we had this was a smallpox case. And we had gotten there -- I don't know -- maybe about a week after he had been there and there was a small child. It was a female, she was two or three years old if I remember correctly and the mother had told us that she had a fever and I go, "Okay." So I said, "Well we're going to have to keep you in the house and we'll supply you with food and water. We'll go out and get things for you but we need for you to stay here." And so we did that and that - even though the child had fever we vaccinated the child because we weren't sure if this was going to be smallpox or not. Well indeed it did turn out to be a very mild case of smallpox but it was smallpox. And a little funny story - and the child did well and recovered and everybody was grateful. But what's interesting, on the form that we had we had to put date of onset and date of discovery. Well, in most cases your date of discovery was a few days after the date of onset of rash. Now, in this case when I filled out my report, I put the date of discovery a couple of days before the beginning of rash. And I thought this is really great, this is good work. We're getting ahead of the disease. I said we're going to - we've got this down. So I was very proud of myself. I was going down to Dhaka to turn in my report to Stan Foster. He'd gotten my report and then he said, "Mr. Radke I've got your report here." And I go, "Yeah, I'm very proud." And he goes, "You've got the date of discovery wrong." "No that was the correct date." "Mr. Radke you cannot find the disease before it happens." I says, "Well we did." I says, "We were right on top of it." And he goes, "No we're going to have to change the date of discovery at least to the date of onset of the rash." So I had to change my report for the date of discovery but what was really important to me was at that point I knew we had gotten a handle on the disease and we were - we had broken that transmission then so that made me feel good, it made me feel real good. Interviewer: What were some of the main obstacles to your work in Bangladesh? Interviewee: Oh, the monsoon season was really tough Dave. It - and that was, for me that was one of the roughest periods because it was hard to move during the monsoon season. The rains were intense, sometimes the winds were very intense so you couldn't get out as much as you wanted and what would happen in Bangladesh when the monsoon hit, the entire land would just flood out. The rice fields and everything would just be covered in water and some of the water could be fairly deep, eight, ten, twelve feet deep. And the only thing you have then in Bangladesh were these built up villages and those were the only things that showed and the people couldn't - they didn't have a lot of boats so they couldn't leave the island. And sometimes if the people or the cows got too close to the edge of the water in these villages, they would slip into the water. And you would see - there would be bodies that would be floating, there would be dead cows would be floating down the water. And it was just - it was tough to work in those conditions, it really was. It was a really rough time in the monsoon season to get around and then to see the death as a result of the monsoon season. It was bad. Interviewer: How would you say your work in smallpox influenced your future? Interviewee: Oh man, it set me on the road to public health. You've got to imagine, I was graduating nineteen seventy from Michigan State. I got to put this a little bit in context here. The killings at Kent State had happened that spring and I along with a number of other students organized to shutdown the campus at Michigan State and we did okay. We shut it down for a couple of days and then the president of the university got smart, gave the school a day off and by the time they came back from school we had - the strike had dissipated. But I didn't know what I wanted to do. I thought well because I hadn't heard from the peace corps yet and I thought well I'll go into graduate school and continue with biology maybe work in a lab or something. So when that call came about to be a peace corps volunteer in Ethiopia and work in the smallpox program, I was excited. And then when I got into the program and to see how a public health program could indeed benefit many people, to me that was very gratifying and I have been in public health in one aspect or another very since, ever since nineteen seventy. It sets me - that's where to get my masters degree in public health and I've been at state and local health departments ever since I got back to the United States in nineteen seventy eight, seventy nine and now I'm in environmental health but it's still it's a practice of public health. So I think there was only a short six month stint in my entire work history that I was in the private sector. So it's always been public sector and it's always been public health so I haven't left it. Enjoyed every moment. Interviewer: Why did you pick University of Pittsburgh? Interviewee: I had applied to a number of schools and Pittsburgh was one of the schools and at the time I'd gotten some financial aid. They were the only ones to offer some financial aid and as a peace corps volunteer even though they set aside some money for you every month while you're a peace corps volunteer, it wasn't a lot of money. So I didn't have a lot of money. In fact when I got to the University of Pittsburgh with a little bit of - it was a U.S. public health traineeship that I got. I also got - had to do some - I had a work study program so that's why I went there. The other schools were a little bit more expensive so I chose University of Pittsburgh. Good school, good school. Interviewer: Did you know Dr. Cutler? Interviewee: Oh my goodness! Did I know... Interviewer: Yes. Interviewee: Dr. Cutler was my advisor. John Cutler was my advisor. He was an inspiration to me. I know some of his past but he was a true gentleman, a true scholar. He guided me on my masters papers that I did and I - I'm always grateful. And he was the one that I approached after D.A. Henderson had asked me to come. I went to him and I said, "Dr. Cutler I have a chance to work in the smallpox program in Bangladesh. Do you mind if I break my education here for a little bit?" He goes, "Vince take all the time you want. In fact we probably can even give you credit for it," for some of that and so I was very grateful. Stayed in contact with him and his wife until his passing but I knew John - knew Dr. Cutler and just a wonderful - just a wonderful man, just a wonderful man. Oh man, that brings back memories. Interviewer: Maybe we better stop then. Wow. Interviewee: You know I've been very lucky. I have met some of the top leaders in public health that have guided me and I just can't - I just can't say enough you know. That I've met either at the school of public health in Pittsburgh or in the smallpox program. It's just tremendous, just tremendous. You can't put a price on that, you can't put a price on it. Interviewer: The smallpox program brought forth an awful lot of good people. Interviewee: Oh, oh my goodness. I can't say enough about Don Millard, D.A. Henderson, Bill Fergie, Joe Breman, yourself. I don't want to embarrass you. You guys were just - were just great, just great. And the support, I mean Dr. de Quadros, Dr. Weithaler, tremendous, tremendous people. Larry Brilliant another one. I can go on and on. I could go on and on. I mean they're just - it was just - it was an honor. At the time of course you don't know it. Actually they're just one of the smallpox guys but later on I come back, it was a real honor and privilege to work with them. And you know Steve - oh I could go and on. Interviewer: You know Larry Brilliant had these tee-shirts made in Bangladesh that said eradicate chickenpox. Interviewee: Pox, right yes, yes. I have a shirt and I'll wear it when I come in July that my wife knitted and it has on the back of it, it has the smallpox target zero on it. So I'll wear that. Interviewer: You can still wear it? Interviewee: Huh? Oh yeah. I don't wear it too often because I don't wear it out but I have it hanging up in the closet and I bring it out occasionally so this will be - I should have worn it here. Interviewer: We'll look forward to it. Interviewee: Yeah, yeah, yeah. Because she even after we got married she knew. While we were married we went over to Kenya for that last year for the smallpox program and she knew how important this smallpox program was to me. So when she knitted that shirt so I'll... Interviewer: You've been fortunate. Interviewee: Oh my God. Interviewer: Another country has been fortunate to have people like you. Interviewee: Oh. No, I am fortunate to have known a lot, a lot of good people in the smallpox program in the public health. And you know another story. I had - when I came back after I got my masters degree at the University of Pittsburgh I had also tried to get into CDC and the EIS program. Well at that time they wanted doctors and you had to have an MD or DMV and so I couldn't get in and I was always - I was always sad about that because I had remembered the training I had gotten here at CDC and the great people. And I thought boy what an institution to be a part of but I didn't okay. So I thought well you got to go on with your life, you just can't do nothing. So I stayed in public health but at the state and local level and that dream of getting into smallpox that faded until one day I got a call - I got an email from two colleagues. One at CDC who I had worked with on food borne disease outbreaks earlier and another colleague in Minnesota that I was working with and both of them said to me, "Vince there's an ideal job at CDC for you." They were looking for a sanitarian for their program there, the environmental health services branch. And I go, "Well." I says, "Guys I'm not interested now. My wife and I are in Minnesota, we're doing great." And the one guy at CDC who was an EIS officer said, "No, Vince you owe me okay. You need to at least apply here." So make a long story short, I applied and got in. To me Dave CDC was always the temple, the public health temple on a mount and so I'm so grateful to be here. Just so grateful. This is a great place to work. Great place to work. Interviewer: On that note we better quit. Interviewee: Yeah. </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/kInVdz_LBis" 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 RADKE, VINCE Subject The topic of the resource Smallpox Eradication Description An account of the resource Vince Radke, MPH., describes his early life, his decision to join the Peace Corps, his work in Ethiopia and Bangladesh during the smallpox eradication programs in 1972-75. Explains how this changed his life and career path. Interviewed by Dr. David Sencer 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 April 1, 2008 Format The file format, physical medium, or dimensions of the resource 7336560000 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:/25593/16s37 emory:16s37 https://globalhealthchronicles.org/files/original/8ed421437307be9c17df32152ef60233.jpg c075e9419d43a4b71404b398c01b823a https://globalhealthchronicles.org/files/original/603d0d6cdad868fcd0961665b7c7a66b.pdf f35b1062812f33f24b46fd45acce0df4 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 Pratt with Interviewer Elisa Koski Transcribed: January 2009 | Duration: 0:31:56 Elisa Koski: This an interview with David Pratt 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 are 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 you signed says that you are donating the oral history to the U.S. Federal Government and that 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 Pratt: Sure. My name is David Pratt and I am aware of the fact that I am being recorded. Elisa Koski: Thank you so much. Thank you for being here today and being willing to share your experiences. I'm going to start with a question about your childhood and how you grew up. Could you briefly describe for me your childhood and your pre-college education and how you became interested in Public Health? David Pratt: Sure. I grew up in a small town in Massachusetts, Newbury Port, Massachusetts and did my primary grades in Newbury Port and had nobody really - I shouldn't say nobody, I had two aunts who were nurses and I think they perhaps had influences. Nobody in my direct family though, neither my parents, nor my grandparents were involved in healthcare in any way. So perhaps it was my aunts' influence that got me interested. Elisa Koski: How did you become involved with CDC, and particularly the Smallpox Eradication Program? David Pratt: Very interesting question. I went to medical school at Tufts in Boston and while I was a medical student at Tufts there were people in infectious disease who were Fellows in training in infectious disease and one Kenny Ratson had actually been an EIS Officer; and I was a medical student while Ken was a Fellow and in discussions back and forth about a variety of questions and interesting topics he shared with me and with the other medical students what it was like to be an EIS Officer. So I became really quite interested in that. At the same time at Tufts Medical School, Jack Geiger and Count Gibson were running a family medicine program and they were doing some very interesting things with Social Medicine in Bolivar County, Mississippi and in Housing Projects in South Boston. So the complete picture of what Public Health could be like from the social, economic and cultural aspects to the infectious disease aspects, really increasingly got me interested. So following my medical school experience with Ken Ratson and Community Medicine, I applied to become an EIS Officer. Now at that time, we have to remember that the Vietnam conflict was ongoing and choosing a career in Public Health was also ethically more comfortable for me at that point in my life. So it was a wonderful way to serve the country, it was an exciting area to learn and be a health professional, and it was an exciting time. Elisa Koski: Thank you. How did you specifically end up in India, you mentioned a little bit, prior to this interview as we were being introduced, that you actually had an option? David Pratt: Right. When EIS Officers in my cohort came to CDC we had a choice of what kind of assignment to take. There were assignments here in Atlanta and there were assignments in the field with State Health Departments; and I chose to actually take an assignment with the Hawaii Department of Public Health. That group was doing routine State- based Public Health, but in addition, we were doing some vaccine development, specifically an intranasal vaccine with measles. It was clear for the group of people who came in when I came into the EIS that there were going to be opportunities, international opportunities. One was an opportunity in Nigeria, the Biafran famine was ongoing and huge amounts of migration of Nigerians ethnically diverse moving across the country and a great deal of hardship and despair over that, and EIS officers were given an opportunity to go and actually do assessments, surveillance, measurement around the famine. The alternative option was Smallpox Eradication. When we came to CDC the West Africa campaign was largely victorious and a very clear strategy had been laid out by Henderson and others and so those two options were available. Ultimately I chose to turn down an offer to go to Nigeria and accept the offer to go to India in 1974. Elisa Koski: What influenced that decision, why would you have rather been in India? David Pratt: I think two things really. One was the - I think even then I understood the magnitude of what we were going to try to do. I also thought that the work in Biafra, though important, and doing the assessment of the famine, and the impact of famine on the health of those children was important, I thought it was also desperately sad, probably tougher going and I thought that the chance to have an opportunity to play a role in the eradication of a disease was very significant and exciting and India also interested me a great deal. As a resident at the University of Michigan, I had a medical student who talked in very interesting terms about work that he had done in India and so I was intrigued by his descriptions, I was intrigued by the challenge and the opportunity and decided that when the call came from Lyle Conrad here at CDC that it was a good thing to do. Elisa Koski: Can you tell me a little bit about your role when you arrived in India? David Pratt: I think as a slight - to step back just a bit - it took a fair bit of convincing in my own life circumstance, I just had an infant son born way away from family, so my wife - and this is our first child, so she was there to take care of a child by herself when I trotted off to India. We knew communications was very poor, telephonic communication was virtually non-existent in the areas that we were going to be in and telegrams were iffy. So I had to really convince my wife that this was of great enough significance to allow me to leave her and my son to go and do this. So the context was socially challenging for me personally, but I thought very important. So the routing that I took was basically from Hawaii over through Thailand, from Thailand up to Delhi and then when we got to Delhi we were met by the WHO people at the regional office in Delhi and began a briefing. I think it's important to explain, or share, how dramatic the arrival in India was for us in 1974. The gulf in terms of economics and in terms of the way the place looked from where we had come from, that is Hawaii and mainland United States, was incredibly different. The smells, the sounds, the beggars at every stoplight, the crush and the throng of millions of people it felt like, was very different and for a while the truth is, I think we were stunned, literally stunned and it took us a while to kind of catch up with the fact that we were in a brand new environment, very different than the West. So there were going to be lessons to be learned about the economics, about the sociology, about the psychology of this new terrain that we were entering. So those first few days were very challenging I think for all of us. Elisa Koski: Of course, there was the challenge with your wife and son. Did you encounter any other challenges when you first arrived, housing, food and water, anything that you can recall like that? David Pratt: The WHO team in New Delhi arranged to pick us up at the airport which is always interesting and hasn't changed too much in India, getting through the airports; and they brought us to our hotels. They had things pretty well arranged, the logistics, pretty well arranged for us. The hotels were certainly comfortable, not lavish, it wasn't anything we expected and I think they built a very nice routine, a briefing routine for us in Delhi before we went to the field. The food of course was very different than what I was used to in Hawaii, but I always have been sort of an omnivore and interested in different cuisine, exotic cuisine, so that was fine with me. I was good with that. I think where it got interesting is when we went by train across the North of India, a group of us all together, to go to our duty station which was in Bihar. Now at the time I really didn't realize that Bihar was among the poorest States of India and that the poverty that we'd witnessed in Delhi was going to be compounded by the kind of misery that we would see when we got to the Bihari regions across the Ganges River to the North. So it got more interesting rather than less interesting as we went further and further to our duty stations. Elisa Koski: Can you describe to me a little bit about what happened when you arrived in your duty station? David Pratt: Okay. Elisa Koski: What was your role? How did you interact with your team? David Pratt: I was assigned to two areas, two States or two regions inside Bihar. One was called Sarn; (S-a-r-n), and the other was Siwan (S-i-w-a-n). The stepping off point for those assignments was in Patna and you may remember from Lord Jim, the name of the boat in Lord Jim is the Patna, ill fated boat-Anyway we went to a hotel in Patna, where we had a further briefing on Bihar and our duty station and then very interestingly took ferries across the Ganges River. There were some wonderful lessons about the ferries. It turned out that moving a WHO jeep across the Ganges River was not as easy as simply pulling up and buying a ticket. It turned out that if you pulled up and bought a ticket, everybody went around you and the reason everybody went around you was because there was another payment being made that was invisible beyond the ticket, so it's called baksheesh. So if you didn't understand that if you really wanted to get that ride across the river, it would be the ticket plus some baksheesh, you would wait a long time at the ferry dock. So cross the river by ferry and then got to Chapra which was the area that was my headquarters for those months that I served in that region. Elisa Koski: Can you tell me about the smallpox situation when you arrived? David Pratt: There were lots of outbreaks going on. I think at the time in my region, there were 18 or 20 outbreaks that were in the midst of being dealt with, controlled; contained. A wonderful experience for me as I reflect on it; was the first day in my region. We went by jeep to an outbreak at a village, we went into a mud hut in the village and a woman presented me with her infant covered with smallpox lesions. I picked the child up as you would to examine anyone; the child was pretty miserable and had still persistent fever in spite of a fairly well developed rash, and the thing that really struck me was at that moment I was betting that my immunization was sufficient to keep me healthy as I went forward in the program. So it really was a challenge; you know, how deeply do you believe in immunization, how profound is your faith, and so it was obviously pretty profound. I examined the child and on we went. I mean, I am recognizing that the case fatality rates are 25%. So it was a huge gamble really that things were going to work. I mean, we all knew the history of the immunization, that it was robust and successful, but when it's you, with a child at home, and so forth, and you are beginning an assignment, you'd rather not get a dreadful illness in the middle of India. Elisa Koski: Of Course. Can you describe to me a little bit about the progression of your assignment there, from your first day onward; how did things move forward? David Pratt: From that day, seeing that outbreak that very first day, it was right at the tail end of the monsoon, humidity was very high, day time temperatures were routinely 40 degree Celsius, 104 - 105 degrees, and taking notes, which I tend to be a compulsive note taker; was very challenging because perspiration would run down your arm onto a pencil right on to your notepad or onto your notebook. So I had to find clever ways to do note taking that wouldn't saturate my books, and so on and so forth. So it was very, very warm, very dusty; when the monsoon ended the dust began. But it was still raining during the time that we first arrived. The Indian Public Health people said that searching, trying to search through the monsoon was nuts and yet the people we relieved had done it and had done it successfully. So we had in some ways bucked the standard wisdom about it and had gotten off on a really good foot. So I was turned over to a region that was well done, well maintained. I stayed in a place that was called the Circuit House. The Circuit House - they were they were also called Dak Bungalows. They were locations where the British mail people went when they delivered the mail around the country. It was basically a squat toilet, there was a shower that was heated by a tank on the ceiling, a little desk, no screens on the doors, we had bed nets that we used and I had monkeys as my neighbors who would come in on my porch and actually come in my room if I wasn't very careful. So I had good neighbors and the accommodations were decent, in the day it got very hot, but at night it cooled successfully; and I didn't realize, but my colleagues, my Indian colleagues assured me that the mosquito nets served a dual purpose, not only would it keep the malarial mosquitoes from biting me at night, but it was also good as a preventive measure against Cobras and Kraits and Russell's Vipers which were snakes that potentially could bite you in the night because you were warm. So they would sense your warmth and come up on your bed. So I had no problem with that, but my Indian colleagues frequently slept on the cement floor in our building covered with their dhotis and mosquitoes would bite right through the cotton. It was extraordinary to see the situation that they were in at night. So the living situation was in the Circuit House or Dak Bungalow. In the morning I had a chowkidar, the servant of the bungalow; he would bring tea to me from a tea stall down the road and one morning I had my tea delivered by this little man and my Indian Epidemiologist counterpart saw this occur and was horrified, because it turned out that the man who delivered the tea to me was an untouchable and that's unacceptable. They were unclean so to bring me food was sort of revolting[indiscernible0:17:11] and being outside the caste system there was no issue for me but there was like a little confab and they discussed it and explained that really you shouldn't do that. I continued to have tea from the chowkidar the day after that, it just wasn't an issue with me, but it was my first banging into the whole issue of caste was right there in the Circuit House that day. Elisa Koski: Okay. How close were your field assignments to the Circuit House? Were you were working right in the surrounding villages or did you have to travel a lot? David Pratt: No, there was a fair amount of travel. We had jeeps and drivers and on an average day, we would probably work 8 or 10 hours driving and you would go from outbreak to outbreak, District Health Officer - you would visit with the District Magistrate, you would meet with the various people who were critical to you being able to get the project done. So there was a great deal of traveling around. We all had drivers and I have to say that the Indian, Dr. Chakravarty who was my counterpart in Chapra was an extraordinary guy, very bright and could accomplish things that clearly I could not accomplish. He spoke the language; he knew how to influence in very effective ways, so he was critical. I would begin the morning by going to his home and his wife would serve me another cup of tea, we would lay out the day and then we would just simply start going; and routinely we'd leave his house probably at 10:00 o'clock and not return until 8:00 or 9:00 o'clock at night - that evening. He never stopped for lunch, I don't know what the guy ate, but he never stopped for lunch, so we just kept going. Sometimes we'd stop actually on the road and our driver would buy in the market cow dung, these dried patties of cow dung, light them on fire and then buy cucumbers and cook cucumbers in their skin and we would eat those as kind of a snack, a break on the road with tea. So extraordinary things, and cow dung was routinely used as fuel. In the mornings in the villages you could smell the cow dung burning as people began to make tea and food for breakfast. Elisa Koski: Very, very interesting. How were you received when you arrived in these villages? David Pratt: Interesting. I am 5'6" tall and they would say the big saab. "The big saab is here," which I always thought was hysterical or they would say, "The American saab is here in the village." So it was a respectful term - the fact that an American would come that far to Bihar to work on this issue was felt to be extraordinary by the Indians. So in many ways there was a great deal of respect. It was beneficial as well that I was outside the caste system because I was allowed to make mistakes and gaffes that an Indian couldn't make, and I could perhaps ask for things that an Indian couldn't ask for and get away with it. So I was well received, respectfully received, and I tried to work carefully with the people, the Indian health professionals that were with us-it was intriguing, when we were there - when my group was in India, Daniel Patrick Moynihan was the Ambassador to India and he indirectly told the American EIS Officers who were deployed in the field never to speak to the press. Only allow the Indians to speak to the press and don't make any derogatory comments at all. So we were well schooled and well prepped about what not to do, what not to say in the country. So we really counted on our Indian colleagues and counterparts to do a great deal of the PR and the outreach and the commentary that Ambassador Moynihan really prohibited us from doing. Elisa Koski: You mentioned earlier that you were perhaps more socially free to have some indiscretions or make some mistakes that Indian people would not have been allowed. Can you describe any particular instances where you ran into a problem or where those mistakes weren't accepted? David Pratt: Yeah. There were times when people would flatly refuse you because you didn't quite look right and I remember specifically one outbreak, a woman became very upset when I personally asked to be able to immunize her, and I think I was bucking probably the male-female divide, Eastern-Western divide, so that was an instance where it was very clear that I was not welcome in that circumstance. But that was the minority. The thing that was interesting, another key learning for me in the villages, is the villages were frequently broken up into tolas [0:22:07] or sections. There was often a Hindu section, there would be a Muslim section and then there would be a section for tribals [0:22:12]; and it was always humorous to me that when you spoke to the different leaders of the different tolas, they would make derogatory comments about their counterparts, and it frequently went something like this. "Oh, you will never get them to be immunized, they don't know anything. They are sort of ignorant." It was intriguing how each of them made similar commentary of the others, but at the end of the day they all allowed us to immunize them; and the strategy was frankly to invite the village headman to be the first recipient of vaccine when we were doing containment. So if the opinion leader in the village would allow you to immunize him, then all things seemed to flow from that. So if he got it done, well everybody would line up behind him and we would be able to do a good job. Elisa Koski: Of course. I would like to talk a little about how your entire experience in India really influenced your life and impacted your career in public health subsequently? David Pratt: You have to realize that this was sort of like winning the grand slam in tennis at 29 years of age. Where do you go from here? You know, it was an extraordinary event and as the years went on and the true eradication was proclaimed, and so on and so forth, it became even more spectacular in my career. So what do you do? What is your follow on act? It's like a first novel, if it's a success, it's a huge challenge. I think that I took a lot of important lessons from the Smallpox Eradication Program. The first one is that sometimes naiveté is a wonderful asset. You know, we really didn't know how extraordinary what we were going to do was, and we went at it anyway assuming that it could be done. So I think that was of importance, the naiveté; and the other thing that goes with it is a comment that Colin Powell makes and he says that - General Powell's comment is that, "Optimism is the most important force multiplier" and I tried to remain - the optimism that I brought to the table I thought was powerful in allowing us to get my region - and by way by the time I left my region we were smallpox free. All the outbreaks had been contained and I left an absolute pristine area, I should say the Indians and I as their assistant, left a pristine area, and I was always outwardly very optimistic although as I read my diaries, I read that there were times when I was very pessimistic that we would get the job done. But ultimately when I spoke to our searchers and spoke to students and spoke to people in the villages, I was always kept that very optimistic view. That's one. I think a second big one is the fact that it is sometimes really simple stuff that makes a huge difference. For instance, the logistics, knowing where to get gasoline, knowing how to keep your jeep serviced so when you had to go to an outbreak you could keep going. Having sufficient Rupees to pay the people who search, just really nuts and bolts of good management were critical to succeeding in India and in the rest of my career they have been critical elements as well. Simplicity too; I think part of our success in the Smallpox Eradication Program had to do with the fact that we were using proven technology for the vaccine, we were using a strategy and the tactics to deploy that strategy that had been proven in West Africa and basically what we did was execute, execute, execute. Just this kind of diligence of doing it every day, following the book, compulsively filling in all the things that we needed to get the job done. Atul Gawande who was a writer, an American health writer, talks about the power of diligence and improving quality in care. Well, it was sure true with smallpox, diligence really paid off. Which reminds me of a point where things were not looking so good, in early October in fact, it was October 5, 1974, I know from my diaries-we went to meet with Bill Foege - Dr. Foege in Patna, and we were explaining how it was going and the answer was: "Not so great" and we were really working hard. I mean: we were doing 10 and 12-hour days, lots of driving around and very bumpy roads, the infrastructure in India was tricky, and we met with Bill and he said, "Not good enough, you are going to have to do more." So we were saying - Jason Weisenfeld[inaudible name0:26:57] and l were working in the region together, and we'd say, "Phew, okay we can do it Bill, but we are not sure how much more." So we went back and tried to think; how do we do this in a fashion that is more efficient, more effective as well as putting in more hours. That was extraordinary. So I think those were the real key takeaways, simple things logistics, good management, proven technology and diligence. Just doing it, recording it, measuring the heck out of it and continuing to execute every day. Elisa Koski: How about in your personal life, I mean you mentioned that prior to going you were quite torn of leaving your wife and son at such a critical time and those obviously had to play into some of your future decisions as well? How did this experience in India indicate your personal decision to continue on in Public Health? David Pratt: Yeah. That's a great question. Actually I didn't continue in Public Health until much later. Well, I'll explain. I was invited to move from India to Bangladesh and then ultimately it would be a move from Bangladesh to East Africa where the smallpox was finally eradicated, Jason Weisenfeld and so forth, his team; and it was pretty clear that I was not going to be able to continue with the effort. Several reasons: I had an infant son at home; I had a commitment to continue my training in internal medicine. My father had had a heart attack, my mother-in-law died while I was deployed in India. I mean it was social catastrophe. So it really probably took me 24 months before everything was kind of right in the world, in my little world back home after I got back. So I made a conscious decision at that point to do something that was going to be less travel and more like traditional clinical medicine. I continued to drift towards Public Health in spite of that and ultimately did a number of activities in clinical care that drew upon the public health model to allow me to get the good vibrations back again about public health, and then ultimately when I retired from being a medical director with a large Fortune 500 company, now I have gone back - actually go back fulltime into Public Health, which is a wonderful place to be. Elisa Koski: Excellent. In conclusion, I'd just like to offer you the opportunity to share anything that we perhaps didn't cover, that I didn't touch on, anything very poignant about your time in India, people, places that you would like to add. David Pratt: Yeah. A couple of things: Number one is that I was a grunt in a huge campaign and it was my wonderful opportunity to be at the right place at the right time with wonderful leadership, Indian, International, American-It was a tremendous experience for me to work with D.A. Henderson and with Bill Foege, Mike Lane, Nicole Grasse, and a gentleman named Yallaporka[inaudible 0:30:02], who was an Indian expert, a smallpox expert. So it was a privilege, first of all, to do that work. I played a minor role in a great pageant of strategy and tactics and so forth, and I am grateful for that. Another thing that was very clear is that it was the Indians who did the job in India. We frequently, I think, perhaps take more credit - the EIS types, but at the end of the day; the day by day, grind them out, hard, hard work was done by the Indians and we need to salute them for the extraordinary job that they did. Bright, bright people very hard working, deeply committed and it was an honor to work beside them and with them. I think that the Public Health model that I learnt in the Smallpox Eradication Program of assessing a situation, trying to decide how do you do the greatest good with the smallest number of resources, in the shortest period of time, served me again and again and again, whether it was organizing programs for farmers in Upstate New York or whether it was thinking about field engineers deployed by General Electric in Nigeria, the same thinking that I learned and was underscored in the India Smallpox Campaign served me again and again. So it was a wonderful learning experience for a young man, it laid a foundation, an infrastructure for a career that has been very rewarding, and I look back on it fondly as both formative and instructive for the rest of my life. Elisa Koski: Excellent. Thank you so much for being willing to share your experiences with us and for speaking with me today. I wish you the best in your future endeavors and as you continue on with your medical training. David Pratt: Thank you, it was my pleasure. [End of audio - 0:31:53] </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/P7eiWFStW5A" 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:/25593/16rhs emory:16rhs Subject The topic of the resource WHO Smallpox Eradication CDC India Format The file format, physical medium, or dimensions of the resource 6891960000 bytes video/x-dv Creator An entity primarily responsible for making the resource Pratt, David (Interviewee) Koski, Elisa (Interviewer) Contributor An entity responsible for making contributions to the resource Centers for Disease Control Title A name given to the resource PRATT, DAVID S. Description An account of the resource Dr. David Pratt, MPH., MD., was an epidemiologist assigned to Bihar State in India for the Smallpox Eradication Program. Language A language of the resource English https://globalhealthchronicles.org/files/original/bee485d6258bab37d8a7b307f5a00a0e.jpg ff521019121152fe258786859a44e3c8 https://globalhealthchronicles.org/files/original/60eab0552344cda3996ab79fcfb041d8.pdf f6f0502df9963ef4248de2d79ab972de 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 src="https://www.youtube.com/embed/09U9r-LfpMc" frameborder="0" width="560" height="315"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource ORENSTEIN, WALTER Description An account of the resource Dr. Walter Orenstein recalls his time with the Smallpox Eradication Program in India, in the state of Uttar Pradesh and then in the city of Aligarh in 1974 and how this experience changed his life. Interviewer: Dr. David J. Sencer Date A point or period of time associated with an event in the lifecycle of the resource April 3, 2008 Publisher An entity responsible for making the resource available 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 Subject The topic of the resource Smallpox https://globalhealthchronicles.org/files/original/d9d3344841f7ee1e31cbf1119e18815e.jpg b119c483da7ce5e9c4aff054054e1608 https://globalhealthchronicles.org/files/original/b9b13dc7be656fa4160662dd5f22a075.pdf 9d00fbcda7d3d95f10ace91b05468fde 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: Dennis Olsen Audio File Transcribed: January 24, 2009 Melissa McSwegan: This is an interview with Dennis Olsen on July 11th, two thousand eight at the Centers for Disease Control and Prevention in Atlanta, Georgia about his role in the smallpox eradication campaign. The Melissa McSwegan is Melissa McSwegan. With this interview we're hoping to capture for future generations the memories of participants and their families involved in eradicating small pox. 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. Now, for the record could you please state your name and that you know you are being recorded. Dennis Olsen: My name is Dennis G. Olsen and I know that I'm being recorded. Melissa McSwegan: Okay, great. Thank you. So to start out with could briefly describe your childhood, your college education and how that led into you working in public health? Dennis Olsen: Well, I grew up in Bend Oregon and all of my pre-college schooling there. Went off to the University of Oregon then for my college work and I can honestly say that none of that prepared me for a role in public health. My first inclination to be involved in public health was through the University of Oregon placement service where I met a CDC colleague E. J. Spike and I was recruited at the CDC and spent thirty two years with the organization. Melissa McSwegan: Okay. Well great. Well how did you then become involved with the smallpox eradication [inaudible 01.53]? Dennis Olsen: I was first recruited to come back to Atlanta out of my assignment in Los Angeles California to actually be involved with the early malaria eradication effort and as the politics of that were working their way through Washington and it was determined that what the plans had been were not going to come fruition, I was contacted to ask if I wanted to go to West Africa for smallpox eradication. Agreed to do that, got married to my lovely wife and off we went to the country of Liberia and spent three years there. After returning from that we knew then eventually that the Indian program was going on and made overtures to be one of the people who went to India for a three month assignment. At the conclusion of that and the enjoyment of that work and the colleagues from around the world and the imminent success of the program I asked if I could go back for a longer term and was - we were accepted and returned for a two year stint and that time I was named the WHO World Health Organization coordinator of the smallpox eradication effort in the state of Uttar Pradesh, a population of about one hundred and ten to one hundred and twenty million people. My role was to assure that the program policies were being carried out, searches were being conducted, that the international staff and the Indian domestic staff that were working on the effort had the resources that they needed to carry out the function, to do spot assessments of the work at the primary health care centers and/or hospitals. Handle largely also to be the banker and make sure all the funds were flowing in the right direction. A very enjoyable experience and I met a lot of interesting people. Besides Uttar Pradesh my wife and I went to Bangladesh for a three to four week period of time to assist in one of the major searches and quite possibly look at an assignment in Bangladesh that they were - they need an administrator and I'm a public health advisor and not a physician. We decided that we're - we appreciated more the Indian aspects of that project and returned to Lucknow and carried out those functions for another, I'm guessing now - six to seven months and then we were reassigned into Delhi in the regional office in order to be the senior administrator for the program for its duration in India and participated with the international commission to declare India smallpox free. So, quite an interesting period of time for us and we really enjoyed the work. Melissa McSwegan: Describe a little bit your relationship with your - with the host country counterparts in India and Bangladesh? Dennis Olsen: On the first assignment, the three month assignment, we were working directly with the - I was assigned to a city in Bihar state or a town called Bhagalpur along the Ganges and our immediate relationship was with the health officer of that town. And the people who had gone before of which there were at least two others possibly three, had developed a strong working relationship so my fitting into that was just a simple as it possibly could be. There was absolutely not difficulty at all. We could work and do what it was that was required, got support to the extent that it was available from the locals and of course a lot of support from Cyro in Delhi. So it was a very easy experience that way. And all of the people, staff for the most part at the primary health care centers had been heavily involved with the effort to eradicate smallpox and participated to the extent that their abilities allowed. There were those times when we had to do a little extra encouragement in some areas and so forth but we still had very strong support of the local health officer and the Indian government from Delhi. Those people made periodic visits to assure that these relationships were maintained and overcame any of the infrequent difficulties that approached. When I became the WHO coordinator in Uttar Pradesh then I worked directly with the Minister of Health for that state and the staff at the other levels in order to carry out the functions. Again these things went very smoothly because of the overall direction of the Indian government from Delhi and the support that they provided to the program and those relationships never got in the way of carrying out the function. That is why I think the program was successful to a large degree. Melissa McSwegan: What would you say would have been the biggest challenge while you were there? Dennis Olsen: That's a hard question. There were - the challenges of first of all motivating the population to report rash like illness. So many other things were impacting on the population. Of course we instituted a reward system, a financial reward system to help with that. The difficulties of just getting around in the country. Not all areas had a road network been established. Quite often those that were established were interrupted for flow of water to farm. Quite often where we had to go roads had never been established so just getting to investigate an outbreak, getting to it was difficult. Getting supplies sometime the area were difficult. Heat, surviving in certain areas was difficult but all of those things could be overcome. It just took a little bit longer to do things than one might have hoped for. Melissa McSwegan: And what do you think - you've talked a little bit about the relationships that you've had and other things that helped it to be very successful but what do you think were the greatest successes that you had during that time? Dennis Olsen: Well the great success was that smallpox eradicated and I think that also a success to show that through a combined effort and the cooperation you could - excuse me - tackle a difficult situation and have some success from it and therefore the encouragement to continue with whatever effort you were in. Quite often we were approached out in the hinterland if you will about doing something for other sets of problems that existed in the country. Something to do with water, something to do with sanitation, to go beyond our scope of work in smallpox eradication to add some assistance or input into these levels. And of course we would report these sorts of requests back through the system but I think our experience and our being on site and the success of the program probably led, I think there is evidence that it did lead to attention being paid to these sorts of circumstances and problems as well and having them attacked when resources and political support were provided. Melissa McSwegan: How did your family adapt to living abroad both in Africa or in India? Dennis Olsen: Well, my wife were together. We don't have children. We're still married so. My wife Carolyn actually was quite involved in the Indian program. Some of the things that I would make recommendations to the central offices in Delhi with technical graphs and so forth that had to do with demonstrating how you could show your project was moving in a certain direction or had these successes or these failures, Carolyn being an engineer and having these kinds of talents put these together. So - and she went with me on the searches out into the field and through her own oral history she'll tell you some very interesting stories from her side but I probably would not have made the full two years if she hadn't have been there. Melissa McSwegan: So, what was it like living in India beyond the working environment, just living in India and participating in the culture? Dennis Olsen: Well, I can tell you from my - I had already been to Africa with that program and so when I thought, not thought but had been accepted to go to India the African situation would prepare me and it was largely true. But I do remember getting off the plane in New Delhi and the heat and the just large numbers of people and the immediate difference with - just an overwhelming humanity kind of thing, I thought what in the world have I gotten myself into. And we had a few days of training in Delhi then we were set out into the field to be with colleagues that had already been in the country two to three months to gain some experience. And I met a good friend Ras Charter in Bareilly who showed me how to get the jeep stuck as soon as you could but did demonstrate how work was done in the field. And then I went off to my assignment and met another CDC person waiting for me in Bhagalpur, Dr. David Hayman who had been there for a couple of months and he was kind of a light yellow. He had hepatitis so I thought well if he can put up with that I can put up with whatever is here. But I - Bhagalpur was a small place in comparison to the capital of Bihar, Patna. Patna was a small place compared to Delhi and I guess the point of this story is when I got back to Delhi after three months it looked like a large European city that I can definitely survive in. That's when - with that successful three months I asked Dr. Henderson - D. A. Henderson - and Dr. Bill Fergie if it would be possible to come back to India for a longer period. And after that longer period both my wife and I asked again if there was some way to stay with an active program be it immunization, diarrheal disease control, malaria, whatever it is that we might do to remain in India because we enjoyed the experience so much. We met a lot of interesting people. The Das family Lucknow. We lived above their residence. The people that we rented from in New Delhi, people in the field, it was just a pleasurable two years. Melissa McSwegan: Have you maintained any of your relationships with people you met in India probably? Dennis Olsen: You know thirty years have passed and I'm not sure how many people are - but the answer to that, short answer to that is not from the Indian side although I understand I will be seeing - we will be seeing a Dr. Dada who was a senior person in the Ministry of Health. He's in town and I look forward to renewing that relationship. We have shared with our CDC colleagues and others over the years when reliving these experiences, honing our lives and things like that. Melissa McSwegan: What would you say are your most memorable moments from working with the smallpox campaign? Dennis Olsen: Oh my goodness. One was going out to the very first smallpox investigation in Bhagalpur with Dr. Hayman. We had to walk through the rice paddies and wade through a river and my shoes were not appropriate. I lost the nails off both big toes, had full foot blisters underneath the - on my bottoms of my feet. Had to have tea and sugar and salts to get the electrolytes up and rode out on a donkey. It was - thanks to Dr. Hayman. Other experiences, I have to take some time to reflect. The international commission we happened to be there at the end of our assignment when they actually the commission came and announced that smallpox was eradicated from India. That was so satisfying to have spent the time and then to actually be there at a moment when history had been made. That will certainly be hard to - I will never forget it. And the others I think were just the individual relationships we made with people. The staff in Lucknow from the secretary to the very important and very good friend paramedical assistant Rujinder Singh. It's just things like that that stick with you and if it ever could happen again would not hesitate at all to do it again. Melissa McSwegan: And how would you say working with this campaign has affected your life and career since then? Dennis Olsen: Well I don't have a career anymore. I retired in nineteen ninety four. Affected our lives is that we're extremely proud that we had the opportunity to do it. I like to think that we did it well and enjoy the relationships that we still have with people that went over and did these sorts of things and days like today when we're back to remember what we all went through. It wasn't always easy. I don't ever want to let people think that it was just all good times and success. We lived in very harsh conditions a lot of the time and we put ourselves in jeopardy many times but just the pride of having done it, the pride of success and listening just this morning to what's happening with global programs. We like to think that maybe we were in a small way part of what allowed these things that now happening to move forward and hopefully enjoy some of the success that we had. We did the pioneer work they live to say. Melissa McSwegan: At what point during the program while you were working on it, at what point did you know that smallpox would be eradicated? Dennis Olsen: The day they announced it. Melissa McSwegan: So you weren't convinced until then? Dennis Olsen: Well you know you always wait for the next person to come forward and say we have a report of rash like illness. And you might have gone for six or seven months or a year and think you know this is pretty much it, we're sort of wrapping so it can happen. When I left Liberia in the African program we were sure for a whole year that we had not smallpox, quite successful and then someone came down from upcountry and said we have a woman and child in the hospital with rash like illness that looks like smallpox. So, when I - my wife and I were just ready to leave the country. Our assignment was over and my replacement had arrived so the same thing could have happened in India. As it turned out the African issue was monkey pox not smallpox but once they made the announcement in India we had assurances after many, many searches that there was no illness, no smallpox. Of course the search went on for anther couple of years to continue to assure that. It really didn't end at that point. It was the point where we said that we had reached that particular part of the goal but we had to confirm it again. Melissa McSwegan: What were the important lessons that you learned from smallpox eradication that you then applied to other parts of your career afterwards? Dennis Olsen: Well, the career after that was some domestic program work in childhood immunizations, then international work in HIV Aids and some work with international immunizations, diarrhea disease control and malaria control. For the international things what was learned was how to deal in an international setting. What things had to be attended to, to allow the program to have some success in the relationships that you needed to develop with the host country. How important it was to assure that you had the proper logistics before you tried, got the plan established and the logistics to carry it out and the resources to carry it out. And the important, very important tools of assessment. Continuing to look to see where you were along the road to trying to achieve your objective. Not just assuming you were doing okay but actively making sure from tools to asses your program activities and a personal relationship skills were honed I think. How to make sure that you were for example whatever credit might be accruing that you made sure it was the local that got the recognition. We knew we were doing okay, we didn't need to be told. So those kinds of things. I think those are always helpful. They are the more mundane things about improving your writing skills and these sorts of things but I think I touched on the more important. Melissa McSwegan: Now you have spoken a lot about the successes of the program. If you had been the one running the entire program worldwide is there anything that you would have done differently, that you would have changed about it? Dennis Olsen: No, I don't think so. How can you fight with success? You know I never ever thought of myself having those kind of capabilities. When you work for someone like D.A. Henderson, Bill Fergie, those are the people that have those visions and skills and at that level it's just a happy occasion that we got to be able to be a part of it. I can't think of anything I would change. Melissa McSwegan: Well do you have anything else that you would like to add about your experience? Dennis Olsen: No, I think we've pretty much covered the territory. Melissa McSwegan: All right. Well, thank you very you much for your time and I appreciate you sharing with us your experience in India. Dennis Olsen: Thank you very much for doing this. </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/vMgriQjaR74" 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 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:/25593/16rjx emory:16rjx Format The file format, physical medium, or dimensions of the resource 4643160000 bytes video/x-dv Creator An entity primarily responsible for making the resource McSwegin, Melissa (Interviewer) Olsen, Dennis (Interviewee) Contributor An entity responsible for making contributions to the resource Centers for Disease Control Title A name given to the resource OLSEN, DENNIS Description An account of the resource Dennis Olsen describes his experiences as a CDC Operations Officer and Manager in the Smallpox Eradication Program in India 1972-1974. <br />Interviewed by Melissa McSwegin. Subject The topic of the resource Smallpox Eradication WHO Language A language of the resource English https://globalhealthchronicles.org/files/original/ff2c1f1c3d3c1897a983062e3a76e2d3.jpg b119c483da7ce5e9c4aff054054e1608 https://globalhealthchronicles.org/files/original/fbb5466d1fb6254baf543bb124d2ad4c.pdf 09cf8366c7d7f1119912c3f9050f7d85 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 Dennis Olsen on July 14, 2006, at the Centers for Disease Control and Prevention in Atlanta, Georgia, about his involvement with the West African Smallpox Eradication Project. The interview is being conducted as part of a reunion marking the 40th anniversary of the launch of the program. The interviewer's name is Diane Drew. Drew: Could you start by telling me a little bit about your background- where you grew up, your schooling, and how you got headed into whatever career decisions you made? Olsen: I was born in 1939. I grew up in Danville, Oregon. My folks moved there in '41. All my schooling through high school was there. Then I went off to the University of Oregon and got a degree in science. And as part of the college leaving process, I went over to the placement office. I was thinking, "I know I'm going into the military, but I'll talk to some folks who are here talking about their companies and organizations." I'd never given public health a thought. And a gentleman by the name of E. J. Spyke, Jerry Spyke, was there representing the Centers for Disease Control. I was quite intrigued and thought, "Well, this would be maybe a good starting point." Government service had never really crossed my mind, but I didn't have any money whatsoever and knew I wouldn't have any coming out of the military. I accepted the position that was offered and thought, "Well, I'll do that for a while and see what it's like, and then probably go back to school to get a graduate degree," as people were doing in those days as a matter of course rather than desire, and I stayed with CDC for 32 years. Drew: Wow! Olsen: Never did go back to school. Whatever other education I got was through the organization both in formal education and working in the field. Drew: And when you came to CDC, did you come to headquarters right at the beginning? Olsen: No. My assignment was the first trainee public health advisor to be assigned to the State of Washington, in Seattle. And I was in Seattle for I think 6 months, and then the second co-op (cooperative agreement) came, and I was transferred over to Tacoma, Pierce County. This was all working with the Venereal Disease Eradication Program. And I was there for 6 months. Then I was contacted by the regional office folks in San Francisco, CDC people. They asked if I was interested in becoming a recruiter for CDC, much the same as E. J. Spyke had recruited me. So I agreed to do that and was transferred down to Los Angeles because that was the base of operation for that. And for a while, I was the only one there doing that. Traveled in, I think, it was 9 Western states at the time, going to college campuses and, if there weren't college campuses, running ads in newspapers. Then I was joined by another fellow. And I think I did that for 3 years. Then I was asked if I was interested in going with a program that CDC was taking command of, to a certain degree, the Malaria Eradication Program. So I came back to Atlanta and was in training status. But as it worked out, there were differences of opinion as to who would really have control-USAID [U.S. Agency for International Development], who held the purse strings, or CDC, who had operational responsibility. And because they didn't agree, most of us in that training program never did see work in the field. I was to go to Costa Rica, but in the meantime was contacted by Billy Griggs to see if I wanted to go to West Africa and join the smallpox program. I agreed then to go and take that up as an assignment. I asked what country. It was either going to be Sierra Leone or Liberia, but I requested Liberia, and that's what happened. Carol and I got married just before going over. Drew: So you'd known each other before. Olsen: We'd known each other about a year. Drew: Did she come from Oregon originally, too? Olsen: Wyoming, Cheyenne, Wyoming. She was a civil sanitary engineer. She worked with the city of Los Angeles, CA. We did our training here in Atlanta in the months of July, August, and September, and we were happy to get to West Africa and Liberia. Drew: Was that a francophone country? Olsen: Anglophone country. Olsen: I think there was Sierra Leone, Guinea, Liberia, and there must have been one other. Drew: Nigeria? Olsen: Nigeria, they were already had public health advisors and physicians. But they may have been training some others to go. It's just too long ago for me to remember who all was there. But I do remember those other countries because I was selecting between Liberia and Sierra Leone. Drew: Was there a program already in operation by the time you got there? Olsen: No. Drew: You were basically sort of starting. Olsen: We were. Drew: Was your program like some of them, working with both measles control and smallpox eradication? Olsen: To my knowledge, at least for the group that went over at the time we did in '67, that was always the intention. Smallpox was the overriding issue and disease we were dealing with, but since we were there and giving vaccinations, the measles vaccine was provided, and that was also then administered. Drew: Tell me a bit, if you would, about traveling to Liberia and maybe the first few weeks or months there, both from your point of view and maybe about you and your wife in terms of kind of the cultural differences, who was setting up the program, any of that. Olsen: CDC was really thorough, I thought, and had experienced people to try to prepare us for the differences that we would find culturally and environmentally. And I don't remember that we had much of a cultural shock. We always say we had more coming home after 3 years than we did going. The States were overwhelming again with all the things available to you. You no longer could even make a decision on which tie to select because the selections were too great. But when we arrived in Liberia, I think the first thing that struck us was the architectural development, if you will, which was limited and so different, and just the tropical rainforest itself. You can only imagine these things and see pictures in books. But seeing it, I thought, yes, this is quite different than what we would have been thinking about. We were, of course, well taken care of by representatives from USAID. They were very kind to us and had housing available- not staffed or anything, but with a guest kit to get started. Dr. Shalimar [sp.] was the health officer for USAID; he and his wife were very gracious people. So it was an easy transition. Drew: Did they have a medical officer from CDC? Olsen: Not then. That came later. The issue around that was that a Dr. Pifer [John Pifer] was supposed to come. But there was an outbreak of war, in Benin, Nigeria, and so CDC had to make some staffing changes because the people in Benin, including Dr. Foege [William H. Foege], all had to leave. So Dr. Thompson [David M. Thompson] and his wife-I think they had one child at that time-came to Liberia, and Dr. Pifer eventually went off to Nigeria. But the Thompsons didn't show up for maybe 3 months or longer after we were already in country. For housing, they put us into a compound that had 2 duplexes. There were 2 other Americans there, a fellow with the Geologic Survey, Jim Sites, and Dorothy Deloof, who was a nurse for the Kennedy Hospital that was being built. And I guess they were both up-country or something. So Carolyn and I are there all alone. We have no phone, no outside road, no car. We're just there. The curtains on the windows were actually sheets. And we were then thinking, "All right, it's time to sleep," and then there's a huge thunder and lightning storm, and rain, which, coming off the ocean onto these corrugated tin roofs was extremely loud.. . And all of a sudden, there was a huge bright light and a big bang, and we pulled one of these curtain things back and looked out, and the lightning had hit a transformer on the pole just adjacent to the house. Fire was coming down the line toward the house and all we could do was sit there and watch it. It went out before it got particularly far. I guess one of us turned to the other one and said, "Let's go out to dinner." But we didn't even know where dinner was. We had been dropped off; we didn't know which direction was what, except the road to get back to the airport. The next day, life started to look more normal as we were introduced to the people at USAID. We started hiring staff for the house, which I'm sure Carolyn will be telling more about that than me. The way this usually happened was that some of the Liberian staff at USAID, knowing that you were new, would send their relatives over to see if they could be employed as staff. And there were little financial kickbacks for this. Well, one man showed up to be our houseboy. His name was Timma. He was a nice, gentle, older man. Carolyn hired him, and he was quite willing to work. But he did the laundry one day shortly thereafter, and we noticed that all of our clothing, our whites particularly, were sort of grayish-blue. He was hanging them on the leaves and things; he was seemingly ignoring the clothesline. Well, it turns out that Timma had on a country shirt, and the dyes in it, as he would wring these things out, were coming off on our clothes. So Timma got another job as our gardener. Then we were introduced to a young man by the name of David Parker, who stayed with us for 3 years, which was unusual because most people have several houseboys. But David and Carolyn and I hit it off. Then, work-wise, we were introduced to the Liberian public health system. It was, I think it's fair to say, primitive. It existed in Monrovia, the capital, but there's no infrastructure up-country for public health beyond some dilapidated buildingsand very poorly trained staff, who are not supervised and not really provided with medical supplies. One author wrote that,"Liberia never suffered the benefits of colonialism." Most of the other countries had been colonized and had developed infrastructure outside the capitol city. Liberia was proud that it had never been colonized Drew: I if I remember correctly, Liberia has ties to the United States in a sense, don't they? Olsen: Yes. Back in the 1800s, the 1840s maybe, there was this whole plan to move freed slaves back to the areas in from which they had originally come. This was most likely guess work for the most part. Drew: Sure. Olsen: The capital of Liberia is Monrovia. The then President was W.V.S Tubman. And their government is made up pretty much like the United States. It's a bicameral system, and their flag is a star and red and white stripes, things like that, so a lot of connection. Now, there was a lot of American money that went in to make sure that they had an opportunity to survive . . They were going to farm, but farming never really took hold. For awhile, they lived on the ships that they arrived on. Many people died from tropical diseases, etc. But, overtime survivors and new arrivals settled and developed what is now Liberia. In any event, we then were introduced to the public health system, and I was to have a counterpart, Dr. Thomas, a Liberian doctor. We were to report to a naturalized Liberian, a Haitian doctor, Dr. Titus. As CDC assignees we reported to, and received administrative assistance from, USAID. It all seemed to work reasonably well. It was hard to get things started. Dr. Thomas wasn't particularly insistent. We tried to move things from the training to go up-country, but there was always a little problem with getting gasoline for the vehicles and getting the teams organized. It was just slow- going. I think we were all just feeling each other out. I spent a lot of time in training programs because we were using Ped-O-Jet equipment, and so we spent a lot of classroom time in operations maintenance of it. And, of course, we had to wait for supplies to come in. There was always something in the early days that was keeping us from going up-country. Drew: That must have been kind of frustrating in terms of developing a program. Olsen: Yes. Since there wasn't really anything there, there wasn't a system that you could just tie into and say, "When these other things come, then we will make the changes and augment your program. Or we'll use some of your materials and supplies; we will then supplement that." There was just nothing. So we had to wait for the vehicles; we had to wait for the parts for the vehicles. Things broke down pretty easily. Drew: What was the prevalence of smallpox or measles? Olsen: It was pretty much unknown because the infrastructure wasn't there. There was no reporting system. Drew: So it wasn't that it didn't exist. It was just that you really didn't have any data to know? Olsen: I'm pretty sure that there wasn't much in the way of smallpox that I have heard about. We made early inquiries with the population up-country-the mining organizations and what health services existed (missionary hospitals)-to see, just as a quasi- surveillance system, what was going on. And I'm pretty sure that there wasn't any smallpox at that time. There had been a previous vaccination program run by an organization called Brothers Brothers that had gone through; I forget what years they conducted a program there. I heard varying reports as to how they were managed and what you could anticipate. Measles is a rash illness, and you would hear about it from folks who were coming down from up-country. So what I planned is that, number one, we needed to get the vaccination teams trained and up and running in the field. Surveillance had to sort of take care of itself. We knew there was smallpox in neighboring Sierra Leone, and so our plan was that it was the border that was most likely going to be impacted. We knew that there was an up-and-running program in the Ivory Coast, which was on the southeastern side of Liberia. That border would be much harder to get to logistically; we probably wouldn't leave for there until we could learn more as to where the prevalence of the disease was, if there was any. And as for the Guinea border up north, a couple of mining organizations weren't seeing any rash like illnesses so we weren't planning to go up that way initially. And once we got up and running and got supplies, it worked reasonably well. We had some good teams. We had 5 or 6 actual vaccination teams, 2 assessment teams. Olsen: These team members had to be pulled from other kinds of projects. That's the way it works in these countries where there are a limited number of resources. We established the logistics system to receive the goods and housed them at Mambo Point, which is where the "preventive health services" was. I had to set up a warehouse inside the building and train someone to do the warehousing and keep track of this and that. Vaccines were stored at the American Embassy-they had a huge freezer storage facility-because there was nothing, initially, in Monrovia that we could find. We eventually moved the vaccine supply out of there to a Montserado Fishing Company, which had freezer facilities. So when I went in to get the vaccines-the Liberians wouldn't go into those buildings - it was too cold for them. I had to go in. Drew: Really? Olsen: All the boxes and so forth smelled like fish. But that's where we stored the vaccines. Drew: Apparently, that was one of the difficulties that some folks faced when trying to deal with the measles vaccine, in particular, was . . . Olsen: Cold, always cold. Drew: Yes. Olsen: We helped solve the cold-chain problem, and I'll get to that. But one of the more difficult parts of distribution of the vaccines was lack of communications with the hinterland, no infrastructure, and then getting to and from these places. The road networks were poorly maintained dirt roads. And we had these big Dodge power wagons that were provided. They were far too big for what we needed. They were fine on for paved roads, but we only had like 50 miles of paved roads. So it was difficult to transport things, and a lot of walking was involved. And, of course, there's this cold-chain issue then, getting the ice. We would have been better off had we been able to negotiate for the kinds of vehicles that were going in because we could have used Toyota Land Cruisers, which were smaller. They were not the things that people run around in today with all the plushness and all the comfort]. They were much smaller. And, there was a Toyota dealership with a service department in Monrovia. And we solved, to the best we could, our cold-chain problems because there was a wide distribution of Lebanese merchants in our area. Wherever you'd go, to a village of any size or along the road, there would be a Lebanese merchant. And all of these merchants had functioning refrigerators. Drew: That's interesting. Olsen: And they'd keep them maintained for the goods that they would sell. They acted as the bankers for the locals and any number of different things, and this was all surely in agreement with the government so that they could stay in business. And the Lebanese merchants were kind enough to house the vaccines and give us ice for the chests and all that sort of thing, so that worked out reasonably well. Drew: Because they were sort of dispersed around the area. Olsen: They were dispersed all over the country. Drew: So it would almost be comparable to like being able to go to a bank that was located near where you were working and get what you needed? Olsen: Near enough that you could keep the vaccines cold and make the ice used when transporting the vaccines to the vaccination sites.. And then come back at another time, when appropriate, and get the vaccines and start all over again. Now, it worked as well as it could. There were also missionaries in areas with refrigeration, and they would allow the vaccines to be stored. It never worked very well trying to transport and use the kerosene operated refrigerators that were provided. We did not use them. Maintenance was a problem. If no one was around, the kerosene was stolen, and if you hired someone it just did not work out well. I remember we had a regional project meeting, in Abidjan I believe. Dr. Foege and the regional staff were interviewing us about our programs. And I mentioned to the group that we had this kind of cold-chain system, and Dr. Foege leaned over to someone and said, "Well, Liberia doesn't need more refrigerators. They need more Lebanese." We had our systematic way of covering the country. We had a public health education unit-not that we organized, that was provided through the Ministry of Health. They assisted us from time to time, with a great deal of our encouragement. They would go ahead to the villages and prepare them for our being in the neighborhoods. They would get the people in a central place so it would be easier for us logistically to maintain the vaccines, get there, and vaccinate. And invariably, the local chief didn't want to go to another chief's area: "Come to my area. I'm the chief." Politics works the same way everywhere. So we had a very difficult time getting people to congregate in large numbers so you could use the Ped-O-Jet most efficiently. But you just had to work with those things. Drew: And at that point in the program, wasn't the approach still to just do mass vaccinations? Olsen: Almost all of the time that I was there, 3 years, it was the mass vaccination approach. Just as I was leaving, the search-and- containment approach was, I think, being at least talked about, if not being implemented in some places. I didn't get involved with that until I went to India for the same purposes. There it was all search and containment. Drew: But you were saying that you did have a fairly systematic way of determining where you would go and what you would do? Olsen: Right, we'd sit down and work with our teams. We had 9 counties, if I remember the count. Some of which bordered Sierra Leone, Guinea, and the Ivory Coast And at that time, a good portion of Liberia hadn't been mapped. It was tropical rainforest. So the teams, knowing their areas, would say, "Well, we know that such-and-such exists out here, so here's how we would cover it." And, of course, we had to rely on them. We couldn't be making these plans on our own. So one team would go out in advance to let the folks know that we were coming and try to do these things I just discussed with you, and then also map out where the villages were for sure. Small villages would move when an area had been farmed out. Drew: Why was that happening? Olsen: Farming. They would just move. If it was a sizable place that would be somewhat stable. If the villages were smaller-fewer huts and so forth, and they were temporary-then the people would go off and go somewhere else. But generally they were stable. We would supply the teams based on the teams' knowledge. I would go and do assessments myself. And if we ever had reports of rashlike illness, Dr. Thompson and or I would go, sometimes with a WHO [World Health Organization] assignee, and investigate. It was harder to get the Liberian senior medical personnel to go. They didn't like to leave Monrovia. Drew: I know in some countries that part of the mode of operating was to deal with the village chief or whoever the leader was. Did you pretty much have that type of introduction into the various developed areas? Olsen: Occasionally, if I went to a bigger place, I might see the paramount chief, or stay with the paramount chief, because there was no housing anywhere else. Quite often the teams would visit with the village elders because we couldn't be with the teams all the time. But, yes, the politics all had to be attended to. You didn't just show up and then say, "This is going to happen." You had to let them know that you were coming and let them make the decision. Then they would get their populations organized and motivate them, to the extent that they chose to do that. But that whole network, with the paramount chief down to the village chief, to then get down to Charley Brown's town, as one of them was called. Drew: Generally, were you fairly well received? Olsen: Always, always. I cannot remember a contentious time, a real problem that we couldn't overcome, working in Liberia in the villages. Now, we had lots of hours of frustration and difficulty at the ministry level because they're being impacted by any number of things. I wouldn't even pretend to know all them. They were responsible for providing the teams, they were responsible for providing the petrol and the monies to support the teams, and it was a constant battle. Whether the resources were limited or whether it was just a lack of priority sometimes, I can't be sure. Drew: And these would be Liberians? Olsen: Liberians. The doctors I've mentioned. Dr. Titus was exceptionally supportive. Dr. Thomas, who was our counterpart, the one I mentioned, he soon went off to get a graduate degree at Harvard. But Dr. Barkley, the Minister of Health, was strictly at the top, a politician, and I have a couple stories about that. I remember going to his office any number of times in a fairly short period, trying to get the chits for the petrol. They wouldn't release money. They would release chits, and we'd give them to the teams so they could give them to the operators of the petrol stations. And Dr. Barkley missed any number of meetings and kept me waiting and waiting and waiting. One day I thought I really had it done. I went to meet with him he didn't show up. I was angry. I left his office and when I got in our truck I slammed the door. And my driver, John Massakoui, a Liberian, started laughing. I said, "John, what is so blankety-blank-blank funny?" We knew each other quite well; we were together all the time. And he said, "Well, Dennis, this is just another one of those times when you learn that you're in Liberia, and here we beat the drums." So, okay. Drew: He probably knew, without your even explaining, more or less what had happened. Olsen: Yes. But it was always a fight for everything. And the team members would come to us, of course, because they couldn't get paid sometimes, and these personnel issues were very, very frustrating. You'd want to go, and you had to go, to the government and say, "You know, the teams aren't being attended to, and they need their salaries," and you wouldn't even get excuses. You would just be, more or less, ignored. It's hard to be that kind of go-between. Drew: Was it because they had their own agendas and their own timetable, or was it a certain amount of control or passive-aggressive kind of thing? They wanted to control the resources? Or they just had different priorities? Olsen: I think they may have had different priorities. I always felt that they wanted to support the project, but who knew what kind of influences were on them to do whatever? And I certainly wouldn't want to be accusing them of anything. We had our guesses sometimes as to how the resources were being distributed, for what purposes. You go through these times and you had to work with them, and I think we did reasonably well. Up until the end, we didn't see any smallpox, and I think our coverage rates for measles were as good as one could expect. That was a much more difficult thing to do. You could assess smallpox because of the vaccination scar. With measles, it was by guess and by gosh. You kept your tallies of the doses of vaccine administered, but that wasn't necessarily a true picture. And then we did see, at the end of my 3 years, a case of probable smallpox. My replacement, Mr. Randy Moser had already come into country, and the teams were up-country. I guess it was Mr. Coleman who came down, and he said, "We've got rash illness in this particular area, and we have taken that lady and her child to the hospital." I said, is she in quarantine?" And he said, "Well, to the extent possible. They may be going home at night. Nobody seems to care too much." So Randy and I jumped on a plane and went up there. The lady was there, in what served as the county hospital, and to us it looked like smallpox. So we took our samples. Got the cases properly contained in the hospital, (paid to get that done), took the samples and got them shipped back to CDC. And then, of course, we sent the teams up to start vaccinating. We thought that we had our first cases of smallpox. Then we got either a cable or a call-probably a cable because the phone system did not work well; we didn't have some of these other things that are very available now-saying that there's something strange happening with this sample, so "Get us some more samples." Dr. Thompson had already left, so it was just Randy and I. And I think the WHO representative, Dr. Hans Mayer, was gone as well. CDC sent another doctor from the smallpox program over, Dr. Pat Imparato and he reviewed what we had been doing, and he said, "Well, you've done pretty much all you can do from a medical standpoint. I've seen that you've sent the samples off." We got more samples. We sent them in. And it turned monkeypox. Drew: Oh, wow! Olsen: The transfer of another virus to humans. Drew: Wow, interesting. Olsen: Monkey was part of the diet. We'd already packed our household effects to return to the states. CDC sent people into Liberia then, searching and taking animal samples, blood samples and things, and it turned out to be monkeypox. There wasn't a widespread outbreak. I think it was actually contained either to just that lady and the child, or maybe 2 or 3 other people. Again, I was gone to the States by this time. But it did cause a lot of people to go in looking for a lot of things because I'm pretty sure we were considering that smallpox no longer existed in Central and West Africa. It was kind of a scary thing, thinking here we'd gone all these years, and now smallpox was cropping up. Drew: You're at the tail end, and all of a sudden you get hit by something like that. Olsen: Yes. And it was also at a time when we had to call the teams off of smallpox vaccination because there had been a cholera outbreak in West Africa. I was over in the offices in Liberia one afternoon. Usually, I was the only person in the office in the afternoon. The whole building emptied out. And Dr. Barkley, the Minister of Health, comes in, and says "There's an unusual event for you." I said, "What can I do to help you?" And he says, "What do you know about cholera?" And I said, "Oh, very, very little. I mean, we have some background information, of course, I've got a lot of books here. But why?" And he said, "Well, tomorrow we're going to start a mass vaccination campaign for cholera." I said, "What?" He said, "Well, President Tubman has been on the phone to President Sekou Toure of Guinea, and they have cholera in Guinea. I said, "Have they notified anyone officially?" He said, "They notified the World Health Organization." I said, "Is there vaccine in the country?" He said, "I don't know. I'm going to Evans Pharmacy to find out." This was kind of a British-run pharmacy in town, a very small operation. He said, "I want you to write a plan for the vaccination coverage." Drew: Surely this was at 3:00 pm on a Friday. That's when most everything seems to happen. Olsen: I don't know if it was Friday or not. But said I can write a plan and base it on our smallpox coverage. Find out who might be most at risk of cholera, knowing full well that cholera vaccine was considered by many people to be essentially worthless. But what about the other things: looking at the source; determining how many and what kind of beds the hospitals had? These kinds of things I had limited knowledge about, and nobody to contact on that particular afternoon to put this plan together. Drew: More like you knew the questions but you didn't know the answers? Olsen: Yes, I didn't know the answers. So I had a formulation of a plan that had to be fleshed out later on, of course. Well, Dr. Barkley went off and he reported back that they had 50 doses of vaccine in the country. I said, "It might not be particularly wise to mount a mass vaccination program since you've got no vaccine." WHO sent in 500 doses of vaccine right away. In any event, we mounted a sort of mass vaccination program. The first thing we had to do was go to the executive mansion and present the program to President Tubman. So I contacted USAID saying, "I've been asked to go, but I'm not representing the United States." So they sent the deputy, Dr. James, from USAID. And on the way up in the elevator to the executive suite, Dr. Barkley punched me in the ribs and said, "You're to present the plan." Well, I knew enough that if I, as an American, presented the plan, it becomes an American plan. Drew: So we met President Tubman. I had not had the pleasure of meeting him previously. He was an elderly gentleman in somewhat failing health, but very gracious. The first thing he did was to serve us all a scotch had. Drew: Single malt? Olsen: I don't remember. He sat us all down, and I was asked then to present the program, and I started by saying that, "At Dr. Barkley's request, and with all of us involved, we-we-"have come up with this" formulation"-not my formulation." And then he looked at Dr. Barkley for funding. Dr. Barkley looked at Dr. James. And President Tubman said, "Well, I will provide $50,000 towards this from the monies that the Congress (Liberian) has allowed for my new boat"-his new cruiser craft or something. "And, Dr. Barkley, you find the rest." Drew: Amazing. Olsen: Yeah. Drew: And, of course, $50,000 was more then than it is now, but still probably not a drop in the bucket in terms of what you need for funding? Olsen: It wasn't enough. So we presented the plan, and the only change that the President had was that the vaccine will not simply go to the areas that we have designated as being high risk. It would be distributed throughout the country so that all paramount chiefs and politicians in the regions would know that they hadn't been forgotten. This was a decision for him to make, not for us to make. Drew: Sure, sure. Olsen: Shortly thereafter, either a day or 2, we had the Radio Broadcasting Company of Liberia announce that the vaccines were there. We showed up one morning, and we had hundreds and hundreds of people outside waiting impatiently. The nurses were all ready, and we had the jet injectors to use. The nurses didn't want to use the jet injectors. They said they could go just as fast with the needles and syringes. And people were clamoring over the window casings. The people were required to get a form that was being run off on an old mimeograph machine. And so people were clamoring up the stairs to get their forms so they could come back and get vaccinated. It was utter chaos! Drew: And you knew that you did have enough doses, or did not have enough doses? Olsen: We never knew if we had enough vaccine. Drew: So you had that tension kind of biting at your heels too. Olsen: Yes. WHO was continuing to support the government and getting vaccine to them as quickly as it could. My only interest then was using the vaccines that we had and getting the people satisfied so that we could calm them down. And trying to reorganize at Mambo Point so that we could get the people mimeographing the forms outside of the vaccination area because the vaccinees having to come and go was just causing total chaos inside. Drew: And, of course, back in those times, it wasn't like you could email CDC and say, "Hey, I need some backup." Olsen: But there were cases of cholera, and it was totally out of my hands in planning the response. Thank goodness I didn't have to do any more with it. But all of the resources that were available and needed to be pressed into shape, including the staff at the hospital and the people who were there helping develop the Kennedy Hospital, they all got involved and had proper kinds of beds and so forth. And I left the country, so . . . Drew: Sounds like a pretty exciting time. Olsen: It was different. I mean, you're barely comfortable with what you've accomplished and organized in the smallpox program and the distribution of vaccines and getting people inoculated for measles and smallpox, then this happens. It was so totally disruptive. And you knew full well the limited resources. It was just going to change everything. And had we had an outbreak of smallpox at that time, I'm not sure what would have happened. Which situation would have taken precedence? Most likely the cholera because it's more of an immediate threat, more people being affected at that point. Drew: It must have been kind of amazing to be sort of on the line. Olsen: It was different. But I got to meet the President. Drew: And you got to speak to him?. Olsen: Yes. I was checking out of USAID when I met this gentleman whom I'd never seen at USAID before. He introduced himself. He said, "I understand that you were in a meeting with the President of Liberia last night ." And I said, "Yes. But I'm leaving 2 days from now." And he said, "Oh, damn, all my sources are leaving the country." Drew: And now a woman is President, correct? Olsen: Mrs. Sirleaf. Drew: Right. Olsen: Harvard educated, and she's got her work cut out for her. I think she's at least got a chance. I mean, the country had so many difficulties to begin with, and then this 8 or 9 years of war. One person described Liberia as "the infrastructure was destroyed and the culture was vaporized," something like that. It was just totally devastating. Young kids running around, apparently drugged up, with big weapons, killing everybody. But I had the good fortune of going back to Liberia before all that broke out. I mean, President Doe had already taken over, and the assassinations at that time had taken place. So I saw Liberia once again, in l980. (We had left in '70.) You couldn't see much in the way of change because there had been so little there to begin with. So you didn't see the infrastructure breaking down, but it apparently was happening. The economy was just going to pot. Although potentially it could have been a reasonably wealthy country with its rubber plantations; iron ore that was very pure; and they had this international free port, and a lot of ships sail with the Liberian flag, so there must have been some sizeable income from that.[ Drew: Did you have any children born over there? . Olsen: No. My wife and I didn't. But the Thompsons, at least one of their children was born there. They had a good medical service there with a mission hospital called ELWA:"Eternal love wins Africa," I think. My wife Carolyn and I say that we went to Africa at the right time. The countries were gaining their independence. There was a great deal of enthusiasm for the future. They were getting to make their own decisions and realize their own successes and failures. Drew: And I'll bet corruption hadn't gotten quite as much of a toehold at that point maybe. Olsen: You know, it's easy to see corruption in a smaller setting than it is in a big country like this one, so you could see it happening. There was a give-and-take there. I remember Dr. Titus commenting to me once: "The way the system works here, Dennis, is that the President allows everybody to take a little bit. But if you take too much or it gets reported to him that you're getting too much, then you are going to be jailed." And people were . . . Drew: So it's kind of like this unwritten system. Olsen: Yeah. But we enjoyed our time there. We think very highly of the Liberians. And given the opportunity in a different kind of situation, with what's going on there now, we'd do it all over again if it were possible. And it enthused us so much that we've always had an interest in international work and travel. I was fortunate enough to continue my international work in Africa and Asia. And nowadays we just pick up and travel 3 months out of the year to see the world. Drew: That's great. # # # </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310167954%3Fsecret_token%3Ds-VrOTt&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:/25593/158xx emory:158xx Subject The topic of the resource USAID Operations Officer Smallpox Eradication CDC WHO Format The file format, physical medium, or dimensions of the resource 563522736 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Drew, Diane (Interviewer); CDC; Nurse Olsen, Dennis (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 OLSEN, DENNIS Description An account of the resource Dennis Olsen was working for CDC when the opportunity arose to join the Smallpox Eradication Program in West Africa in Liberia as an Operations Officer. David speaks of arriving in Liberia and starting up the smallpox and measles vaccination effort there - even storing the vaccines in the freezers of a local fishing company or refrigerators of local Lebanese merchants. Dennis reflects on the politics of vaccination in the villages and with government officials, coping with a cholera outbreak, and a case of monkeypox. Dennis went on to have a 32-year career with CDC. Language A language of the resource English https://globalhealthchronicles.org/files/original/f511eaf351fca33dd931d73b53f72ca3.jpg bc48be88f6f273f40238ff6efd93d765 https://globalhealthchronicles.org/files/original/29a432a70495ed1beb0b629e39dad491.pdf 7d32ae7f525a12ef5444e0be9e3c968b 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: Carolyn Olsen Audio File Transcribed: January 22, 2009 Interviewer: This is an interview with Carolyn Olsen on July 11th two thousand and eight at the Centers for Disease Control and Prevention in Atlanta, Georgia about her role in the smallpox eradication campaign. The interviewer is Melissa McSwegan. With this interview we are 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 you signed says that you are donating you're donating your 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. Interviewee: My name is Carolyn Hardy Olsen and I know I am being recorded. Interviewer: Okay, great. Thank you. Okay, so would you please briefly describe your childhood and you education and so on and what led you into work or participating in public health campaigns? Interviewee: I grew up in Wyoming and after doing all my schooling in Cheyenne Wyoming I went to the University of Wyoming where I graduated as civil engineer. And so I was working in Los Angeles when I met Dennis and shortly after we were married. We went to Africa and we enjoyed our three years in Liberia then we came back and again I worked as an engineer. And we were in Springfield Illinois when he went to (Bagapur) for three months and during that time I was working for the environmental protection agency and also getting my masters degree in environmental engineering. So, when he went to India I said I can't go right now I have to finish my masters degree. So, he sold the house out from under me and so I house sat that summer while I finished my degree but he knew I was coming to India cause I didn't have any place to live. And so I finished my masters degree and then I arrived in India and he met me in Delhi and it was pretty bad. And so after two days he put me on a train and we went off to Lucknow and he said, "I didn't decorate the apartment because I thought you could do it. And I sat there and all the wire was on the outside, the refrigerator was in the living room. It was really basic and I thought, "Oh my goodness." And so he said, "I've got to work now," and when he came back he said, "I've got to go the field tomorrow," and he wanted to go so we went off for a ten day field trip and when you go on a field trip you stay in very interesting places. Probably the best items that we took to India were our sleeping bags cause we were staying - they call them dock bungalows and they were usually about fifteen cents for a place to stay and breakfast and it wasn't worth it. Interviewer: Oh, right. Interviewee: They were really very basic and if we had water we would - if we had hot water we were very lucky but usually we had water. Then when we came back from that first trip Lucknow looked great then about a couple weeks later I used to have to fly or take the train into Delhi to get supplies. And like Dennis said it was like going to Europe. I mean Delhi looked first class after being in the field. Interviewer: Your perspective changed quite a bit during that time. Interviewee: Yes. Interviewer: How did you - you mentioned that you went on a - on field visits with your husband when he was working with the smallpox campaign. Did you play any particular role during these trips? Interviewee: Well, many of the villages were very rural and so I would usually walk along and because many times by having a woman with him the women were more comfortable but also I found that it's very interesting. Sometimes they have [inaudible 04.23] these different things in the village. I'll tell you one of the most interesting days though, in India women always have their legs covered and usually their arms. So I used to wear Levis and a kurta and I had very long blonde hair at that time and often wore it in a pigtail or pulled back. And on one occasion we came to this village way out in the middle of nowhere and I was reading a book that was really interesting so I said I'm not going into the village, I'll just stay here in the jeep. And so all the children come and they looked at me then they all ran away. And then all the ladies came and they got in a nice little line and usually people will go 'Namaste' but if you're very important it's 'Namaskar'. And the ladies were all giving me the 'Namaskar' and then they would chat away in Hindi. Well, the driver was just howling. I mean he was over by the - just holding his sides. The children had told the women that Indira Gandhi had come to the village so they were all telling me - and all the men were in the field because they were farmers and so probably in some village in India there is the [inaudible 05.41] of the day Indira Gandhi came to visit. But in general we would always go to the different health units and many times the Indian doctor was somebody who was either trained in Delhi or Bombay, now called Mumbai, and they were so glad to see somebody who spoke English. I mean they would get out their wedding pictures. These poor young ladies had arranged marriages and now they're in a village and they were used to living in a big city and so often times we had dinner with them. I mean it was a very - they were very hospitable and we just had a very interesting time in our field visits. Again we would go to many different health units during a day tracking down things and making sure their records were right. The sanitary facilities, again being an environmental engineer were not always that great and so you always had to watch your intake during the day. And so everybody wanted to give you tea and I didn't know at first how to say no and then I found out that, again it was Rujinder Singh our - Dennis' PMA who told me, "Tell them you're fasting." So I would say, "Oh thank you but I'm fasting today," and they would say, "Why?" And I say, "Oh I'm fasting for the health of my husband and the success of the smallpox program," and they would think I was just this wonderful person and then two health units further I would have a cup of tea again. But again you were in an environment that was very different than what most people especially during the hot months it was like a hundred and twenty degrees and you couldn't roll down the windows in the jeep because the wind coming through. And one day our driver took a shortcut so we got lost and we ended up stopping in a village where they went in, took the straw out and got us a piece of ice out of the ground which we put in a bucket and bought about twenty four Coca Cola. And we would get towels wet, put them on our head and it was just a interesting day, I mean very trying on us. Interviewer: And did you have the opportunity to apply your engineering and engineering training while you were living there? Interviewee: Not really. Again sometime there would be water questions and - but it really didn't lend itself to get involved. I was able to do that more when I was in Liberia. I taught sanitation workers how to do mapping and different things but again we were - actually we were moving quite a bit when we were in India. Interviewer: Describe a bit your relationship with the host country counterparts or the people you were interacting with on a day to day basis. How did that work? Interviewee: Being a woman in India is different. Our living arrangement was quite nice in that we lived upstairs in what they called (vasadi) of the Dases. And Mrs. Das was actually the president of the girls school next door, Isabel Thornbird College which is a prestigious college for Lucknow. And Mr. Das had been the police chief for the whole state and so we were included in that part. So there I felt very comfortable being a woman but when we were in the field it was - or when you were alone you always felt like, especially young boys between like fifteen and twenty three, they were very aggressive and so you would always like to make sure that you were - and as a result the PMA and the driver and everybody were always very protective of me. And being a professional person I was not used to having to have to kind of being protected. And then later on when we moved to Delhi it was a matter of having the taxi driver watch you while you went into the market. And it wasn't that you felt security, I mean it was just that they wanted to touch your hair or something. One time - oh, I had - I was having a strange pain and my fingers were starting to go numb and so I went to a doctor in Delhi and they said that I have Hobo's Disease. It was my arm from riding in the jeep I would have my arm up and it was pinching a nerve. And he says, "I think we should X-ray you." So I went in and the doctor came in and he started laughing because the paramedic had put my hair, my blonde hair so it was like a halo while I was laying there. But in general you just go with the flow of things. It was quite interesting. Interviewer: What were some of the biggest challenges to living in India? Interviewee: Food actually was kind of a challenge. We were - when we were in the field we were usually vegetarians because you didn't know the last time somebody who may have come through and eaten meat so you didn't know how old the meat that was in the restaurant. And we ate at the truck stops along the way and so we would always have to ask them to put the samosas back in or put new samosas into the hot oil so everything we ate was hot. The embassy doctor used to just be amazed because we would not get ill but we didn't eat fresh vegetables unless we were home and they were peeled even if we went to a very nice hotel or a nice buffet and we had a lot of soup and a lot of things but also we had a cook. He had a reputation. He had worked for Dr. Francis and Dr. McGinnis and everybody knew that Iddu was just a wonderful cook and so Iddu was an old man, I mean now he is probably forty but he seemed like an old man to us at that time. And he became ill and they gave him streptomycin which caused inner ear damage and so he was having a hard time walking and so then I would pay for a rickshaw to bring him right up to the door and then I had him bring his daughter who had had smallpox so it was really quite appropriate. She was blind in one eye and had pox - to help him so that he could his work. And one day - she would marketing, he would do the cooking most of the time. One day I am cooking, he is sitting there with his feet up, she is outside drinking tea and I'm thinking, "And I have servants," you know. But during that same period of time Iddu got more sick and so about every six weeks or so we would have this regional meeting and all of the epidemiologists would come in and the international epidemiologists would come for lunch and then the Indian and the international ones would all come for dinner which would be about a hundred people. So, we would have usually about twelve to fifteen for lunch and I had Sabra who would help but Iddu was gone so it was up to me. So I thought, "Well what," - so for lunch we had peanut butter and jelly sandwiches and Kool-Aid for the international group and then for the other people I did manage to find some things that were almost ready made, you add two vegetables and you became, you know. And I thought okay this is adequate. Well, the next month as we're going around to the different epidemiologists to see how things were going and everything, all the international ones says, "Boy I hope you have the same lunch next time we're here. That was the best thing. I go to bed at night dreaming of that peanut butter and jelly sandwich." And then the Indian doctors, and Indian doctors actually had a harder time finding food because their wives had taken care of their food in their houses and rarely did they eat out. And in India you have to sort your rice and you know all those different things. Well, a couple of them asked for my recipe for the different curries I had made that night and I didn't have the heart to tell them that I had gone to the store and bought a box of something that I put in it. So I kept on like don't, [inaudible 15.21] the recipe you know, but I had an enjoyable time. It was a challenge and you never quite knew what the day was going to bring. Interviewer: Were you able at some point to decorate your apartment? You had mentioned your apartment had all the wires on the outside and did it eventually become more... Interviewee: Well, it actually started looking pretty good. Interviewer: Okay. Interviewee: I mean, we had fluorescent lights and definitely - but during - well, electricity was not always available and so sometimes you would have company or somebody and all of a sudden all the power would go out. And before the game Trivia Pursuit, we used to play a game that you would give the person the almanac and the flashlight and they would ask the other people questions. So that was our entertainment on that but when we were in the field sometimes if you didn't have power we would go to the movie because the Hindi movies are four hours long, they usually have fans or if they are upscale they have air conditioning and they have their own generators. So we used to go to a lot of Hindi movies when we were traveling and it was - like I said the heat was a challenge when you have a hundred and twenty degrees. Then the cold was a challenge because you had fifteen foot ceilings and no heat and so if you invited people over for dinner you would put the heater under the table and everybody would sit there in their coats and you would usually have soup or something hot. But other than that I mean it was probably the most grueling experience I have. I mean if you look at going to school, going to college, going to India is just straight up. I mean it's like they say you see the poorest, you see the richest. You are the hottest, you are the coldest. Everything is a dichotomy and the people there were just absolutely very hospitable and very, very nice. They were you know again I would say kind of shy but some of the doctors that we met especially the Indian doctors that were in charge of different areas were very, very nice. And this apartment that we had since they would come to visit us, they would see what we lived in so then they felt like they could invite us to their home so whenever we went to Delhi we would be invited to some of the doctors' houses. And probably one of the best invitations we ever had was Dr. Hakoli. While we were there they had the Kumbh Mela in Allahabad which happens I think every fifteen years and it's on the river banks of the River Ganges. And on a busy day there's about probably ten to fifteen million people come and we were invited to come and stay in one of the tents for a minor bathing day so there was only about five million people there. And so the Jumna, the Sangam and the Ganges all meet there and everybody goes to bathe and they have - they pray to the Sadhus. And the first night we arrived there was this chanting so I asked Mrs. Hakoli, I said, "Do they pray all night?" cause it sounds like the Hare Krishna chant. And she said, "Pray?" And I said yes and she said, "Oh! No they're listing hundreds of women who were lost today." And it was a tradition that when you went back to your village you stopped at lost and found to see if anybody from your village had come and gotten lost to take them back. And you would see these ladies with their saris tied together and some young son taking all their aunties to this festival. So it was very, very interesting. Interviewer: What were some of the biggest differences between India in Liberia in comparing your two experiences? Interviewee: Well, I worked in Liberia so I was working as a school teacher there and teaching math and in India I felt like my role was more to support my husband and then there were a lot of social functions like when the international group came again we hosted at our house. When we lived in Delhi and probably - well the type of people we met in India were very different even from the international side cause the Soviet Union was also - had provided quite a few epidemiologists and doctors for the program. And so we not only had Russians but we also had people from Chezkslovakia and a lot of Eastern European countries. And it was an education in social morays and also in how different countries looked at the Soviet Union and how when they socialized and when we socialized it was very different. Cause like if we were to go to a party it was put on by Dr. Codokevich or something as opposed to when we had a party we would look around and find out who else had a servant who would be the bartender and somebody else. So we had all Indian staff working the party. When we went to a Soviet party it was people from the embassy. I mean there were all kinds of ladies and other people that were Russian that were - you weren't uncomfortable but you knew it was very, very different. Interviewer: How did your time abroad particularly in India and Liberia with the smallpox program, how did that affect your career and your life afterwards? Interviewee: Well, on a I guess - India is such - I mean it's just there's so much energy and so much to do and so much to see that I just suddenly felt like I either had to write a book or do something and instead I started painting and in about six months I painted sixty some pictures all Indian. And in India you can do anything so I had a one woman show and sold my paintings and it was really, it was quite interesting. And one of the highlights was that Dr. Sensor actually purchased the first painting I ever painted which was of a train station and gave it to Dr. Fergie. And so my claim to fame was that one of my paintings was in the Carter Center for a while but on a professional side it really brought home the need for clean water. And my profession as it moved forward I was commissioner of water and pollution control for the city of Atlanta and I was very involved in a lot of water and waste water activities. I also then became the president of a non profit which is called Water for People and it gives you a real empathy for how important clean water and drinking water is because when we were in the field in order to have clean water we used to carry - the old milk buckets there are kind of made of aluminum and about this tall. And each night we would fill our jug up with water, put the immersion heater in, boil our water and put it in a - so we never had cold water but we had clean water. And with all the disease and the different things you just realize that water is probably one of the most important parts of our existence. Interviewer: Well, do you have any other stories or anecdotes that you would like to share with us? Any memorable moments from your time there? Interviewee: Oh, I must say that one of the - when we moved to Delhi I didn't get to go in the field anymore so I became a professional traveler and as a result anybody going anywhere I would go. And I was able to go up to an area close to the Nepali border which was called Tiger Haven where they would bring tiger - small tigers back from London and get them back into the wild. And they would put you up in a cage and let you watch the animals which was very interesting. Another time I went with some missionaries and we took a train ride on a no class train and it was a twenty four hour ride down to New Bombay and I was with some Swedish people and it was very, very interesting cause we used to travel by train but we used to travel at least first class something which wasn't that great. But this was - I think it cost me ten dollars to take a twenty four hour trip one return. And on one train we were in a car and the rest was freight and all of a sudden there was a band and it came through playing and it then got off the train. We come to find out they were on top and that's where - also that's where they would make tea and they would lean down over and sell you tea into the compartment but they riding up on top. And the last trip that I took that was very interesting was some people from the embassy were going to go from Delhi to Kabul, Afghanistan. So we went through Pakistan and through the Khyber Pass and into Afghanistan. And that was all in the seventies so that was before the Russians came and I just feel very sad when I see what has happened to Afghanistan. I don't know if you've read it or not but Kite Runner when it described at the beginning is the kind of Afghanistan that I had seen and I also had empathy for Afghanistan cause when I went to University of Wyoming, University of Afghanistan, University of Wyoming were sister colleges so I had met Afghans then also. But other than being a world traveler I think that was pretty much a very positive experience and again I'm sure it changed my life. I mean it just gave me a whole different way of looking at the world and from a South East Asian standpoint but also with all the different cultures that we met through the program. Interviewer: Well, thank you for sharing your story. Interviewee: Okay. </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/vfecYsSMtAs" 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 2008-07-12 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16rc7 emory:16rc7 Subject The topic of the resource CDC Smallpox Smallpox India Format The file format, physical medium, or dimensions of the resource 5847600000 bytes video/x-dv Creator An entity primarily responsible for making the resource Olsen, Carolyn (Interviewee) McSwegin, Melissa (Author) Contributor An entity responsible for making contributions to the resource Centers for Disease Control Title A name given to the resource OLSEN, CAROLYN Description An account of the resource Carolyn Olsen, wife of Operations Officer Dennis Olsen, discusses life in India and in Liberia, during the Smallpox Eradication Program. Language A language of the resource English https://globalhealthchronicles.org/files/original/6d5a1e1404f5438ea282aaaef5ee22f3.jpg bc48be88f6f273f40238ff6efd93d765 https://globalhealthchronicles.org/files/original/bea45593d2b48447984e83ae33645ab2.pdf 3f622a9eb6649dd4597eb78826583ba3 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> McNutt: This is an interview with Carolyn Olsen. It's July 14, 2006, and we're at the Center for Disease Control and Prevention in Atlanta, Georgia, and this is about her involvement with the West African Smallpox Eradication Program. This interview is being conducted as part of the reunion marking the 40th anniversary of the launch of this program. The interviewer is Kathryn McNutt. McNutt: I'm glad you're here. The purpose is to do an oral history. We hope to capture for future generations the memories that you have about all of the participants and their families in eradicating smallpox in West Africa. So, essentially we'll just kind of walk through your story and what your and your family's experiences were. You were involved in the Smallpox Eradication Program in Liberia. Could you tell me what years you were there? Olsen: We lived in Liberia from September '67 to May '70. McNutt: And what was your family situation. Olsen: My husband and I had just gotten married in March of '67. We came to CDC for training in July, August, and September, and then we went off to Liberia. McNutt: That's a bit of a transition. Olsen: Yes. We were in California before we came to Atlanta. So the weather in Atlanta was hot and humid, and when we arrived in Liberia, it was actually cooler and less humid. McNutt: Really? Olsen: Even though we were on the equator. McNutt: So, what was your experience? Kind of paint a picture for me. When you first got to Liberia, what were your living arrangements? Olsen: When we arrived in Liberia, the living arrangements were interesting. The house was outfitted so that you had your basic needs until your freight came. We were met at the airport, which was about 25 miles from town, and taken into town. Dr. Shalimar and his wife took us out to dinner. Then they took us to our little house and said that they would come back the next day. It was a Saturday. We were living in a kind of a compound, and right at the gate there was somebody else's packing crate that someone was living in. When your packing crates came, oftentimes the local people would take the box, which was very large, and make it into a house. It was probably 9:00 PM, but when you're on the equator, it gets dark at 6:00 PM and gets light at 6:00 AM. So we were going to go to bed. We had sheets on the windows because, again, we were just moving into this house. All of a sudden there was this bright light. So we opened windows, and a transformer on this pole was burning. We were going to call the fire department, but we realized we didn't have a telephone. So we just watched it and thought, "Well, if it comes to the house, the house is made of cinderblock." But the fire just kind of went out. And after it went out, we realized that we did have a telephone. However, the black rotary telephone that was under the bed had no cord or connection. Since we really didn't know where we were-and our neighbors were gone for the weekend, so-it was probably just as well that the telephone was inoperable. So that was an interesting start. McNutt: Is that when it hit you that you were in West Africa and not the States? Olsen: I think that when we stopped in Senegal before arriving in Liberia, that was when it hit that us that we were in a very different place. And living overseas then was very different than it is now. There was no email or operable telephone. And so basically for 3 years, we did not talk to our family. We sent letters and, if necessary, there was teletype and occasionally a telegram Also, occasionally at work, my husband would talk to CDC. But most of the time we were on our own.[ And, again, we didn't have a telephone-even though we were in the biggest city in the country. McNutt: Monrovia? Olsen: Yes. And on that first Monday, 2 days after we arrived, the USAID van came to get my husband to go to work. There were about 20 men on the porch, and the driver said to my husband, "Oh, they all want to work for your wife. They want to be the houseboy." I looked at them, and I thought, "How am I ever going to choose?" I'd never had house help. So I thought, "Well, I'll just take the first person, and I'll just have a different person every day until I pick somebody." McNutt: You're trying them out. Olsen: Trying them out. And so I told Timha I was only hiring him for one day. And in Liberia, they speak pidgeon English. It's a little different than English. So Timha came to work for me that day. He was an older man. I was only 25, so he probably was 35, but he seemed like an older man. And we didn't have anything in the house, and so I thought, "What can he do? Well, he could wash some clothes." So I had him wash my husband's shirts and a couple of things because we'd been traveling. After he finished that, he hung all our clothes on the bushes outside so that they could get dry. I thought that I could bring them in, so I said, he could go. And then I looked a little later, and I thought the shirts were mildewing because they all had blue and green on them. So I brought the clothes in and I used all the different cleaners to get the spots out, and I was thinking, "Boy, things really mildew fast here." So when Dennis came home for lunch, I told him we had to buy a dryer. Well, the next day came and everybody was on my porch again. Timha was there again, and I noticed that he was wearing a country shirt, made out of indigo. I realized then that when he was wringing the wet clothes, he had put them up against his shirt, and the dye in his shirt had bled on all of our clothing. Well, luckily, the driver had a friend or a brother or something, and he introduced me to David Parker, who then became our houseboy for the next 3 years. He was a very nice man, and it worked out very well. McNutt: You didn't have to try all of them. Olsen: Didn't have to try. And Timha became our gardener. That was the job he wanted. He didn't want to be the houseboy. Another episode with Timha was funny. The farmers do slash-and-burn in the fields. So I asked him to clean up the yard, and all of a sudden I look out and there's fire. Everything he cut down is burning. But other than that, keeping the house was easy. McNutt: You had electricity, you had a stove, refrigerator, a dryer. Olsen: We bought a dryer, and we had a stove that was furnished. The stove used gas, and so we always had to make sure, if we were going to have company, that we had enough gas so that all of a sudden we didn't run out in the middle of entertaining. Somehow, USAID [US Agency for International Development] would only give us one gas canister at a time. But the people were very, very nice. We felt very comfortable. And the American community was nice. But the smallpox program didn't quite fit with the embassy and it didn't quite fit with USAID, so we were kind of our own program. I am an environmental engineer, and so I wanted to find a job. I found one, working for a firm that was doing an extension of the airport. But then someone who I didn't know took a job that supposedly took a job away from a local person. The upshot was that no dependents could work except as schoolteachers or nurses, so I couldn't work. And then they approached me and asked if I would substitute at the American school. So I taught 7th through 12th-grade math. I had never taught before, but somebody told me the first day of school that you need to be really tough. So I was really tough. Any time the kids were not good, I would immediately give them a test. So after about a week, they just knew they were going to be good when they came in. And, having never had any education classes, I just taught them like I was taught. Years later, it was rewarding when I met some of my students who had actually done well. It was a relief that I didn't do permanent damage. McNutt: They can't blame you for anything. Olsen: Right, right. And then, I guess it was the second year, the principal or the superintendent of the American school crossed the Liberian government and was asked to leave Liberia, so I became superintendent. One day I was sitting in my office and the phone- I told you the phones didn't work, but all of a sudden the phone on my desk rang. I was so excited. I picked it up and said, "American Cooperative School," and they said, "Oh, wrong number," and it never rang again. But the thing that was so nice about our African experience, it gave us a feeling not only for Africa but also for what French countries were like, since we took trips, as part of the smallpox program, to Ivory Coast, which is a francophone country. And we were given vacations every 2 years or so. On our first vacation, in l968, we went with a Peace Corps charter to East Africa for 6 weeks. That was when Jomo Kenyatta was Prime Minister of Kenya, and Uganda, Tanzania, and Kenya were on such good terms with each other that they had common currency. McNutt: Really? Olsen: The drought had not occurred yet in Ethiopia. It was a very kind and gentle country under Emperor Haile Selassie. So we saw part of Africa that no longer exists, and it was a very enjoyable, interesting experience. It was also interesting to see how that part of Africa was different than West Africa. Now, we weren't always just going on vacations, but we were able to go to Europe also. Neither of us had been there, and to spend 6 weeks in Europe just wandering around was really interesting. It was winter, so we ended up in a lot of art museums and other museums. It gave us a whole different perspective on the world. McNutt: Sure. Olsen: Those breaks were nice because, when we went back to Liberia, we could kind of look at life a little differently. In Liberia, there were only a couple paved roads, and we just looked at the same thing every day. And as far as the smallpox program goes, I did not go up- country with Dennis because there was really no place to stay. Later on, when we lived in India, I used to travel with him because they had guest houses and different places where we could stay. But oftentimes he would stay with Peace Corps volunteers, and so a lot of the Peace Corps volunteers would then come to stay with us when they came to Monrovia. Toward the end of our stay, we got very excited because cholera was all of a sudden detected in Sierra Leone. They anticipated it coming into Liberia, so Dennis had an opportunity to meet with President Tubman, who was one of what they called an honorable. His parents had come back to Africa after Abraham Lincoln was president, when many of the descendants of slaves in the United States went back to Liberia. So Liberia was never colonized. But Liberia had an American influence. Their Pledge of Allegiance is just like ours, with a few words changed, and their flag is just like ours except it has only one star. And during the Second World War, Roberts Field was used as a base where the planes would fly to Africa from Brazil and then up to Europe. In fact, sometimes you would see houses made of military runway materials. But in theory President Tubman was a benevolent dictator. And when we came back, we were in Washington for a short time. I would tell people that Liberia was the kind of place that, if you went out at night, you always took a flashlight because there were no lights except the Moon and the stars, and you wanted to make sure you didn't step on a snake or step in a hole. You had no fear of any of the people. And at that time in Washington, DC, if you heard someone walking up behind you, you immediately turned to see who was there. I remember seeing the soldiers. They didn't carry real guns; they carried wooden guns. And oftentimes, after a parade, they would carry their shoes on their guns because they weren't used to wearing shoes, but they had to wear them for the parade. McNutt: How interesting. Olsen: But socially, we had to make your own entertainment. McNutt: Sure. Olsen: The last year we were there, they brought in television. But before that, it was the BBC news. And, actually, Liberia was 45 minutes off of Greenwich Mean Time. During World War II, there was supposedly a German ship off the shore that sent word they wanted to meet with the president of Liberia at 10 o'clock, and so Liberia changed its time so that the Germans would be late, as 10 o'clock became 10:45 Liberian standard time. McNutt: No way! Olsen: Yes. But sometimes people would say that Liberia was like a poorly done United States. But we were in our 20s, and it was our first assignment. We had a very enjoyable time and we met lots of people. At the American school, about 50% of the children who I taught were Americans, about 25% were from other embassies, and the other 25% were Liberian students. Of this last group, some had parents, who were doctors and honorables, and some students were on scholarship. So it was a nice blending. We got to know people from all kinds of different embassies, like the Asian embassies. And if you were their child's schoolteacher, you were a very special person. The students seemed to get together very well. They took care of each other. McNutt: So tell me a bit more about the social life. You were probably one of the younger couples there, I'm assuming. What were the social activities that you did? Olsen: There were a lot of cocktail parties, and you found excuses to have parties, like for St. Patrick's Day. The social life on weekends was really out at the Voice of America transmitter site, which was about 20 miles out of town. They had to maintain short grass around the transmitter, so they made it into a 9- hole golf course. The golf holes were sand with a little bit of oil mixed in. People kept the sand raked. So if you got out on the green, it was like putting on the bottom of a sink: the ball went down toward the hole, like water toward a drain. So you really had an unfair advantage. But it was very interesting. And we all had young Liberians as our caddies. They lived near Harrisburg, which was where Voice of America was. My regular caddy was Michael. He would make sure there were no snakes where I was going. But I never had a bad lie because Michael could pick up a golf ball with his toes, and by the time I got up to my ball, it was sitting on top of a nice little tuft of grass waiting to be hit. One year before Christmas, Michael said, "Missy"-they called a man Boss Man, and the ladies were called Missy-"Missy, are you going to get me a Christmas present?" "Well, Michael, what would you like?" And he said, "I was looking in the book, and I think I would like roller skates." Now, there was no pavement. I mean, there was a dirt road to get there, there was a dirt parking area, and there was grass on the golf course. And so I said, "I think that you really don't want roller skates." But in ways it was kind of sweet, the simplicity of life and not realizing some things. Another sweet moment was when we all made curtains. You could always tell when people came to Liberia by their curtains. People who came in the rainy season had bright curtains; people who came in the sunny season had dark curtains. I used to sew things, and I always had material left over. And David, who worked for us, said, "Are you going to use that material?" So I gave it to him. And one day, Dennis was up-country vaccinating in a certain area. David's wife and children were in that area, so he went along so that his children would definitely get vaccinated. And they took a picture. And there were my bedroom curtains-everybody was wearing them. McNutt: Oh, my gosh. Olsen: But I'm trying to think of some of the other social things we did. I remember our going-away party. Usually when you invited people for these cocktail parties, there were always so many things to do that maybe only 50% would come. And just about the time we were leaving the country, there was an outbreak of what they thought was smallpox. It was way out in the hinterland, where you had to hike in. It turned out to be monkeypox. But Dennis and his replacement, Randy Moser and the team hiked in. And so for our farewell party-and the Moser's welcome-to- Liberia party-they were all still up-country. But Barbara Moser and I were putting on this party, and everybody showed up. And our house was just like they used to stuff Volkswagens: it was just full of people. And about halfway into the party, Dennis and Randy arrived in their Dodge truck. One lady, as she was leaving, said to me, "That was a really good cheese ball." "Oh. Did you like it?" She said, "Yes. My friend and I ate the whole thing. We got stuck in the corner and we couldn't get out, so we would get drinks from out the window, and we just ate the whole cheese ball." I think the thing that was nice about Africa is it gave you a totally different perspective of the world and gave you a wonderment for travel, for things you can do-or the things you try to do anyway. McNutt: So it's great to have that perspective in your early or middle 20s. Olsen: Right, yes. McNutt: Changes your whole outlook. Olsen: Some of the people who are here at the reunion I have never met before. They were in the first group in '66. We were kind of the fill-in group, so we had a much smaller group. There were maybe 10 or 12 of us. So, except for meetings that were held about once a year in someplace like Abidjan, we didn't meet the other people because Africa was so remote that to get from one country to the other you often would have to fly to France first. McNutt: I've heard that. That's crazy. Olsen: And, as opposed to India, where we traveled all over, Africa was hard to travel in. But we had a lot of people from CDC come through -and it was always fun people, like Jim Hicks [James W. Hicks]. Then we would catch up on the news, because we were never quite sure what was happening in the world. Bad news travels fast though, so when Martin Luther King was killed, we knew within hours of its happening; the same thing with Bobby Kennedy. Like I said, bad news traveled very, very quickly. And it was hard to convince Liberians that there was actually a man on the Moon. That was happening while we were there. The local people would say, "Oh, yes, Missy, oh, yes, there's somebody on the Moon." But they had never flown; they had never really been aware of so many things out there. McNutt: It was 2 different worlds coming together. Olsen: Right. But, then again, you don't have to be educated to be smart, or to be wise. I think that all of us learned a lot from the different people we encountered. And at that time, since Liberia had a heavy American influence, we would have a lot of American foods. We had 2 supermarkets, run by Lebanese. The Lebanese also were the jewelers. When I went into the supermarket, I would check the cottage cheese to see if it was green or not. Or I would buy one box of cereal and take it home, and if it didn't have weevils, I'd go back and buy a whole bunch of boxes. But weevils and ants were just everywhere, so we kept everything that wasn't canned in the refrigerator. Even when I baked a cake, I took it out of the oven and put it in the refrigerator. If you left it sitting out for a little while, you'd come back and it would have ants all over it. And if I made spaghetti, I had a strainer so that, after it started boiling, I could scoop all the weevils off the top. Otherwise, it would look like you had pepper in your spaghetti. Flour was the hardest thing. You had to sift your flour because the weevils didn't go through the holes, and then you'd throw them away and you'd make whatever you were going to with the flour. McNutt: What did you do for water? Olsen: Originally, we were on a well. We had to boil the water and put it through a filter. We had these big tall filters with clay candles on them. Once a week, the filters would be boiled and cleaned so that we always had water. Now I was teaching school. One day I was taking a shower. I was totally lathered, and the power went off. So the water went off. So I called David, who brought me the water from the dehumidifier and I poured that on. I still needed more water. So then it was ice water from the refrigerator. So even to this day, I wash my hair, rinse it off, wash one arm, rinse it off, just in case. McNutt: Tools of the trade. Olsen: And after that day, we had a large plastic garbage can that we always stored water in, and every couple of weeks we would replace the water. [Toward the end of our tour, we were actually on a water system, but we still boiled our water just as a precaution. We had excellent restaurants. Salvatore's had probably the best Italian food I've ever eaten in my whole life because they had to make everything from scratch. So they had their own pasta, their own cannelloni. When I went to Italy, it was almost anticlimactic because I had better food in Liberia. And eating out was a very social thing. We ate out quite a bit. There was also a Lebanese restaurant. And this is kind of funny. They had an expansion, and the back area-again, you're talking 100% humidity, 90°-100°F-was decorated like an ice cave, with blown white plaster. You'd go back in there, and they'd have air-conditioning blowing down. They made wonderful hamburgers and shawarma sandwiches. And since I worked at the school, some of the teachers were from different neighborhoods. We had a Haitian French teacher, and we had some Liberian teachers. It was a nice way to get to know different nationalities and different people and work with them. McNutt: What did your family think about your taking off at age 25 for Africa? Olsen: Oh, I had already been to Brazil with the Peace Corps,. I grew up in Wyoming and my first job was in Los Angeles, and I had never been to California. Being the youngest of 7, I was a bit of an adventurer. McNutt: So what special training did you have? You mentioned training at the CDC. What prepared you or your husband for West Africa? Olsen: The participants all went through the EIS [Epidemic Intelligence Service] course, so even though my husband is not a doctor, he went through the course that's usually reserved for the EIS Officers. McNutt: Is that a 2-year course? Olsen: No. It was a 3-month summer course. The EIS Officers who were staying then worked with CDC for 2 years. But we went off to Africa. So there was a lot of statistics and epidemiology, even mechanics. The spouses were invited to attend any of the sessions that we wanted to, which was quite interesting. Plus they had another course, one taught by Dr. Waddy [B. B. Waddy], who was very English and had spent many, many years in Africa. He talked about tropical diseases and the African culture. Other people talked about things like the weather. So we had demographics, history, and geography. But when we first arrived in Liberia, we had very, very little because you were only allowed to carry 40 pounds of materials with you. So we had a couple books and a few other things. But then CDC sent some program materials, so, with nothing else to read, I read the book on tropical medicine. And one by one, you followed the pictures and would see the diagnosis. And not being a doctor, I would think, "Oh, I've got this rash." I think I needed something else to do. I had a couple bouts of food poisoning. One was caused by strawberries. They looked just like the kind of strawberries you bought at the grocery store, but they had probably been frozen and thawed a couple of times on their way to Africa. They used to actually send California lettuce and California celery to Liberia. It did not come by airplane; it came by ship. McNutt: And it made it? Olsen: Yes. We would save the lettuce for special occasions. We had these green Tupperware containers. If you took the core out of the lettuce and put the lettuce in a paper towel, it would last. I'm sure it had no food value, but it was like, "Oh, lettuce, lettuce from the States!" And the tsetse fly is in that part of Africa, so they couldn't raise cattle because they would be killed by the tsetse fly. So all the meat was imported. About the only thing you would get locally was chicken. McNutt: That answers a huge question for me because I did not see many cattle when I was in Liberia in June, and I was wondering why not. Olsen: There is some other bug that gets into clothing that is washed. The bug is in the water, and so you have to iron everything. McNutt: Interesting. Olsen: Yes. And at that time, there were parts of Liberia that were not mapped, because the heat would cause steam to rise in the rainforest. We had some friends who were with the USGS [US Geological Survey]. They kept waiting for a clear day. But if you look at the 1967 USGS map, there was a section of the Liberia map , they probably have mapped the area by now because of the satellites. But I'll tell you about one of our regular activities. Everybody wanted to have some African art. It was very "in" in the States to have African art, and so people would buy different things. There was a group of vendors or sellers, who were called Charleys. So there would be Charley number 1, Charley number 2, Charley number 3. And if you purchased something from them, you could actually write check to "Charley Number 3". Liberia used the US dollar. So I have cancelled checks to Charley number so-and-so. The Charley's must have had a great network. You would hear a noise on your front porch, and then you'd hear the doorbell ring. You would open the door, and there would be like a little store. The Charley would have laid down all his artifacts, and then you would look to see if there was anything you wanted. They would often come on weekends when most people were at home, and we would bargain and bargain. The Muslim Charley's, would sometimes take a break and go say their prayers and come back, and you would bargain some more. My husband didn't like to bargain, so I would be out on the porch to bargain, and then I would bring an artifact in the house and he'd, "Oh, that is so ugly, I don't like it in our house!" and I would go bring it back out and the price would be lowered. One day, I started bargaining because I was bored and there was nothing else to do. I was probably at maybe $10 and the Charley was at $15, and after an hour we were going nowhere. And then I decided I would use a different technique, and I said, "Well, $7." And he looked at me and said, "Missy, $7, two aspirin, you give me a headache." And I still have the artifact. It looks like somebody made it out of mud. It's an interesting, kind of strange piece. One time, my husband was up-country. We had night watchmen, so I felt perfectly safe. One of the Charleys that I hadn't dealt with before came to the door. He had a fine Senefo artifact. It was the only piece he had, and so I knew there wasn't going to be a lot of bargaining. I think I probably ended up spending $100 or maybe $125. It's a beautiful piece, and I must get it into a museum someday. But the next night the doorbell rings, and there he is again, and he wants to buy it back from me for $250. So evidently, somebody had heard about it and had offered him much more. But I said, "No, no, no. It is sold." McNutt: Someone within your group heard? Olsen: One of his customers, because we would describe art pieces we were interested in obtaining. The Charley would then try to find them. . If you had company, especially when anybody from the States was visiting, the Charleys knew it. If you were having a cocktail party, all of a sudden you would hear a ring, and there would be tie-dye on the porch banisters and different Africa items at their little store on the porch. And then, sometimes rogues-they didn't call them burglars in Liberia-came in at night. They never hurt anybody. McNutt: While somebody was there? Olsen: Yes. So at night, when you went to bed, you locked the front door, the kitchen door, and every door in the house. You had these big skeleton keys. Then you locked yourself in the bedroom. And if you were lucky, you had a bathroom attached to the bedroom, but if not, you locked the bathroom too. And off to bed you went. The first incident occurred the first time my husband was out of the country. It was my first night alone in Africa and I had locked myself in. I hear this tap-tap on the window, and I think, "My goodness, somebody's coming in." Finally, I looked out, and there was my husband throwing rocks at the window. He had come back early, and when he rang the doorbell, it rang in the kitchen, and I was 2 locked doors away. McNutt: Your husband was trying to break in. Olsen: Yeah. But then one time I got up in the morning, went into the kitchen, to turn the coffee on, and noticed that we had been broken in. I ran out of the kitchen and locked the door, and I said, "We've been robbed." And Dennis said, "What did they take?" I said, "The water filter." And he said, "What?" And I said, "They were in the kitchen. The only thing I could see is that the water filter was gone and the window was gone." (We had these sliding windows). It was just before Thanksgiving, and the embassy had brought in turkeys for us. So we had 3 turkeys in our kitchen freezer, one for Dr. Thompson and his family and 2 for us. Well, the rogues had taken 2 turkeys and a kitchen curtain to wrap them in because they were frozen solid. That's all they took. We all had tin roofs, and when it would rain, it was like somebody playing the drums. We had the most exciting electrical storms. There were big booms, and the power would go out. The storms would come in off the ocean. The robberies were timed. Just as the thunder boom resounded, the rogues would take the window out. In our bedroom, we slept with our heads against the wall. On the other side of the wall was where the burglars had actually come in the house. We didn't hear them at all. We were in embassy housing. So Dennis went to the embassy to report that we had been rogued. The burglars had gone through the whole area; they had taken money; they had taken stereo equipment. Dennis said he felt kind of strange saying they took 2 turkeys and the kitchen curtain. The robbers had tried to get out of the kitchen, but they couldn't get the door open, so they were confined to that little area. McNutt: That's funny. So, security-wise, you weren't worried while you were there. Olsen: No. We were never in fear. I mean, there was just no concern. McNutt: It was relatively stable out there? Olsen: Very, very stable. Again, you had a night guard. But you paid him, and I'm sure he paid whoever it was that was stealing so they wouldn't come and rogue you. I have a letter that a night guard wrote me. He was a very old man. The letter said, "Dear Mother, please buy me a bed so I can sleep on your couch while I guard. I might have considered his request if he had called me Missy, but "Dear Mother." McNutt: What kind of problems did you have in establishing working relationships with the African counterparts there? Olsen: Well, I wasn't working, except at the school. I really didn't have problems. By that time, I could understand pidgeon English, and usually they were a very kind and quiet people. Many times, the little boys who played soccer with a grapefruit in the vacant lot next door would come over to get a drink of water or just to say hello. Or they would pick the papaya off my tree and then want to sell it to me. But we never felt threatened at all. I'm sure things have changed-the world has changed-but then it was very nice. They made beautiful tie-dye. I used to buy tie-dyed material from the lady who lived under the bridge. Her name was Mama Sony. I would take other American women to her. I think sometimes people were reluctant to interact with local people but I was very comfortable with them because I was teaching Liberian children at school and working with Liberians. So it was very natural. At that time, there was a large international population, too. There was the German store, and there was a large Irish population, so we made many international friends. We would get invited to their houses for dinner, and so we'd have all kinds of different foods. McNutt: So, what about your husband? Within the smallpox program, how did he or the team work to get people to sign on to the program and agree to being vaccinated? Did they have to go to tribal leaders? Olsen: They didn't have the kind of health systems then that they had in some of the colonial countries. Oftentimes they would go to the different villages. And all of his staff were Liberian. He oversaw program operations, and Dr. Thompson was in charge of the medical aspect. I don't know; he'll probably describe it. But his office was incredible. It looked like it washed out to sea and came back. His office was in an interior room, and somebody had painted it a few years before, but when they painted it, if there was a bookcase, they just painted around the bookcase, so you could see where the furniture had been in the past. I remember one time he was really upset because, again, it was really humid and really hot, and he had gone to the USAID mission and asked if he could have an air-conditioner. And they said, "No, that's a Liberian building, you can't have an air conditioner, or everybody will want one." The statement that was made was, "You have the benefit of working with local people. Therefore, you should be able to cope with the local conditions." But he enjoyed working with the Liberian staff. Years later, he went to Liberia on short-term consultancies. His staff were still there and were very pleased to see him. He went up country, where he found out that his driver was now a paramount chief in one of the villages. On his way back, there was a pole thrown across the highway, which meant stop. It was placed there because John Masaquoi wanted to give him a present. He had this country shirt. He stepped aside and said to Dennis, "Tell Carolyn to wash it in Clorox; it's been under the bed." We have only fond memories. We have things that probably no longer exist. They made country money. Nimba Mountain had such rich iron ore that they just pounded the iron ore into 6- inch sticks with kind of a forked end and a round circle at the top and twisted, unrefined iron; one piece of country money was worth a penny. Years later, I met somebody whose cousin had lived in Liberia back in the Firestone days. She used to go into the bush. In the afternoon, they would tell stories, so she made a whole book of notes. After Liberia had all its problems, she went back to her notes that she had taken in the '40s, and even though she was in her 70s, she made a book on Liberian folk tales. It is entitled, You Can't Unsneeze a Sneeze. And reading those tales just brought back so many memories. Food, for instance. They have one thing that's made out of casava called dumb boy, and it is to make you feel full. And you're a dumb boy if you don't swallow it quick because if you chew on it, it swells in your mouth and you can't swallow it. McNutt: That's interesting. Olsen: And then you would eat it with just a little bit of what they called soup, which is kind of like our chili. McNutt: Wow. I love to hear these stories. You said that you did a lot of work, and you spent a lot of time with the locals as well as the expatriates. What was it like coming back to the States? How did you fit in again? Olsen: We came to Atlanta for about a month, and then Dennis was assigned to San Francisco Bay area. One of the hardest things was going back into the grocery stores, places where you had so many options. You had a whole row of dog food. We had gotten so used to having a limited amount. In Liberia, if the ship came in, everybody knew that there was fresh or at least new products. I think the part that amazes me is when you return to the states and you start to tell people about your experiences, and suddenly their eyes glaze over. Then you realize that you are now a part of a different group. If you really want to communicate about travel or about experiences, you have to find a new group of people who also have done similar things or who are well-read. I find that people who are well-read oftentimes enjoy the same interests. The thing about reading or seeing movies of these areas, be it Darfur or whatever, you don't get the heat and the smell. And the heat and the smell are just as much a part of everything as everything else. I think it gives you an appreciation in the United States of many things, but at the same time, it makes you realize that you're fortunate and you need to give something back. McNutt: What was the toughest problem you faced, and how did you handle it? Olsen: It must have been so tough, I put it out of my mind. I feel like I had no problems. Oh, I know. This is a funny problem, but it seemed traumatic at the time. They didn't have parallel parking. You pulled in. And a parking spot in front of the grocery store was always prized. We had a little green Volkswagen, and I'd just been to the grocery store. I was backing out. I looked and no cars were coming; it was clear. And I backed up and I ran into a car, a big black Mercedes. McNutt: Oh no! Olsen: And a lady came out. I could tell she was an honorable's wife. I was in the middle of the main street, but all of a sudden, I was totally surrounded by Liberians. Everybody was talking about this great wreck. The woman was distressed. The policeman was there. And I am the only white face in the crowd. All of a sudden this very tall black man comes and puts his arm around me and stands next to me. He was the husband of one of the schoolteachers at the American School. Dennis was up-country, and so I gave the woman my name and I told her we would have her car fixed. What had happened was, she had passed my parking spot, but her friend said, "Oh, there's somebody coming out," so she backed up, and so she ran into me. McNutt: She should have been looking for you. Olsen: She should have been looking for me. So I was looking for oncoming traffic, and she is backing up down the street. Bang! I was so distressed. I went home and knitted. Whenever I'm distressed, I knit, so I knitted. And when Dennis came back, I said, "You've got to talk to Honorable so-and-so because I ran into his wife's car." Well, the honorable said, "Forget it. She was distressed because she had just gotten it out of the shop from her last wreck." But, I mean, when you're suddenly surrounded, I mean, it's scary. McNutt: So you were glad that man was able to help you. Olsen: Oh, yes, yes. He said he was driving down the street and he saw this big crowd of people. When somebody sees a crowd, something must be happening. He said, "And there you are in the middle of it." McNutt: So, back to smallpox, at what point did you think that smallpox would actually be eradicated in Liberia and West Africa? Olsen: Well, I have to tell you, I've never seen a case of smallpox. As close as we came was toward the end, when they found a case of monkeypox. It was the first time they had found monkeypox transmitted to man, and the lesions looked like smallpox, but it didn't manifest in the rest of the family. And so a lot of people went up into that area. They would take a scab and send it to CDC to be verified. So it was kind of like the show-and- tell. But it was kind of an exciting time. But, like I said, I never saw a single case of smallpox. Evidently, somebody had come through and vaccinated the people years before. Or perhaps, because of their isolation, smallpox just never happened there. But there was so much migration. People from other countries moving in and moving out. McNutt: The tribes aren't divided along country lines. Olsen: No. McNutt: So, had your husband seen smallpox there? He was more up- country. Olsen: Not in Liberia. He saw it in Sierra Leone. He went there short- term. One day we were driving. Our car hadn't arrived, so we always took the taxis. And I said, "Dennis, look! I think I see smallpox!" And here was this little kid sitting there by the road. They have what they call the sandy society, and they have mud stuck all over them, and it looked like some kind of disease. But taxis were interesting. The taxi drivers spoke in pidgeon English. You could take a bus for 5 cents, or you could take a taxi for 25 cents. But you would have to flag the taxis down. Even the policemen didn't have police cars; they used taxis. You would take a taxi up-country. Our Peace Corps friends would go down to the taxi area to catch a taxi up-country. One time the taxi driver was very aggressive. His fare was inexpensive to take them all the way back up to their village. They went with him, and the person in front was not talking. About 5 miles out of Monrovia they realized the passenger in the front was dead. The taxi driver was taking him back to his village. McNutt: Oh, my God. Olsen: One night we had a group of Peace Corps people come to visit. It was late, so we were going to take them back to where they were living in Monrovia. We were going down the main street; 4 of us were in the back of a Volkswagen, and 2 big guys were up front. And all of a sudden this taxi pulls around and tries to stop us. And pretty soon this taxi goes around us again, yelling, "Stop in the name of the law!" So we pulled over, and this policeman, who was drunk, comes to our car and says, "You're under arrest! You have 2 people in the front, you have 4 in the back. That's 7; that's too many." And he said, "Follow me. I'm taking you to the police station." And we're thinking, well, should we go or should we not because we had always been instructed to go to the embassy. The one fellow in the front with Dennis was Peace Corps, and he was teaching law. He said, "I'd like to see this part of the law." So we proceeded to the police station. It was midnight. So Dennis and the arresting officer walk into the police station. They have to wake up the policeman on duty. So now the policeman and the arresting officer come out to the car, and you can tell that this policeman is really tired. He looks in the car and says, "Professor!" The policeman was one of the lawyer's students. So policeman said to the arresting officer, "Now, I know these people and they are okay, so we will let them go." It's now like 12:30 AM. Just as we're leaving, the officer who had tried to arrest us said, "Okay, I'll let you go this time, but if I see you out after midnight, there'll be no mercy." Policemen also directed traffic. If they arrested you, they would get in the car so that they could take them to the police station. But we had these little driver's licenses, little red books. The people who work there for business had told us that if we ever got stopped to just put a dollar in the license and give it back, and they'd let us go. Well, I had one friend. She was downtown, and this policeman started to give her a ticket, and she had done nothing wrong. So she proceeded to give him the riot act. He took her license and put a dollar in it and gave it to her! McNutt: How funny! Olsen: But, again, you would go to the movie and you would always have some young fellow watch your car. When you got out, you would give him a quarter or 50 cents, and your car was safe. Your car probably would have been safe anyway, but it's just the way that they made some extra money. But the movies were interesting because it was back when they had reels. Sometimes you would see the middle reel, the first reel, and then you had to try to figure out the movie. Or they would have broken it and spliced it in backwards or something. When we saw "Wait Until Dark," the opening scene showed the plane backing into the airport port from the sky. McNutt: Whoa! Is there anything from your experience or from the program that you were involved with that you would change? Olsen: Nothing I would change. It was such a wonderful opportunity. I think that it is a shame that young people don't have that opportunity now. You know, Peace Corps sometimes gives them an opportunity. But, actually, they usually work at a grassroots level, and this was more on the professional level. The thing that was kind of amazing was that most of the people in the smallpox program were probably 10-20 years younger than their counterparts. They were all in their mid-20s or early 30s, and most of the doctors and people in Liberia that Dennis worked with were probably in their 40s or 50s. On the social level, it probably took us 2 years before we started getting invited to Liberian houses. When we were in India, it was much easier. In India, we lived in what was basically an Indian house, and we would have different people come to a party at our house, which was probably not as good as what they lived in. So then when we would be in their city or New Delhi, they did not feel uncomfortable inviting us to their house. So that made it much easier to interact. But I think in Liberia, there was a status level that was involved. Even though the salaries weren't that good and the housing wasn't that good compared to stateside, they were still better than what many people had. When the power went out, we had a game we would play. Whoever had the flashlight would have the almanac and ask questions. The other entertainment, if it was light, was watching the geckos. But I think that we benefited because of the people who went before us, in 1966. So I would say the training for the group that went in '67 was good. The other thing is, Bill Foege [William H. Foege] and the Thompsons had had to leave Nigeria, because of the civil war, so they were at CDC during our training and gave us first-hand experiences of what it was like. And different people would tell you things to take to your post. We were very spoiled as far as having American foods. People who came to visit from Mauritania or Guinea would think they'd died and gone to heaven because they could have dill pickles and ice cream and all these things that you couldn't get in other countries. McNutt: So, how did participating with this project change your life? Olsen: I would say that, being an environmental engineer, it gave me more of a global view of the world, and also a real appreciation for water , especially the needs of people for clean drinking water. Unless you have lived in a situation where you really have to plan what you're going to drink, you don't have that same appreciation for water. And remember we lived in Africa before bottled water. Nobody carried bottled water around, and you didn't go to the store and buy a case of bottled water. So you had to make sure that your water and your food were clean and good. That was a challenge. McNutt: And did this first experience contribute to later work experience? You talked about India. Olsen: Yes, India, and in my profession. I was a utility manager, and I was on the board of American Water Works and Water for People. Then I was the president of the nonprofit Water for People. For the last group, I would talk to people, trying to raise money for water projects. And being a woman in a professional field, Africa was, to some degree, a matriarchal type society, but in India you realize how downtrodden women are. But in any society, it's the women who end up carrying the water. McNutt: And the little ones. Olsen: The little ones, yes. And so it just gave me a real appreciation, for different cultures. And to know that almost everywhere you go, there are people who are wiser than you. McNutt: So is there anything else that you want to add? Any words of wisdom for the next generation of public health workers? I mean, you've had so many nuggets already. Any last statements? Olsen: I think that it is very good that we were able to see the world and see the problems of the world. I think also that people need to realize that there are problems here that are also very trying, and we need to be aware of that. People really need to know about health issues. Maybe we don't have the tropical diseases, but we have the overweight and the diabetes and the other things that affect that same socioeconomic group here. Water and wastewater are my areas of special interest. Global warming and cultural changes are going to see the development public health problems that we don't even envision yet. McNutt: Thank you for your time. Olsen: Thank you. McNutt: What a wonderful discussion. # # # </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310135748%3Fsecret_token%3Ds-Hx2bg&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:/25593/158ws emory:158ws Subject The topic of the resource CDC Smallpox Eradication Life as expatriate wife USAID WHO Format The file format, physical medium, or dimensions of the resource 753573744 bytes audio/x-aiff Creator An entity primarily responsible for making the resource McNutt, Kathryn (Interviewer); Rollins School of Public Health; Graduate Student Olsen, Carolyn (Interviewee); CDC; Wife of 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 OLSEN, CAROLYN Description An account of the resource Carolyn Olsen recalls life as an expatriate in Monrovia, Liberia in the period of 1966-1970 while her husband, Dennis Olsen, served as Operations Officer. Carolyn talks of taking a job as a teacher in Monrovia, expatriate social activities, and daily life living in Monrovia. Carolyn also briefly compares life with the smallpox program in Liberia to their later posting in India. Language A language of the resource English https://globalhealthchronicles.org/files/original/b07847907b2c8762b6d63c2a4536e899.JPG 91f148317e5d406c7b2ea2a8433f68df https://globalhealthchronicles.org/files/original/1152aa1d46ef31f9bc016b68e3a2f616.pdf 1b2d762a6f4793cf6640a5fcd223fd75 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> fThis is an interview with David Newberry 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. Diallo: You started out working at CDC in venereal disease. Could you talk a little bit about how your education before that and your upbringing led into a career in health? Newberry: I have a Native American ancestry mixed with an upbringing by very humble parents who really prompted us to seek education. I was a high school dropout, joined the US Army, went to Korea assigned to the 3rd Infantry Division. After completing Basic Training, Ardyce Timmons and I were married January 29, 1953. I served 3 years in the army. Upon returning to Kansas, I tried various jobs but with little education and a GED Certificate, it was clear that there was no way I would be able to provide for my growing family. I went to the local university and applied for entrance armed with my GED. They tested me, and the Registrar reluctantly agreed to let me enter as a probationary student. I carried a double major (Pre-Med and Secondary Education) with a double minor (History and Chemistry) in my undergraduate work. With a growing family I needed to work full- time in a local 750-bed hospital laboratory, as a nonregistered medical technologist. We had 6 children, and that always made seeking higher education difficult. We suffered the death of a 6- month-old child, who was being watched by a babysitter who let a fan blow a plastic sheet over her face. I was accepted as a student at the Kirkwood Missouri Osteopathic School of Medicine. We did not have the necessary $600 needed to reserve my place in the class. I was employed by the Midwest Medical Research Foundation as a research assistant. We were working on mitochondria and some of the early, basic research on liver transplants. We were using dogs as study subjects for liver transplants. I assisted in surgical procedures, postoperative care of the animals, and enjoyed the work but I really missed the person-to-person contact of working in the hospital environment. So when CDC advertised for Public Health Advisors (PHAs) to serve as basic epidemiologists in identifying sources and spread of sexually transmitted venereal diseases, I was hooked. While serving in the military, one of my NCO assignments was to give lectures on venereal diseases. So I applied for the CDC job, and since I was a 15-point veteran, CDC really had to hire me. My application and personal status did not meet the usual CDC recruiting profile or employee pattern. Personnel (the organizational term used then) offered me and my family one assignment choice: New York City as a cooperative employee with CDC on a probationary basis assigned to the NYC VD [Venereal Diseases] Program. We had 5 kids, no money, had never been to a really big city, and were totally ignorant of CDC's work climate, and so we immediately took the assignment. My CDC clinic supervisor was a truly gifted professional who was committed to disease prevention and control. I was directly supervised by Joe Benkowski, who was the Senior Epidemiologist at Brooklyn's Fort Green Facility, which was located on Flatbush Avenue Extension. It was one of Brooklyn's Social Hygiene Clinics. The morbidity there was a huge volume of syphilis cases (all stages), gonorrhea, and other diseases spread by sexual contact. I probably interviewed about 2,000 homosexuals, serving as a Cooperative CDC assignee and later as the Senior Epidemiologist at Fort Green. During our 3 years in Brooklyn, we interviewed thousands of primary, secondary, and tertiary syphilis patients. I really enjoyed that assignment. It was a little tough on the family, but the kids really adjusted. They attended St. Joseph's Catholic school around the corner from our apartment on Underhill Avenue between Bergen and Dean Streets. We sort of integrated that poor Brooklyn neighborhood in reverse, which had transited from a turn of the century Italian neighbor to a mostly black one. CDC only paid a little over $4,000 a year then. The Newberry family could have actually taken in more income by going on city welfare for 5 kids in New York City and being eligible for NY Medicaid than working for CDC. But, anyhow, we had a lot of fun, a lot of laughs, met some great people, worked with some wonderful epidemiologists, and I learned a lot from those folks. There is a lot for a family to enjoy in New York City. We could walk to the Brooklyn Museum, Prospect Park, and take a train to the Hayden Planetarium in Manhattan. One night, about 3 years into the assignment, the liquor store just below our apartment was robbed and a gunfight broke out between the thieves and police while our children watched from the fire escape. It was time to move on. I applied for a job with the CDC Tuberculosis Control Program and was selected for an assignment in Memphis, Tennessee. So the Newberry family moved to Memphis, Shelby County, Tennessee. My CDC predecessor was the Acting Tuberculosis Director for Memphis and Shelby County. I became the Acting TB Division Director there, supervising some 35 county employees. Our clinical activities were provided by the West Tennessee Tuberculosis Hospital located across the street from the health department. Within 18 months, we were recruited by Billy Griggs [Billy G. Griggs] for the CDC/USAID [US Agency for International Development] Smallpox Eradication and Measles Control Program. So we prepared mentally and physically to move to Ghana in West Africa. Diallo: So what would you say motivated you to get into smallpox? Newberry: Oh, I think probably the idea of eradicating any disease really appealed to me, and from what I'd learned while studying epidemiology, this prospect was a huge turn-on with me. The CDC staff talked about it; "Hey, let's eradicate this smallpox disease. Let's get rid of it forever." That really resonated with me, and I thought. "Hey, we will go to any lengths to do that." Also, my culture, and my family's culture, has always been that you should make the world a better place because you're in it, and that you should do everything you can to help others. And, of course, I'm Catholic, too. The nuns beat service into in my head. The guilt for not doing a perfect job I was able to develop on my own! Diallo: Okay. So then you applied to the program, you got accepted. Newberry: Right. Diallo: And you got your assignment in Ghana. Correct? Newberry: Right. Billy Griggs recruited me, and again the Newberry family sort of broke the mold in terms of the usual kind of folks who went to Africa as CDC assignees. We had a huge family. And the guy that I was replacing, Jim Lewis [James O. Lewis], had no children. So he actually leased the former Japanese Ambassador's residence, with 6 bedrooms and bathrooms all over the place. The backyard had a little Japanese garden with a pool in the back, and it to us it was awesome. Accra was just starting the Lincoln Community School, which conducted classes through the eighth grade. CDC/USAID helped subsidize tuition so we able to pay for school for the kids. By the end of our CDC tour, I ended up being chairman of the school board. That was an adventure in itself. The complexity of eradicating smallpox was accomplished by the wonderful Medical Field Unit (MFU) of the Ministry of Health. Being chairman of the school board led me into experiences and lessons in politics, power struggles, and money that banded several strange coalition groups together to apply pressure on the school board chairman! Diallo: So, you had a family with 5 children, you knew you were going to ship them all off to Africa. How did you prepare, and how did the CDC training help you prepare? Newberry: Well, at CDC, we had an excellent orientation, but basically it was kind of a fear school. We were being prepared for all sorts of health and disease risks and adventures. I tried to not to freak all my family out. When you talk to your wife and children about Loa loa, a filoriasis of the eyes, and the timbu fly, which causes cutaneous infestation with furuncular lesions in sub-Saharan, it scares the pants off everyone! Later I did experience a cutaneous infestation, and it did freak me out a bit. But these were nothing compared to some of the horrendous diseases and illnesses that were out there. But then my work in a 750-bed hospital situation helped so I wasn't too intimidated by those kinds of health threats, and ignorance is bliss! Also I had served in Korea so I know what it's like being overseas. So I wasn't very intimidated myself, but for the family I was really fearful. Our children are the greatest-the kids looked upon it as an adventure. I mean, these kids are great. They're amazing. And my wife's an amazing lady. She never did like it over there, and she still doesn't treasure the experience, but she did it and did a really did a good job. As soon as we arrived in Ghana we took a field trip to meet the Medical Field Units of the MOH and all the field staff. There were 315 field staff, with names like Quadgo, Kwame, and Cockaleeka. By the way, Cockaleeka is the Twi word for cockroach. One of our field staff insisted that he was to be Cockaleeka because that way wherever we went, he would already be there. So that's what he wanted to call himself, a cockroach. During that first field trip I met all 315 people the first 2 weeks in Ghana. I couldn't even pronounce one name correctly. We went into this one village, and suddenly here is a red-haired American, and he says, "Hi, I'm Bob Carter. I'm working on an agriculture program," or some such program for USAID. We shook hands, and I didn't see him again for 2 years. Two years later, I saw him in downtown Accra, and I said, "Hey, Bob Carter, how are you doing?" He couldn't imagine how I could possibly remember his name but the secret was simple: after meeting 315 people with unpronounceable names, meeting Bob Carter will always be in my memory bank. Diallo: That was the easy one. Newberry: That was the easy one. Anyhow, in order to implement the Smallpox Eradication and Measles Control Program, we traveled a lot. I put in about 240,000 miles on our Dodge twin-cab pickup. All this travel was in Ghana; it was all in the country itself. I went to every major village, market, and cultural place of geographic importance. I took the children on some of the trips, and they amazed the Africans. They would touch the skin and hair of the children and ask questions like, "How can you tell the boys from the girls because none have pierced ears"? I had then, and will always carry, the highest respect for my African colleagues for what they do, where they do it and the hardships they experience doing it. We at CDC, World Health Organization (WHO), and others may put our arms out of joint patting ourselves on the back for the eradication of smallpox, but the real people, the real heroes, the real staff, the real soldiers who eradicated that smallpox as a disease were those who lived in the countries who did the nitty-gritty work. These folks got to the communities; they got to the households and administered the vaccine while conducting wonderful surveillance systems in place. And I have nothing but absolute respect and awe for what they did, and where they did it, and how they did it. Diallo: Could you talk a little bit more about that, about establishing working relationships with your African counterparts? Newberry: The Director of the program was Dr. Frank Grant-God bless his soul, he died not too long ago-and he was one of the most amazing men that you've ever met. His father was a minister, and Frank was a true gentleman, an excellent epidemiologist, and a wonderful, patient human being. Frank was educated partly in the U.K. and partly in Accra, Ghana. I can't say it well enough: he was just a wonderful human being and a highly intelligent person. He was a well-trained Medical Officer and one of the hardest working professional persons I've had the pleasure of knowing. I traveled to some of the most remote locations in Ghana. I was housed in old huts seldom used because professionals rarely actually went to these locations and worked. I never traveled to any desolate corner or stayed in any hut that didn't bear evidence that Dr. Frank Grant had been there sometime before me! I quit smoking cigarettes in his home, in 1971, because his wife, Mary Grant, who was also a physician, said to me, "Why do you smoke? Have you read the US Surgeon General's advisory on smoking?" "Yeah," I answered, "I read it back in '57, right after Luther Terry published it as part of his findings. I found it very convincing." Mary Grant said, "Well, why are you still smoking?" and I said, "You're right. I won't." So I quit. February 9, 1971, I smoked my last cigarette. I hasten to add that my children made sure that every piece of tobacco disappeared from the house. Later I did take up the pipe but gave it up when I overheard the children trying to justify Dad doing it because it was less of a health risk. Frank Grant was one of the fairest people that I have ever been blessed to work with, in part because of what has already been stated. In addition to those comments, I feel the need to add additional attributes he possessed. Frank Grant was honest to a fault and loved his family and his country. In return he had the love of his staff and his family and the people of Ghana. There was no question about his devotion to Ghana and the health of Ghana; it was incredible. You could not be around him and not be inspired and touched by him. And the intellectual process that he exercised was inclusive and resonated with individual "ownership." He loved the MFU staff, and even we expatriates; he always maintained our equality in a relationship. I didn't know more than him, and he didn't know more than me. I respected his authority and never questioned it. We learned together and walked a path together. And later, Mary became advisor to the head of state on health matters, Jerry Rollins. And so I continued to have a lot of input over the years because of that relationship with the Grant family and with those wonderful people. The Brits trained the MFU staff, which was an organization that the Brits put together because the infrastructure hadn't existed. The capacity to provide outreach health services was extremely limited. So the Brits brought this program for training in treatment and outreach infrastructure together to serve the rural people by training national medical auxiliaries in treatment and public health. They were sent out to the people in what they called MFU teams. These teams actually rotated out to every part of Ghana. Health Inspectors were also trained, and the MFU was charged with a simple task of mapping the entire country. The way they trained those folks was amazing. They had medical auxiliaries. Now Ghana has 2 medical schools, but then they were just setting up the one in Accra. And so they trained these medical auxiliaries; they had a 4-year program and a 2- year program. And the sophistication of the training and the clinical practice of a 4-year graduate of that paramedical school was awesome. So they were our team members. They were the ones who really went in the trenches to eradicate smallpox. We developed surveillance systems. My predecessor, Jim Lewis, and the Medical Officer were exceptionally good people. They were great to follow. Their talents and the legacy they left were real easy to pick up, and we just carried it to the next stage. And everywhere I went, the Medical Officers were good. There were some expatriates from India and other places that were probably a little more interested and focused on the money they were making, but I made lifelong friends with most of the African people who I worked with. I go back to Ghana, even now, and I still occasionally see a person or 2 who I know real well. Diallo: You mentioned a little bit about that British legacy they left behind as far as infrastructure and so on. Would you talk a little bit more about that? Newberry: Yes. The Brits trained medical and paramedical, and set up a system that was really quite comprehensive. You could probably criticize colonialism, but that aspect you could not because they provided and developed a service and accessibility to health services that didn't exist before they were there. They actually had the good conscience and did develop those systems and those structures. They built the hospitals, and they formed the labs. It was complementary to what the missionaries did. I mean, you'd find a Baptist hospital in one place and you'd find a Catholic hospital run by the white fathers in another place, and they were all coordinated with the government hospitals, the missionary hospitals, as well. So they worked together and shared resources occasionally when there was a need. Father Kelly, was one of the first White Father missionaries who first came to Ghana in 1918. They arrived when Ghana had only "Long Boat " off loading from ships as no harbors were built yet. These amazing priests pulled all of their possessions off a ship in Accra (then the Gold Coast). Then loaded them on "long Boats", and then landed on the beach at Labadi at the foot of Accra City. These missionaries then hired porters and carried all their belongings, up-country 500 miles, on their heads. Father Kelly found the poorest tribe living in/under the most wretched conditions imaginable in the northeast of Ghana. He made a whole new life for the people that he grew to love. Where does one get that kind of dedication? When I became acquainted with him after he had developed a written language for 'his' tribe and built any number of maternity hospitals. Father Kelly had a particular love for women and their childbirth sufferings. Whenever you went to see Father Kelly, you had to work basic construction with him as you talked. He wouldn't take a fridge for vaccine storage because he was afraid he'd be "tempted" to use it for himself. We were able to set up a mechanism whereby we could store vaccines and he couldn't be "tempted". So they set the structure up. And the British trained folks who were incredible. When you said, "We'll leave at 6:30 AM for village A, B, C, and D," at 6:30 they were there. Diallo: That's amazing. Newberry: And they knew they were going to stay all day. And no one was late. I mean, that's the legacy. They were very precise, very dependable, very comfortable to work with. I mean, they were so dedicated and committed. Diallo: Wow. That's good, that's really good. Can you talk a little bit about some of the problems of living in the villages and adapting to life in a new country? Newberry: Well, I'm left-handed, and you go up north and you can't hand anything to anybody left-handed. And you're not supposed to eat with your left hand, and so it's sort of like sitting on your hand and trying to work with your right hand. Understanding the culture and the taboos I think is really important. Of course, I was raised in sort of a primitive society as well, so I think I had an advantage over some of my colleagues. I learned over time what protocol really demanded. If I went to a village and it was very poor, hospitality has to be extended to you. But you know that if you ate, you're eating somebody else's food because somebody had to give up their food for you to eat. So I found out that no one could eat until I took 3 bites, and, of course, you ate with your hand. And I found out that if I took 5 bites total, then I didn't have to take any more food. My obligation is finished. So I take 3 bites, everybody can eat; I take 2 more, and I'm finished. So I think little practices like that you had to be tuned in to what was going on. You really had to look for these cultural nuances in order to be more effective. I think a lot of us in the West, we tend to look at Africans as primitive. Let me tell you, I sat in villages when a chief was presiding over a court. And it was the most remarkably precise, fair, and balanced proceeding I've ever witnessed. I could quote you several cases. I'm just telling you, believe it, it's a fact. And it was kind of a funny thing because there are mores attached to ordinary human conditions and problems that we don't even think about. For instance, we were in this village, and a chief was hearing an important case about someone violating fishing rights on a river. The water, food, and all the rest of this is very important, and owners' rights are very important. And so he was hearing witnesses. And then a madman, a Mahakachee, came in and approached the group. And no one paid attention to him until he crossed some invisible line-and I didn't know what it was-but when he crossed that line, everything stopped. And he came around, and he saw my skin and he touched it. I was used to that, so I didn't react at all. And then somebody had given him some food, so he was carrying that food because they couldn't let anybody starve. After all, this is a brother. He's not a social pariah just because he's mad. And so he wandered around and then, again, he crossed over this sort of invisible line, and the witness immediately started testifying and the whole proceeding picked up again. It was so remarkable to me. We tend to look down on folks who don't have the same culture and the same processes that we have, but it was absolutely remarkable, that experience. Diallo: How did your family like Africa? Newberry: Oh, the kids loved it. And I'd give them a task. I'd say, "Okay, the task is that I'm giving each of you 50 cents, and you have to buy your own food for the whole week." And everybody did it-everybody except my oldest son; he liked Coca-Cola or soft drinks too much, so he went over his limit because he bought soft drinks. Diallo: How old were they all then? Newberry: Well, the youngest, Phillip, was just getting ready for second grade. And then, the oldest was one third of the eighth-grade class. (We had 3 eighth-grade students at Lincoln Community High School then.) So our children ranged from first to eighth grade. And they loved it. They'd go to the field with me, and all the Africans loved it. I actually put my children to work when we'd go out to help mobilize a community. People would come to see the kids, and then we'd immunize the people when they came out, that sort of thing. And I actually put my oldest son in the field working with a team during summer vacation. Diallo: I bet they have great memories of that. Newberry: They did love Ghana. And then, we went back later for guinea worm eradication, and my youngest daughter sent her son with us so he could have that experience. So I took my grandson to Ghana later. Diallo: Wow, that's neat, that's really neat. How did participating in smallpox change your life and the course of your career? Newberry: I think it would be easier to phrase that question the other way, Melissa: how didn't it? Diallo: Okay. Newberry: It changed my life in every way that it could: professionally, personally, ethically, from a moral standpoint. I can't think of any part of my life that hasn't been touched by my initial African experience. And have I had some sad experiences? Yes. We experienced the death of people that we know and love both in our own family and outside. But the Africans, the people we lost in Africa, I think were real special, each in their own unique way. Their appreciation for life and death was just amazing. I once asked Frank Grant how Africans accept death. And he said, "Well, let me tell you. We have so many proverbs that cover everything that are our way of life, and our trust in God, is really much like that of the American Indian." And he told this story. "A man was in the forest one day, and he saw 2 snakes. One snake was consuming the other, and he took a stick and broke up the fight and stopped it. That night there was a knock on his hut, and he opened the door, and there's a man. He said, 'I am death, and I was being consumed today in this form of a snake that you saw. So, because you saved me, I will grant you any wish that you want.' The guy says, 'Well, I want to be warned before I'm going to die so I can live the way I want, but I can die the way I should.' So he went through life with no regard for other people. He was selfish and sought pleasure. And then one night, there's a knock on the door, and he opened it, and there's death, and he says, 'I've come to get you.' And the man says, 'Wait a minute. Our agreement was, because I'd saved your life, you were going to warn me.' And death said, 'I warned you with the death of your brothers, with the deaths of your mother and your father and your friends. Now I've come to get you.'" And that's such a poignant way to look at death, and every aspect of life itself. But I think the things that are more important to me were the hospitality and the acceptance that the Africans have. Some Westerners will say, "Well, basically they give you hospitality and greeting because they're going to get something back." That's not true; that's not true. They do it from the genuine openness of their heart. They'll give you their last bite of food. And is it because of protocol? No, it's not because of protocol. It's because that's the way they are. That is their standard. That is their upbringing.. And they taught me how little I know. The first African phrase I learned was to-ba-see-bro-nee, which means, "Take your time, white man." So they taught me there's a pace and a rhythm to life. They taught me what little I know, and the fact is that I need to know more. They taught me a sensitivity for culture and language. I did learn to speak Hausa subsequently in Nigeria. They taught me what family is all about. And I don't mean your immediate family, but global family. They taught me that when one person suffers, everyone accepts you can suffer. They taught me justice in terms of the courts and in terms of being tolerant about people; that you can't draw lines. Because somebody's bad doesn't mean that you ignore them. Some of the customs are so quaint, like if a husband and wife have a disagreement, they can hire an arbitrator. An arbitrator has a little stool, and they come to the house and they sit down on the stool, and while they're seated on that stool, they are arbitrators, they are marriage counselors, and they hear both sides of the disagreement. On sort of a macabre note, in one instance there was a couple who had the arbitrator in, and the wife became so angry at what the arbitrator said that she grabbed the stool and hit her and killed her with it. Diallo: Oh! Newberry: I mean, like I said, it's sort of a macabre thing. But the society and the culture are so rich in Africa that I think we Westerners have missed a lot of it even by being there, even by working with them, even by living with them, and in some instances even by learning the language. Because you can be bilingual, but you can't be bicultural. And certainly the richness of culture also changed my life. I also think road safety and common sense is a major factor. When I used to teach students, I'd say, "You're learning all these things about preserving your health and about avoiding disease organisms," and so on. "Will you get out of a car, will you stop a vehicle, if you're a passenger, and get out?" "Well, why?" "Well, if someone's driving unsafe or at a great speed, your life is in greater danger then than it is from these little organisms. Stop the vehicle and get the heck out." I know I'm rambling, but I'm just trying to look at your question in a holistic way. My oldest daughter married a second-generation missionary in Cameroon, and they went back and lived there, so their household language is Falani. They speak Falani at the household, and they're back here now. Diallo: Oh, and they still speak Falani? Newberry: Yes, they still speak Falani. So in all the ways that you can be affected by living and residing and learning about another culture, Africa had its impact on us. Diallo: What would you say was the biggest problem or challenge that you faced when you look back, specifically at smallpox and how the eradication program went? Newberry: That's a really good question. I think the biggest challenge was developing surveillance and response because we went out with the idea that we immunize people, protect against smallpox, and we would eliminate disease. But the strange thing was that we immunized 25 million, had a big celebration, and we still had smallpox. We gave out 50 million doses, we have even a bigger celebration, and we still have smallpox. Foege [William H. Foege] had figured out that we had to deal with the disease itself, so we needed to get our surveillance system moving, identify those exposed, and protect those individuals. And my colleagues and I, I don't think any of us could ever remember anyone who had been immunized, either early or late, even after onset of the disease, who had died. The biggest challenge, I think, was getting surveillance- and-response systems organized so that they really functioned where smallpox was being spread. I didn't get my surveillance reports, and so that's one thing we really kind of plugged into, getting surveillance workers. If you don't have surveillance, you can't respond. So I used the police telegraph because we didn't have any communication up to Gushiagu, which was well over 500 miles away on the Togo side of Ghana. And I hadn't received reports from the guys for about 6 months, and we were kind of concerned because that was an area where smallpox could occur, and we'd occasionally have smallpox on the other side of the border. So I sent up a Telex saying, "Give us your report." Well, I got back a report within a very short period that said they had 50 cases of smallpox. So I sent 2 teams, 2 vehicles in, and we trudged up there, and one bridge was out. We had to drive across the stream, and all this stuff. We got there about 4 o'clock in the afternoon, to this village called Gushiagu, and I said, "Okay, let's get in the field." Well, there was a lot of palaver, talk, talk, talk, talk. And I'm all anxious to go, and they're going talk, talk, talk, talk. And then, 'Let's go, let's go!" Talk, talk, talk. Finally they said, "We don't know how to tell you this, but when you sent the Telex requesting a surveillance report, he decided just to go and put anything down, so he thought, well, smallpox, about 50 cases would be a reasonable number. So we responded. And, of course, they were totally blown away by having 2 full vehicles with teams driving up there to help them with this outbreak. Diallo: They didn't think you'd come. Newberry: They didn't have a clue we would come. I think we didn't understand the traditional African culture, and we didn't appreciate it or use it very much. Everything looked to us like it had to be done a certain way. You couldn't hire your cousin or your brother because of nepotism; we tried to keep people honest according to our standards. And then we often had trouble with understanding their basic needs, how the African worked. So, like our payout teams would go out, and they always got a kickback. And so when we found out about that, it drove us crazy trying to stop it. But the real enemy was smallpox, and so it was real hard not to focus on smallpox. It was difficult not to get entangled in the personal and cultural and traditional kind of situation and instead really focus on the fact that everybody realized that the real enemy was smallpox. Let's keep that in our focus, our sights, and that's what we're going to fight. Diallo: In retrospect, since hindsight is 20/20, if you were the one who had been running the program overall, is there anything that you would have changed? Newberry: Yes. I think probably the Griggs and Jim Hicks [James W. Hicks] and Bill Foege, Mike Lane [J. Michael Lane], and Don Millar [J. Donald Millar], they all did a great job, there's no question about it. I think probably what I would have done differently, I would have assigned people long-term at strategic state-level assignments in-country. We did a little bit of that in Nigeria. Most recently, when eradicating polio from Nigeria, WHO, UNICEF [United Nations Children's Fund], and all these other high-flying groups would send somebody out for 2 or 3 weeks as an expert, tell you you're doing it wrong. During smallpox days, we didn't do that. We had key CDC personnel assigned to the epi units in northern states of Nigeria. And I lived up there, and that's how I learned the language. And what we did, is we used a holistic approach. We went to the emirs. Each emir has his own chancellor for health, his own government, his own courts, his own religious leaders, and so we went up as an extra pair of hands. And I always made a point to go, Melissa. You tell me where the toughest place to go to and get to is, and that's where I would go. I wouldn't care how tough it would be because that was the challenge. If I'm going to be there, then I want to show everybody that there's no place I won't go, there's nothing I won't do to get rid of this disease. So 6 years ago I wrote a plan for polio eradication, based on the institutional memory that I have from smallpox, and I gave it to some folks, and they said, "Oh, it's too expensive. We can't do that." And now we still have problems with polio in Nigeria. So that's what I would have done. I would have put more people in strategic places, living with, learning, and being a part of the local government, working with traditional leaders, whatever the structure is there, rather than to come fly in and then fly out again. That's probably the only change I would make, if it's a remarkably good, well-planned, and well-executed program with some superior people at all levels. Diallo: So, with everything that you learned from the smallpox campaign, you came back to the States and went on to work with guinea worm and polio. Were there any particular lessons that you learned from smallpox that you were then able to apply to those other 2 diseases? Newberry: Oh, many, many. I couldn't even begin to describe to you how valuable having that experience in smallpox was and being able to look at the logistics of the epidemiology, the use of information and data, that we applied in these other diseases. But for guinea worm, the major problem is trying to modify human behavior. With smallpox, that wasn't really the issue because if the chief says you'll be immunized and your family will be immunized, it happened. Well, in guinea worm, what I learned from my lessons with that, was that we got a little too fancy because all you need to eradicate guinea worm is a piece of cotton cloth, 120 batt, which is produced in every country in Africa. All the people have to do is pour their water through that before they drink it. Right? Simple. No. Diallo: Right. Newberry: You give me a glass of water and I pour it through my handkerchief before I drink it; it can't be done. So I did in a little experiment. I did training way up in the north, in Ghana. Well, you know the Housa tradition, their welcome is to ask, "How are you?" "How was your rest?" "How's your wife?" and "How are your children?" and so on like that. And so as part of my training, I used to add to "How are you?" "How was your rest?" "How's your wife?" "How are your children?" "Have you filtered your water today?" And I didn't tell anybody that we had done this; it was an experiment. And about a month, 6 weeks later, I sent a guy up just to see how the post-training reaction was, and he came back and he was blown away. He said, "They asked me how my wife was, how my children were, and they asked if I had filtered my water today." So, again, that's just one application that I found very useful. I think the other application I learned from smallpox is to look at the use of data. It's so important. With polio, we have an incredible ability to locate cases, and just collect specimens, determine whether this is polio or whether it's acute flaccid paralysis, and we can use that information because it tells where transmission of the virus is not being interrupted, and that's where we go. Again, the enemy is the poliovirus. We're going to eradicate it. We're going to kill that enemy. So I learned that through my smallpox experience. And I think one of the things that really, really distressed me then, and continues to distress me, was that we didn't leave a legacy. In every country that we went to work in for smallpox eradication, if they had a little, we took everything out. We didn't leave anything but an interest in immunization. And with the guinea worm program, we don't leave anything, maybe a few wells that'll last for a week or 10 days or whatever. You know, a year later, nobody uses it. So there's no legacy. But now, with polio, we've improved the global capacity and technical expertise of laboratories by 1,000%. It's unbelievable, the legacy we'll leave with those laboratories. The use of data then feeds into that because epidemiology is about learning the facts, it's about getting your lab confirmation so that you know what to do, when to do it, and where to do it. We also learned that, as far as the legacy, it should be complimentary. For instance, in India, we hold health fairs, so we're de-worming kids as well as addressing adult needs. We're looking at anemia, and we have these little health camps when we do immunization programs. And, again, it's kind of a holistic thing. I'd like to see this continue. So I think the idea of leaving a legacy is one of the things that we've been able to apply. Diallo: Oh, that's great; that's a good example. I know you're at CARE now and have worked with different organizations since this particular program with CDC. How do you see the differences in administration and so on? Newberry: Well, you know, Dave Sencer was a remarkable chief. I couldn't say enough good things about Dave Sencer. So if I were to look at some of the inherent difficulties with other organizations that I have and continue to work with, it's really a lack of leadership. Let me rephrase that. It's the difference in dynamic leadership. And we took some shortcuts at CDC. Our focus was on the eradication effort, and we didn't put a time line on it. When you put a time line-and in India we had a time line- then people look at missing it as a failure. It's not a failure. You missed a time line. So don't put a time line, like, you know, the time line from when the last person develops polio and passes the virus through his or her system. So I think that's probably one of the most important things that we can look at, the leadership we had, the support we had. I never made a request of headquarters that wasn't fulfilled immediately. I almost got jailed in Nigeria for stealing a boat because we had to immunize all the people living on the banks of the Volta Lake, and we didn't have a boat. So leadership and strong support, knowing that what we ask for that we could get. The organization, I think, with logistic focus, was tremendous and outstanding. I didn't see a lot of ego and turf problems; in fact, a lot of the normal barriers that are evident in a common effort, I didn't experience. Diallo: Dr. Sencer said I should ask you about negotiating your cook from Ghana to Nigeria. Is there a story behind that? Newberry: Well, we had the Ibos, and getting the Ibos in Nigeria to work for us in Ghana was a tremendous challenge. The Ghanaians thought people coming from Nigeria were taking jobs, and they were to a certain extent. But it took considerable intervention and effort going out to the highest levels of government to get that the Nigerian Ibos to come to Ghana with us. Then, when I went to Nigeria on a follow-up assignment, to close out the smallpox regional office, I took a Ghanaian, my driver-mechanic. I recruited him from Ghana, and I also had to go to the highest levels of government to get him approved. Diallo: You must have had good faith in your staff to go to those efforts. Newberry: I'd say it was allegiance, it was trust. We became like a family. Diallo: Well, that's good. Well, that's all the questions I have for you. But if there's anything else that you would like to add to go into posterity . . . Newberry: Well, we could talk all day about anecdotes. Like one time I had a Housa working for me who had been married 39 times. Diallo: Wow! Newberry: Thirty-nine times. And I would say, "Wow, this is really remarkable." I said, "How, answer me one thing. Have you married the same woman more than once?" And he said, "Oh, yeah." He was married to one woman, he said, 4 times, but not very many. There were about 3 or 4 women he'd been married to more than once. But this one woman, he was married to her about 4 times, and he couldn't live with her, couldn't live without her, couldn't live with her, couldn't live without her. Finally he learned to live without her. Many of the people we kept our relationship with long after. When I went back to Ghana for the guinea worm program, I recruited some of the same staff and the same superintendent, and they probably tell more anecdotes about me than I do about them. But, no. I think the lessons are humility on our part as we work in a program. I think the major task is teamwork and the recognition of who does the real work. It's the house-to-house work. It's getting in the communities, working with the community. And, unfortunately, CDC and most multilateral agencies are not connected at the household level. Take polio. That's one of the big problems. They're not connected at the household level. They come in with the experts at the upper, rarified air of the stratosphere, and that's not where it happens. It's got to be at the household level. And then you have to recognize that the enemy is the organism you're fighting; it's not people. When people tell me they're working in Nigeria and they're going to try to keep the Nigerians honest, well that's not our job. I mean, I love Nigeria; I really loved Nigeria. But I don't try to make them honest; I don't try to interfere with their culture, their tradition, and their practices. I always figured that you were successful in Nigeria when you only lose about 25% of your assets to theft and pilferage. Diallo: Wow, that's funny. Newberry: So, anyhow, Melissa, thank you so much. Diallo: Thank you very much. # # # </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310134984%3Fsecret_token%3Ds-fX2yR&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 2006-07-13 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/158vn emory:158vn Subject The topic of the resource CDC Smallpox Eradication USAID WHO Operations Officer Format The file format, physical medium, or dimensions of the resource 502921104 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Diallo, Melissa McSwegin (Interviewer); Rollins School of Public Health; Graduate Student Newberry, David (Interviewee); CDC; Operations Officer Contributor An entity responsible for making contributions to the resource Reunion of West and Central Africa Smallpox workers (2006 : Atlanta, Georgia) Title A name given to the resource NEWBERRY, DAVID Description An account of the resource David Newberry was an Operations Officer assigned to Ghana. Dave speaks of moving his family of 7 to Ghana, his Ghananian colleagues, cultural experiences, and how it impacted his own life and the lives of his children. Dave identifies surveillance and response systems as the biggest challenge during his time in Ghana. Dave went on to work in guinea worm and polio eradication and offers comments on how leadership and support were crucial to the success of the smallpox eradication effort. Language A language of the resource English https://globalhealthchronicles.org/files/original/9e73adb0276dae8e3e81b079dded3264.jpg a6b7596f97213fa0478af4a827dbca76 https://globalhealthchronicles.org/files/original/593067580a4e333a354d709d49ccd453.pdf c49df0c586f37185344bfce41561d04a 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: Stan Music Audio File Transcribed: January 29, 2009 Interviewer: This is an interview with Stan Music on July 11th, 2008 at the Centers for Disease Control and Prevention in Atlanta, Georgia about his role in the smallpox eradication campaign. The interviewer is Melissa McSwegan. With this interview we are 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 you signed says that you are donating the oral history to the U.S. Federal government and it will be in the public domain. So for the record could you please state your full name and that you know you are being recorded. Interviewee: My name is Stanley Music and I know that I'm being recorded. Interviewer: Thank you. To start out with can you talk a bit about how your education and upbringing led you to work in the health field? Interviewee: Yeah. My father was an immigrant although he came to this country at a very early age. He was the oldest of five or six children and when his father died he was still a teenager and he had to quickly abandon any of his hopes at a higher education and start earning a living for his family. As a result of that he always encouraged both his sons -- me and my brother -- to become a professional man whatever that meant to him but he wanted me to be a doctor or a lawyer or something professional and not have the financial worries that he had pretty much all of his life. Interviewer: And so then once you did - begun working in health how did you get involved with the smallpox campaign? Interviewee: Well I went to - I got accepted to two medical schools one of which was in the same city in which I lived and the other was an hour away and would require that I be in residence away from home which opportunity I jumped at because I had been to college in the same city in which I lived. So I went to University of Maryland, medical school and fell under the influence of professor of medicine Ted Woodward who was quite well known in international infectious disease circles. Because I fit his profile of whatever he was looking for, during my junior year summer between third year and fourth year of medical school he sent me as a research assistant to Pakistan. And I saw an incredible variety of infectious diseases, human rabies, smallpox, cholera and a few others that made a deep and lasting impression on me and probably set my values for somebody who wanted to help make a difference in diseases of poverty in tropical areas and generally trying to bring the benefits of twentieth century medicine to a population that was living in hundreds of earlier times in effect. Interviewer: So, when you first began working with the smallpox campaign what was your role? Interviewee: Oh. We have skipped an awful lot of history then. So I was very much interested in infectious disease, internal medicine and actually specialized in infectious disease but couldn't quite see myself as an academic fighting for grants etcetera. So I followed a friend of mine, Mike Greg down to CDC and paid him a visit where he was part of the EIS program and editing the MMWR and got very interested in a career in the public health service in epidemiology. And the following year I applied to the EIS - excuse me - and was accepted and because of my Pakistan experience when I was an EIS officer and Pakistan and - West Pakistan and East Pakistan had a falling out and East Pakistan wanted to become an independent country called Bangladesh. I was part of the team that was sent by CDC to work in Bangladesh on a nutrition survey designed to make sure that the food that was in the country was given on a priority basis to the areas that needed it the most. That experience in turn led me to learn Bengali and that's why Stan Foster was very interested in recruiting me to the Bangladesh program because I had been to the country before and I spoke enough of the language to get around on my own. So that kind of set the stage for my smallpox involvement. I protested mightily when he asked me to join because I had just acquired admission and a full federal scholarship to University of London to get an MPH equivalent degree. But he agreed that if I gave him two years of smallpox eradication that he would see to it that I continued on in my academic studies before joining CDC permanently as a staff member and he was good to his word as was I. Interviewer: So tell me a little bit about the working relationships you had with your counterparts on the ground and what were the successes and failures you had with that. Interviewee: Well, counterpart was I think in many ways an exaggeration because they really had no clue as to what was expected and what was going to be done. We ended up actually setting up a whole parallel system of employment. We used Ministry of Health personnel to be sure but by giving them - by basically doubling their salaries and giving them access to motorbikes and Land Rovers and other transportation we elevated their status and they became very loyal to us. They became reliable surveillance partners who could go out on a schedule and be in a village market on a given day at a given time and advertise about the smallpox program and get information about whether there was any smallpox showing pictures of kids with smallpox and asking if they knew of anyone. But we set up a whole parallel system. The government of Bangladesh was very good at acquiescing to our stated and carefully thought out -- most of the times -- needs but they really weren't partners in the delivery of the services. They just stood aside and let us do our things mostly. Interviewer: What were some of the biggest challenges you faced on the work on the ground? Interviewee: Well, one of the biggest challenges was getting people to do what they were supposed to do. They weren't used to being inspected. They weren't used to being challenged, they weren't used to having somebody count the number of vaccines vials and then three weeks later come back and ask how many people had been vaccinated and then go back and count the vaccine vials again and see if things actually jived. I learnt very early that the Bengali intellect is quite well formed and they know for example that there are exceptions to every rule. So when I said you know if you find a smallpox case the whole village is quarantined and you vaccinate everyone, but if I then did an inspection when they said everyone had been vaccinated, they would - I would discover a guy dying of TB or congestive heart failure or something lying off in a corner of a hut, and he had been exempted from vaccination. But I said there are no exemptions and they said every rule has exemptions and I said okay, thought about for a while and then I said, "Okay. We are now going to vaccinate everybody with one exception. We will vaccinate no dead persons." And they laughed but they understood and then I had no problems. So it was a matter of understanding the culture, understanding their attitudes and the challenge then of translating my desires into something that they could follow and give me results that I was looking for. Another big challenge was these seasonal fairs that pulled people in from many, many miles away. They were a source of revenue to the district commissioners who got a piece of the commercial action but when I found that a particular fair was actually a disseminating source of smallpox because people who were infectious were coming, mingling with people who were still susceptible who then spread out and returned to their villages, I had a big problem. And I had to - people who were earning the money threatened me because I was going to report this. In the end I went to Dhaka and informed my superiors about it but basically got no support until D.A. arrived from Geneva, listened to my tale of woe and did his little magic with the political heads of the health department and WHO and then we managed to put vaccinators into the fair areas and stop the transmission. So there were challenges all the time. Another challenge we had was a lack of petrol in the area that I was designed to cover. So we had Land Rovers and we had jeeps and we had motorbikes but we couldn't run them because we didn't have any fuel and there was no way to get any fuel. But we ended up doing something quite inspired, quite illegal and quite dangerous. We found a train siding run by the army with cars full of petrol. We ended up one night unpinning the connection to the last car, rolling it a couple of miles down the track and siphoning out all the gasoline and finding ways to store it and returning the car under the cover of darkness back to the train as if nothing had happened only it was now largely empty instead of being full. But we needed the petrol to make our surveillance rounds and to keep pressure on this disease to stop it from spreading. So, yes there were challenges every day of many, many kinds. Interviewer: Tell me a little bit more about life in Bangladesh from a cultural perspective. Not so much just about the work but what was it like living in Bangladesh? Interviewee: Ha. It meant when the sun went down the lights went out. It meant learning to be patient, it meant learning to enjoy the simple things like a home cooked meal. There were a mixture of Muslims and Hindus and a few Christians and a few non believers of every variety. There were some people of the old ruling class under the days of the Maharaja who still lived in crumbling palaces but it was a wonderful education and at night there was nothing to do but talk. There was no radio or television or anything although I did have a little portable shortwave but the culture was rich, the people were wonderfully talkative. The oral traditions were great and I learnt a lot about the people and their culture, their habits, their food, their clothing, their rituals and the way that they accepted life. And although they had by my standards a very primitive existence, they actually enjoyed their lives I thought to a much greater extent even with all the poverty and the disease and the premature mortality and the excess morbidity to a greater extent and with more relish than I could recall from the United States. Interviewer: As you were working with the smallpox campaign, was there a particular point where you knew that smallpox could be eradicated and would be eradicated? Interviewee: Well, actually no. I had the belief that it could be because I understood the epidemiology and nothing in my experience had given any reason to believe that my understanding was different than reality but every day in Bangladesh ten thousand - that was the birth rate - ten thousand new susceptible would be born. So even if as in my dreams we could fly B-52 bombers wing tip to wing tip over the country spraying vaccine so that everybody who took a breath would be vaccinated, the very next day we would have ten thousand new susceptible. And I knew that just vaccinating, trying to vaccinate and keep a population fully vaccinated wasn't going to work. What we needed was an epidemiologically oriented program that Bill Fergie designed and clearly when we were working efficiently with good surveillance and good follow up, good containment, good ring vaccination, good quarantine, we stopped the spread cold and it worked every time. So I knew that once we had it all together it was going to happen very quickly and it did. Interviewer: Now that you have thirty some years of perspective on this campaign is there anything you would have done differently? Interviewee: No, I don't think there was actually. I think it was a treasure of an experience, it shaped my life and my career and my attitudes, my values. I thought that smallpox was just the beginning, that we would then march on to measles and all the other vaccine preventable diseases. After all we had the surveillance organized, we had the trained staff, we had people in place, all we had to do was implement it but that was not going to be. But my generation of CDC epidemiologists were always somehow more empowered and more aggressively public health oriented than our colleagues who didn't have this experience. Interviewer: What are the most important lessons that you learned from smallpox that you then applied to other areas of your career after the campaign finished? Interviewee: Well, to a certain degree smallpox was about breaking the rules or interpreting the rules with flexibility bordering on breaking the rules because nobody sitting back at a desk could figure out what was really going on in the field. If you went to the field you learned about the fairs that were spreading smallpox, you learned about the people not being vaccinated because they had some other illness and etcetera. So smallpox taught me to break the rules if I was going to be successful, if I was going to be carrying out the disease reduction, following through on the results of an investigation. But you can't operate that way in the civilized world and in modern European or in America. So I had to change the way that Bangladesh had taught me and learn how to be patient, learn how to educate, learn how to involve the public and not be the kind of imperialistic dictator that solved the smallpox problem but was not going to cut the mustard in the real world after that. Interviewer: And how did the overall experience impact your life? Interviewee: Well it made me a public health believer because I had a monster success under my belt. They gave me a quarter of Bangladesh, twenty five million people then, five districts, a suitcase full of money and some vaccine and some bifurcated needles and said go do it. And I had a driver and we did it. It was amazing and it filled me with a desire to have a full public health career and to carry out those initial dreams that I had when I was but a medical student wanting to bring those people up to the twentieth century in terms of their morbidity, mortality and infant child mortality experience. Interviewer: Did you continue working in infectious diseases? Interviewee: Well I continued working in epidemiology but I came back to CDC and worked with Lyle Conrad in supervising EIS officers that were assigned to state and local health departments. I kept my hand in international consultation and did a few WHO and USAID consultancies. I used the time to understand a lot about other countries and eventually was recruited to the global EIS by Phil Brockman and then when he retired I was named his successor and I put programs in Thailand, Indonesia, Mexico, Saudi Arabia, Taiwan, Philippines, Peru, Italy and Australia. And said no to a couple of very big countries to the disappointment of my boss because those countries weren't ready and they weren't going to participate but that was India and Egypt which have since changed and there are now cooperative programs with those countries. But I used that, that was - that helped define me. Interviewer: Can you tell us one - one of the most memorable moments you have of your time in Bangladesh? Something that happened, an event that happened, something that you remember and think back on. Interviewee: Yeah, I think I can. I don't think that there are very many people who know this story. There was a famine in Bangladesh at that time, at least in my area. There was a - they had two or three rice crops a year depending on how much water there was and the physical geography of individual areas. And a rice crop had failed so there was quite a bit of [inaudible 24.14] starvation and it was getting hard to hire people because the wages that we were authorized to pay wouldn't give them enough money to buy the food that they needed so we weren't really competitive. And then the new rice crop which was not failing was about to come in and here they got a living wage plus they could put handfuls of rice in their pants pockets and they could earn a lot more, in essence take home take a lot more than they could working for me. And working for me meant being guards, vaccinating around infected villages. Well I couldn't live with the idea that we could identify villages and then not protect them and not vaccinating those villages and not break the chain of transmission. And I sat down with one of my subordinates an Egyptian physician, Ali Salim [inaudible 25.32], wonderful man, and we sat up at night and thought about our dilemma and how we were going to resolve it. We had radioed back to Dhaka and they told us the price that we pay for each guard was fixed. I don't remember how much it was, fifteen taka a day or something like that but we couldn't pay anymore and we needed to pay more. And I said, "Look you're leaving me in an awkward position. I've got infected villages. I can't quarantine them, I can't vaccinate any of them. I don't have enough people." "Those are the rules." Okay. So Ali and I sat down and decided we were going to invent villages and were going to invent outbreaks, and we were going to invent workers and we did and we paid them the right wage on paper. And we encumbered then a lot of need for money which we then divided up among the real workers and paid them enough to keep them working for us and not harvesting the rice. So yes, I can tell you that and probably other stories as well about what we had to do to stop smallpox. Interviewer: Wow. Interviewee: Yes. Interviewer: Well, is there anything else that you would like to add or any other stories that you think? Interviewee: I think I've probably gotten myself in enough hot water you know. Interviewer: Like do you really want that story [inaudible 27.18]? No. Well, thank you very much. I appreciate your time in sharing your experience with us. It all looks very interesting so thank you. Interviewee: Okay. </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/-tJBUIy58qc" frameborder="0" 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/. 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:/25593/16rzk emory:16rzk Subject The topic of the resource Bangladesh Smallpox Eradication Smallpox Eradication Smallpox Eradication Format The file format, physical medium, or dimensions of the resource 5947080000 bytes video/x-dv Creator An entity primarily responsible for making the resource McSwegin, Melissa (Interviewer) Music, Stanley (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 MUSIC, STANLEY Description An account of the resource Dr. Stanley Music describes his experiences as an epidemiologist in Bangladesh with the Smallpox Eradication Program from 1973-1975. Language A language of the resource English https://globalhealthchronicles.org/files/original/a9f3467b7db2391364bee10ac5687a6d.jpg 12d6c00d1ea77ebb7d729b86916fc2ed https://globalhealthchronicles.org/files/original/fe408524bbac2714bd3af07fabbfb22d.pdf e2dc6b2f07dfdc5accb0f12094f47f38 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> This is an interview with Leo Morris about his activities in the West Africa Smallpox Eradication Program. His wife, Jane Morris, is also present. The interview is being conducted at the Centers for Disease Control and Prevention, on July 14, 2006. This is during the 40th anniversary celebration of the launching of the Smallpox Eradication Program. The interviewer is Kata Chillag. Chillag: How did you come to choose public health as a career? Morris: It was a bit serendipitous. My background is statistics, and I was studying statistics at the University of Florida. Usually every summer, I went home to Miami to work, usually in the hotels, to get money to go back to school the next fall. But during my junior and senior year, I thought I'd better get some experience. The Public Health Service had a traineeship program for statisticians, and 1 other person and I were selected from the University of Florida. Our assignments were just random. He got assigned to the Department of Agriculture, which turned out to be pretty boring, he tells me; and I got assigned to the Tuberculosis Program, Public Health Service, before it was transferred to CDC. After that summer, they asked if I'd consider coming back after graduation. And I might add, in those days-'59, late '50s- a statistician, even one with just a bachelor's degree, was in great demand. There just weren't many around. And I said, "Well, you know, I'd like to stay closer to Florida," and they told me about CDC. The Serfling-Sherman Polio Immunization Surveys were being conducted then, so CDC was looking for statisticians. So they recommended me to CDC, and there I was. Chillag: And so, how did you get tracked into smallpox eradication? Morris: I started out in the Polio Surveillance Unit, when we had cases of polio in the United States. I worked in that unit for 3 years in the EIS [Epidemic Intelligence Service]. Then Dr. Langmuir [Alexander Langmuir] supported me for employee development, and I left and got my Ph.D. at Michigan, where our first child was born. (The first was born in Michigan where I got an MPH in biostatistics in biostatistics, the 2nd in Atlanta, and the 3rd in Brazil,.) Then I worked with D. A. Henderson [Donald A. Henderson], mostly on viral diseases in the Surveillance Section. The Investigations Unit was devoted to bacterial diseases back in those days, with Phil Brachman. I also worked a lot in reviewing material for the MMWR [Morbidity and Mortality Weekly Report]. That was '63. I worked on a big St. Louis encephalitis outbreak that year in Houston, Texas. In '65, I worked with Larry Altman. He became the first person to go to West Africa in the measles program in West Africa on a TDY [tour of duty]. We were getting involved in some smallpox work, and I was chosen to be part of it. We had a 5-person team in '65, including Don Millar [J. Donald Millar], who later became head of the Smallpox Unit at CDC, to evaluate the vaccine produced in Brazil. Basically, we were comparing the Wyeth freeze-dried vaccine with the freeze-dried vaccine produced in Brazil. We worked in the Amazon territory of Amapa, which is now a state. We were gone about 5 weeks. When we left here, it was winter. In fact, we had a snow storm, and that day we didn't know whether we were going to get to the airport or not. And there, of course, it was summertime and 100° in Rio de Janeiro before we went up to the Amazon. That was my first trip to Brazil. I did some polio work in Chile and Puerto Rico in 1960 and 1961. I really sort of fell in love with the culture in Brazil, and the people and so forth. That was '65. Then '66 was the start of the smallpox program, so I stood up with D. A. Henderson and others in the original group that started the Smallpox Eradication Program. I was in charge of the statistical end and evaluation. In '66, we trained the first group that went to West and Central Africa. I had interviewed many of the nonphysicians who had applied. Then the Pan American Health Organization (PAHO) came to CDC. At that time, Brazil was the only country with endemic smallpox in the Americas. There were some overflow cases into neighboring countries. It was variola minor, not variola major, so it didn't get the publicity of some areas. But PAHO, which is part of WHO [World Health Organization], said they were going to put advisors into Brazil. They had a newly created Smallpox Eradication Program, and they needed a statistician, an evaluation person. They had 3 physicians, 1 from Paraguay, 1 from Peru, who was the team leader, and 1 from Colombia. So I was asked if I might want to go to Brazil. I said, "Where do I sign up?" I was very eager for that. In February of '67, we left for Brazil. And that's how I got to Brazil. I was there 3 years as advisor to the Smallpox Eradication Program after I had participated in sending the first trained group over to West Africa. Chillag: And, Mrs., Morris, how did you feel about that? Mrs. Morris: I loved it. When Leo asked me, "What do you think about going to Brazil?" I said, "When?" Morris: We both learned how to samba. Chillag: Yeah, there you go. So, you mentioned that before the actual smallpox eradication, you did the trial between the 2 vaccines, correct? Morris: In '65. Chillag: In '65. And then, after that, was there a typical day for you as a statistician working on this in Brazil? Morris: Well, we had several primary objectives. I spoke Spanish reasonably well, but I took some Portuguese courses so I could forget my Spanish because it's hard to combine the 2 languages. The director of the program in Brazil was a man named Silva. He had recently retired from being the head of malaria control in all of the Americas at PAHO in Washington and returned back to Brazil. Because of his vast experience, they talked him into taking over this new Smallpox Eradication Program. He was the only one in the office who spoke English. Now if you went up to the Ministry of Health in Brazil, a good percentage of the people spoke English. But he was the only one who spoke it in this office back then in 1967. So on my first day there, we conversed in English, about the surveillance we needed, reporting, and so forth, and then he said to me, "This is the last day I'm going to speak to you in English," and he never spoke to me in English again. So in that environment, it was easy to really improve my Portuguese. We had 3 primary objectives. First was to develop a reporting system, which they didn't have. There were 22 states at that time, and I think only 6 or 7 were reporting cases of smallpox . Sao Paulo, the biggest state, with the most cases, never reported. Starting a surveillance report based on the reporting was the 2nd goal. And the 3rd was to start thinking about evaluation. I had worked on the system that they were going to use in West Africa for evaluating the vaccination program. We wanted to extend it to Brazil, although in Brazil we could be a little more sophisticated because they had better census data to use as a sampling frame. Chillag: When you talk about evaluation of vaccination, what all does that entail? Morris: Two primary things. One would be a sample of villages or towns, sometimes big cities in Brazil, to look at 2 things: 1) asking everybody in the sample households if they had been vaccinated in the campaign; and 2) checking everybody </pre> Player html for embedded player to stream video content <iframe width="100%" height="166" src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310131763%3Fsecret_token%3Ds-OergU&amp;color=ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false" frameborder="no" scrolling="no"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource sound recording - nonmusical interviews Date A point or period of time associated with an event in the lifecycle of the resource 2006-01-13 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/158th emory:158th Subject The topic of the resource Smallpox Eradication USAID WHO CDC Surveillance Format The file format, physical medium, or dimensions of the resource 574078512 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Chillag, Kata (Interviewer); CDC; Anthropologist Morris, Leo (Interviewee); CDC; Statistician/Surveillance Officer Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of West and Central Africa Smallpox workers (2006 : Atlanta, Georgia) Centers for Disease Control Title A name given to the resource MORRIS, LEO AND JANE Description An account of the resource Leo Morris describes the smallpox program in Brazil and the eradication of the disease. Jane Morris relates some of the challenges of life abroad. Leo, was already employed with CDC, and helped interview and train the initial group that went to West Africa. He served as a statistician for the Smallpox Eradication Program in Brazil, which was the only endemic area for smallpox in the Americas. Leo helped develop a smallpox reporting system and surveillance, as well as an evaluation program for the smallpox vaccination campaign. After his time in Brazil, Leo continued his work with surveys and evaluation techniques in the area of reproductive health. Language A language of the resource English https://globalhealthchronicles.org/files/original/c0e9e0e50be5cbaed70d73c2e712fcda.jpg 2b5d3c2fab535c5de4db7a737df904af https://globalhealthchronicles.org/files/original/6c8301345e9e95c987ef3effc9d5eec3.pdf 60556767adac34a43a4ac18eb01fa7f2 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. Donald Moore on July 14, 2006, at the Centers for Disease Control and Prevention in Atlanta, Georgia, about his experience and involvement with the West African Smallpox Eradication Project. The interview is being conducted as a part of a reunion marking the 40th anniversary of the launch of the program. The interviewer's name is Diane Drew. Drew: Welcome to Atlanta, and I hope you have a good visit. Could you start by telling me where you're from, your background and education, and anything that strikes you? Moore: Okay. I was born in El Centro, California. I came to San Diego in 1942, was raised there, on the beach actually, in Pacific Beach. I did a lot of surfing, spear fishing, swimming, and water sports. I went to Mission Bay High School and attended the University of California at Berkeley, graduating in zoology. I was briefly employed by the State of California Department of Fish and Game as a research biologist and then was accepted to medical school. I completed medical school at L.A. County, at USC Medical School, and then did my internship at San Diego County, UCSD Hospital. After I completed an internship, I entered the US Public Health Service as an EIS [Epidemic Intelligence Service] Officer, but not exactly, because I was entering the smallpox and measles program. I was married then and had 2 children. We moved to Atlanta and lived in North Decatur while I was training for this position. I was advised that I would need to speak French on entering the country, and so as soon as I found out that I was likely to go to a francophone country, I started learning French, even before I had finished my internship. Drew: Could we back up for just a second, because I'm interested in how you happened to decide to go into medicine? Was there anything that particularly influenced that choice? Moore: I had been interested in clinical work early on. Sort of in the back of my mind, I was interested in medicine and surgery. Drew: It sounds like you must have found out about this program while you were an intern, if you had started to learn French. Moore: Yes. While I was at the University of California, in Berkeley, I was accepted into the dental program at UC-San Francisco and into the veterinary program at UC-Davis, and I just kept thinking that I may as well become a doctor, so I just proceeded along that path. I had an opportunity to take over a family business in electronics or stay in research biology with the Department of Fish and Game. The Department of Fish and Wildlife, the federal government, also actually offered me a job. But I decided the best thing to do would be to go to medical school, so that's what I did. Drew: So you started picking up French and then came to Atlanta at some point with a family already. Your wife and a couple of kids? Moore: Yes. I wouldn't say that I was particularly facile at learning languages, but I did know Spanish from working at L.A. County. One had to speak Spanish. So French was not that difficult to learn. As I said, we lived in North Decatur, in what seemed to be rehabilitated military housing of some sort. The training period started in July 1966. It was supposed to be 3 months long in immersion French and a lot of epidemiology and infectious disease background training. Living in North Decatur was fun. The kids picked up southern accents. Drew: How old were they then? Like little toddlers? Moore: Toddlers, yes. I guess one was 5, and one was 2. They enjoyed running around with the other kids in this project we lived in. The kids would run as a herd from house to house, so it was a wonderful place for children. We always felt safe because it was an enclosed project. And it was nice to come to Georgia and get a feel for a different area of the United States. I'd always been a Southern California sort of beach boy before, and I guess returned to it. We were scheduled to go over to Niger in the fall, around October. However, the bilateral agreements had not been signed, so we were delayed another 3 months. We arrived in December in Niger. It was very hot. When we first came, it was a strange place to adapt to, but we had read books on Africa, books on Niger, so we knew what to expect. Drew: And your wife and children went? Moore: My wife and children. My wife was totally prepared to do it, and she loved Africa too, and took good care of myself and the children. I remember that we had to wash all of our vegetables in iodinated water. We took Aralin twice a week to prevent malaria. Interestingly enough, I had been told a scare story that the female secretary for the embassy had been shipped home in a lead casket only about 10 days before because she refused to take her cloraquin. We did not want to make that mistake. Drew: That's interesting. I do remember hearing that a person wouldn't take her cloraquin, but I also heard about somebody who wound up with hepatitis. I guess there were really a lot of health risks. Moore: Oh, there were many diseases that one could contract there, a lot of them parasitic diseases. We were always concerned about that. Schistosomiasis could be contracted in the Niger River; malaria was everywhere; onchocerciasis was around, schistosomiasis was just recently controlled but still around. So there were many health dangers over there. Drew: That must have been particularly challenging with children in terms of keeping them healthy and safe. Moore: It was. But they seemed to do very well. They adapted to the French schools nicely. It was a little different because my son was used to a little more freedom. The French were very disciplined and kind of rigid in teaching. One time I recall that my son was doing something, probably misbehaving, and the teacher slapped him, and we were up in arms. Then we had to just think back and consider where we were and what the cultural aspects of being in that situation were. We complained, but we did not make a big deal out of it. One always had to be careful of cultural interactions that could result in adverse consequences. We lived in a very nice home there, as the homes go. It was on about an acre and had a fence around it and had a nice patio and deck, where we held many parties, inviting people from the embassy and the Peace Corps. The program itself got under way quite nicely, I thought. We were shipped 7 trucks, which arrived in the port, Cotonou at Dahomey, and we went down there and picked these trucks up with drivers. Drew: Were these the infamous Dodge trucks? Moore: Dodge trucks, yes, extended-cab trucks. Tony Masso [Anthony R. Masso], a very competent individual and a wonderfully gregarious and nice person, was my Operation Officer. He and I went down to this port to drive these trucks back up with other drivers. Dahomey was a very interesting place. I had read a little bit about it. But at the time, we were quite young and just over from the United States. It was a little shocking, driving up along the road, to see bare-breasted women. I think that Tony, who was younger than I, and not clinically used to seeing nude females, was pretty impressed with these beautiful women. And the roads were red clay, which got all over the trucks. Some goats ran across the road, and, unfortunately, we hit 1 or 2. But we heeded advice not to stop because in the outer villages you could be attacked if that happened. You couldn't explain why you had hit the goat. So we didn't stop. But later, the villagers were compensated for those goats, I believe, by our embassy. Drew: And this was at the very beginning? Moore: It wasn't at the very beginning because we moved into an office at the building facility called the Service des Grandes Endemies (SGE), which was also called the Trypano [phonetic]. The government of Niger furnished us with a nice office there. Niger was a French colony before it was granted independence, but the French still were involved in the infrastructure of Niger. And one of those places was the health service. Their director was French, Dr. Shamrun [phonetic]; he was very nice, very cooperative, and very intelligent. I understand that in some areas, the Medical Officers had difficulty with the French counterparts because they looked at them as competitive, but we did not at all. Dr. Shamrun [phonetic] cooperated fully, and the Minister of Health did everything he could to help us. So it wasn't difficult to organize the vaccinating teams, 7 of them. We also got a big map of Niger and all the erandisements [sp.] that we had to vaccinate. Drew: Was that like a French overlay on the local system? Because I associate that terminology with Paris. Moore: Yes. The country is organized along the French lines of geography and names. I can't quite remember the name they used for the larger sections. But, in any case, we formulated a plan of vaccination and trained the teams with a vaccinating gun, and it seemed to work out quite well. We had leaders in the teams who were quite good, and they were well motivated. And for our program, it worked well. In an organized fashion, we were able to vaccinate the entire country. Drew: Was your program coupled with measles control as well? Moore: Yes. This brings another point. One of the difficulties we had was that the measles vaccine needed to be refrigerated. We really didn't have any method to do that. We had ice chests, which we could periodically keep the measles vaccine in. And, of course, in Dahomey, that was no problem because we could have the vaccine refrigerated. But when we went out in the field, we had to keep the measles vaccine cool, which was somewhat difficult. But I do remember an incident when we traveled to Agadez. And this is always with me. It was a sad occurrence. We were vaccinating all over the country. My Operations Officer, myself, and a vaccination team went up to Agadez because we'd heard that they were having a measles epidemic there, and, sure enough, they were. But when we arrived, we asked, "Where is the chef de village?" and we were told, "Well, he's over there." And we went over there, and "over there" happened to be a cemetery for the children who had died from measles. There were, as I recall, about 30 or 40 graves, maybe more, and the people were sitting around them mourning. And, of course, we came and said, "We're the measles-smallpox vaccination team," and they said, "Well, doctor, I wish you could have been here about a month earlier." Drew: Wow! Moore: We felt badly because we had moved as quickly as we could and did everything. Of course, we vaccinated everybody for smallpox and measles. But it was sort of like closing the barn door after the horse escaped. I never forgot that. So from that time on, we tried to be as expeditious as we could getting the vaccine out to the rural parts of the country, which was difficult. Drew: I'm sure a part of that too, must have been how you would get information from rural areas about measles occurrence. Moore: Yes. We got this information usually by telephone or telegraph. A lot of peculiar things happened. Tony Masso was with me on a trip to Zinder, and then, from Zinder to N'guigmi, which was called au fin du monde, the end of the earth. It was near Lake Chad. And it was really primitive. But it was interesting. We had to fly out there in a small plane flown by the French. When we took off, the door fell off of the aircraft. And we're sitting there with open air right beside us, and they said, "No problem. We'll land and put it back on." So they landed the plane, put the door back on, and we got back in. But I noticed that my Operation Officer turned white. And I said, "It'll be okay. These guys, they know what they're doing." So then we took off, and we're flying near Lake Chad, and they kept changing course. I asked them, "Do you know where we are?" and they said, "Well, we're a little bit lost right now." And so we were lost over the Sahara Desert. But, finally, they did find the airfield and landed. Drew: And Tony was already pretty pale. He probably got paler after that. Moore: He didn't like that flight at all. I don't know whether he recalls it or not. On the return flight the French pilot permitted his student to land the plane-which was a very rough landing and the plane almost skidded off the runway. I quietly asked the French pilot how many landings his student had made; he replied, "That was the first one". But, anyway, then we went out with the teams. They had already proceeded to that area by road. Drew: This was the au fin du monde. Moore: Yes. This was N'guigmi, near Lake Chad. We were vaccinating up there and just observing how teams were working. And I remember a harmaton came up there and blew our tent down. We were camping out. Drew: What came up? . Moore: A harmaton. Drew: Is that a weather phenomenon? Moore: It's a big wind that comes in Africa. It's like a hurricane on the sand, a huge wind that comes up with a big sandstorm. It's a sandstorm, basically. And it comes up suddenly. You can see it coming for miles away because it forms a huge wall of sand in the air. Drew: And it's moving toward you? Moore: And it's moving towards you. Drew: So you know to make preparations. Moore: That's why camels have these great eyes and eyelashes, which can close and keep the sand out. So we had that to deal with this sandstorm. I remember we were making some rice, in the same camp area, and a plague of small grasshoppers or small locusts came, just clouds of them came. There was no way to keep them out of the tent or an open- air area. We lifted the lid on the rice to see if it was done, and several of these grasshoppers flew in. And that boiled rice was the only thing we had to eat. So either Tony or I said, "Well, open the lid and quickly get the grasshoppers out." But when we opened the lid, before we could get the grasshoppers out, more flew in. So then we decided, well, we'll just eat the grasshoppers. And so that's what we did. Drew: It would be a little like having water chestnuts in your rice. Moore: One time I went out to look at teams, somewhere east of Niamey. It may have been around Zambia. I traveled out there and I visited these Peace Corpsmen, and they invited me to stay in their house, and so I did. They had an outhouse. So I went to use it. It was all dark inside the outhouse because it was all enclosed, no light really. I sat down, and I heard some strange scratching on the wood planks around there. I was wondering what it was. Drew: Is this daylight? Moore: It's daylight, but the outhouse is dark. So I finished and I opened the door, and the light came in then, and I started looking around, and there were these big scorpions everywhere-on the corners, underneath where the planks were, where the toilets were. They didn't seem to bother the people using the outhouse. They just were scary. It upset me. I said, "If one of those bites you on the rear end, or stings you, it can be pretty painful." It also seemed a little bit unaccommodating, unfriendly, to the people trying to use the outhouse. So I said to the woman from the Peace Corps, "Why don't you take some spray, Raid, and spray that outhouse out there and get rid of those scorpions?" and she said, "Well, we did that, and the scorpions didn't die, they just came into our house here, so we don't do that anymore." But you live and you learn. I remember a lot of cultural things too. Usually the village chef invited us to eat. Once they were passing around this bowl of camel's milk and millet mixed together. It was a common bowl. So we were sitting there, and the bowl came around. The entire rim of the bowl was covered with flies. I was a little concerned because it was a pretty communal thing; we were drinking with about 10 Africans at a time. To drink it, you had to clear a space to put your mouth and clear out the flies to drink the camel's milk, but you couldn't refuse. So, of course, I drank it. Things like that went on-you had to make accommodations to the culture. Drew: And hope for the best. Moore: And hope for the best. Drew: How long were you in Niger? Moore: I was there 18 months. I was an active commissioned officer for 2 years, but I was there for 18 months in Niger. But in that 18 months' time, we did get the initial vaccination done. When I left, another Medical Officer came; I think Dr. Logan Root was his name. Tony Masso, my Operations Officer, a really excellent facilitator, stayed there another year or maybe a year and a half. I was very happy with the program. We had trouble sometimes with the trucks. Initially, there was a problem because our trucks were supposed to be taken care of by the Vinel Corporation, a contract corporation that took care of government vehicles running overseas. However, in Niger, we found that these people just were not the kind of people we wanted to work with because they didn't take care of the trucks and they used our parts for other vehicles. And so Tony said, "This isn't working." And he said, "I would opt to take our trucks back, keep them here in the Service des Grandes Endemies yard, and take care of them ourselves. We can take our parts back and put them in a garage." And I said, "Well, go ahead and do it." We went to the Ambassador and said, "We just have to have control over our equipment." And so he said, "Yes, go ahead," and we did. I think that, if we had not done that, the program would have had a lot more trouble. Drew: It sounds like a lot of other programs, either officially or by default, may have taken care of their own vehicles, too, because I keep hearing a common thread among a lot of folks in the program that they learned how to do maintenance. Moore: Well, some were blessed with excellent mechanics. The Operations Officer in Mali was Jay Friedman [Jay S. Friedman], who was a very competent mechanic before he came into the program. Drew: Yes, I interviewed Jay yesterday, and he was telling me that he can't deal with modern cars, but he knows old-fashioned cars, and I guess he got so he really knew how to deal with the trucks. Moore: So I think that was a real plus in the program. And we were actually blessed with having mechanics among the drivers. You know, they were very good mechanics and could take care of the trucks just fine if they had access to the parts, which we obtained. So that helped the program a lot. I remember coming back from Agadez-Tony was driving-and this horse ran in front of us. It was sundown, dusk. Tony swerved to miss the horse. I still remember the horse; it was big and brown. The truck rolled completely over, and the top of the truck got smashed and the windshield broke completely out. And we were upside-down in the truck. Drew: This was before seatbelts and everything, wasn't it? Moore: You know, I believe it was. I don't think we had seatbelts, no, because I actually sprained my neck a little bit. Actually, we had been told previously that if an animal runs across in front of you, don't swerve off the roads because there are no shoulders in Africa, and you will hit sand and you can roll a truck. But it just happened so suddenly. And, of course, he was trying to not strike this horse. Drew: Well, and I'm sure hitting a horse is a little more formidable than hitting, say, a chicken or a pig or something. Moore: So maybe that was justified, swerving at that time. But I knew one thing. I knew that if we didn't get the truck turned back over quickly, the oil would drain out, and then we wouldn't be able to drive the truck, and if driven, the engine would be ruined. So we quickly assembled the villagers there, who were happy to turn the truck back upright for us, and we drove back to Niamey without a windshield. At that time, it was cold there. It was a pretty cool trip back, but we did make it. That was the only serious accident that we had there. Lots of times we would have to send money or get money sent because the teams would be out of gas. But all in all, it was really a good time. It was fun working there because we connected, we had social interactions, with the Nigerians, the French. And there were people of other nationalities traveling through all the time, Europeans. Niamey was sort of a hub in Africa for people who were traveling from the southern part of Africa up to North Africa and on to Europe. I met many people in the Peace Corps. The Peace Corps doctor stationed there was interested in psychology-psychiatry; he was a psychiatrist, basically. And I was more of a clinician. So I took care of lot of Peace Corpsmen clinically there. Once I had to make a decision about whether this woman in the Peace Corps had appendicitis or not, and decide whether to evacuate her from the country, which would have cost about $20,000. Finally I decided she didn't, and we didn't evacuate her, and she survived. But it was pretty primitive. On the other hand, there were parties. There wasn't any television, so people had each other. So, for entertainment, they had many parties. Sometimes there'd only be a sack of peanuts and some beer. Sometimes the parties were fancier. It was relatively inexpensive to give a party there. The food wasn't that expensive, and, of course, there was plenty of inexpensive help. And the Peace Corpsmen, coming out of the bush, were always happy to come to a party and do some dancing and meet other Peace Corpsmen. Drew: Were they living in more austere circumstances? Moore: They were living in very austere circumstances. They had to because they had to identify with the people very closely in order to do their work. But it was a time of heavy idealism. They were really motivated, idealistic young people, and the Nigerians loved them. The programs were fantastic there. They had well-digging programs and all these different things that they were doing. And it was a time, of course, of Bobby Kennedy; it was John Kennedy's program, and so these were all idealistic, liberal kids, and we loved working with them too. The Nigerians that we worked with were wonderful people, too. Many of the team leaders, although not educated, were highly intelligent so it was easy to teach them these different methods of vaccination and organization of supplies and equipment and recording of data. They did pretty much everything we asked them, but sometimes it was a little cruder than we wanted. Some of the data that we collected were not exactly as accurate as we wanted. But all in all, I think that they did a wonderful job. Drew: My sense is, too, that a really key part of a person's working in that kind of program would be knowing how to compromise and when to compromise. You had to know where you had to maintain some standards and where you could be more adaptive. Moore: That's true. We had to work with the government officials pretty closely, especially the village chiefs. The chef de village is kind of like a mayor here. And I learned early on that if you were going to make a trip to their village, the chiefs needed to be notified in advance because part of the respect of the people and their role as chief was to make a visible welcoming of any important visitors. They needed to be notified so they could prepare a welcome that was appropriate for their office. Drew: So, if you were to show up without them knowing ahead of time, it would almost be viewed as an insult or disrespect. Moore: That would be viewed as gauche. And if it wasn't done, they were very nice, of course, and they wouldn't say anything. But this is something that one always had to be cognizant of, notifying them so they could make the appropriate and respectful preparations for visiting dignitaries or persons that were official. So we tried to do that. As I recall, we had the only active cases of smallpox in West Africa at that time, except in northern Nigeria, where they had a few. But ours was a major place that smallpox was still extant in Africa. So we felt that we could play an important role in eradicating smallpox in that we were vaccinating in a place where it was still active. And I've always felt good about that. Drew: Did you come back to Atlanta afterwards? Moore: I came back through Atlanta briefly. Drew: Did you do any additional tours in Africa? Moore: No. I did 2 additional tours with the Ready Reserve of the Public Health Service. One tour was for 2 weeks in Fort Indian Gap, taking care of Cuban or Haitian political refugees fleeing Papa Doc Duvalier. And I did another 2-week tour in the Yakima Valley, Washington, taking care of farm workers. But I love the Public Health Service. I have great respect for the organization. I very nearly chucked my plans to go into a surgical subspecialty and almost decided to stay in the Public Health Service, to go back and get a Ph.D. in epidemiology, and work in that area for the Public Health Service. It would have been a very interesting and viable alternative. So I have great fondness for the Public Health Service. Through the years, I've followed what they do, read about CDC in the paper or in articles, and I still go back to them for information on infectious diseases and different problems. Drew: So when you finished your tour in Niger, you came back to CDC or . . . Moore: I came back and started a residency. Drew: Here in Atlanta? Moore: At Los Angeles General Hospital. Drew: General surgery? Moore: I did the general surgery year of the neurosurgery program and started the second year, but then I decided to change to obstetrics and gynecology. In fact, when I came back, I was accepted in the program of ob-gyn at the University of Washington and neurosurgery at USC. But I started the neurosurgery program at USC and then changed to obstetrics and gynecology just because I liked it better. Drew: Neurosurgery can be pretty grim. As a nurse, I have worked for neurosurgeons; it's a different field. Moore: Well, you know, it's technical, and you have to be happy with partial results. But at L.A. County, I had done quite a bit of OB as a student, and I just liked the action and the idea of taking care of 2 persons. It's always exciting and vital. You're dealing more in the young end of life. So it was something that attracted me. But I could have done either neurosurg or general surg as well, and, alternatively, I always liked epidemiology too. At the time I made the decision, I wanted to do more clinical training. I'd always imagined myself as a clinician when I was a doctor, and so I did do that. But, as I say, retrospectively, I don't know whether it may have been better to stay with the Public Health Service and go into epidemiology. I think I could have been happy, but I may have always regretted not doing the clinical work. Drew: Don't you think there are always those kinds of junctures in life where you think, well, what if I had done this instead of that? Moore: They're difficult decisions to make, true. I'm training residents now at the Navy Hospital, in ob-gyn. We have rotating through our service some internal medicine residents from private hospitals who just want to get some experience in gyn. And if they talk to me about their careers or they're undecided about what to do, I never fail to mention the Public Health Service and epidemiology as a career, and how it isn't what you might think it is, that the science of epidemiology can be applied to so many different problems. I just try to give people who are coming through our service an idea that there's more to medicine than just being a clinician. Dave Sencer [David J. Sencer] asked us to list 3 things that we got out of the program in West Africa. I don't know about 3 things, but I can tell you one thing that I got for sure, and that is that one man, or a team of a couple of men, with the backing of a strong government, like the United States, with the Public Health Service behind them, can make a fantastic impact on a large population of people. A country can make a major world health impact. And that's something that you can't really do as a clinician working one-on-one. You can, but you do it singly, and you have to have lots of clinicians doing similar things, if you're trying to make an impact. It isn't quite the same as if you're organizing a broad program to affect world health. So I think that if somebody wants the satisfaction of doing something that will really impact people's well-being, there could be few better choices than working in epidemiology and the public health sector. Drew: Not too many careers, either, where people can really truly say that they have that firsthand experience of having a positive impact on a large number of people in terms of things like longevity and quality of life. Moore: There aren't. And this Public Health Service facility has made a great impact on the well-being of people throughout the world. I think, overall, if you look at the 2 areas of clinical medicine and public health service, it's really public health service that makes the maximal positive change, for the most people. It drifts down. You know, their recommendations and their advice on what should be done to improve health do come down to the clinician, who does it on a more limited basis. But the initiative comes really from broad programs, at least in terms of a major improvement in people's life. Drew: We're kind of at a point where we probably should think about wrapping up, so I want to be sure and give you a chance, if there's other things you'd like to talk about... Moore: Well, I was trying to think of any little incidents there. I know my daughter- Drew: Are your children French speakers? Did they pick up French? Moore: My son speaks some French. My daughter was too young. My son also speaks Indonesian, Dutch, and some Spanish. But he works a lot overseas now. Talking about getting involved with a culture, I can remember my daughter, when she was just 2 or 3 years old, going out to where the guardians sat in the morning. They would have this really sweet tea. They offered her a cup of tea, and so she copied them, sitting cross-legged right down on their rug on the sand, drinking this tea that they were giving her. And I thought, how neat that she could have that experience. There were a lot of cultural interactions like that that I really enjoyed. Drew: Those things enrich a person's life so much. Moore: They do. It was really an enriching program in terms of my life and, looking back, really an important part of my life. Drew: Well, I really appreciate everything you've had to say. Is there anything you want to add? Moore: Only that I really appreciate what everyone in this smallpox program has done to preserve the memories of it, the archives and all the things done by the people working with CDC to be sure that the program is remembered, because I think that's important. Drew: Well, it's a pretty unique program and really had a pretty amazing effect, I think, on a global level. Moore: I think so. Drew: Thank you. Thanks for your work and thanks for the interview. # # # </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310130821&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 text 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:/25593/158sc emory:158sc Subject The topic of the resource CDC Smallpox Eradication Program USAID WHO Epidemiologist Format The file format, physical medium, or dimensions of the resource 578415600 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Drew, Diane (Interviewer); CDC; Nurse Moore, Donald (Interviewee); CDC; Epidemiologist 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 MOORE, DON Description An account of the resource Dr. Donald Moore, was an epidemiologist stationed in Niger. Don speaks about moving to Niger with his wife and 2 small children, the French colonial legacy of the health infrastructure, the challenging logistics of delivering vaccinations, working with the Dodge trucks and with local customs, and muses about a hypothetical alternate career with the Public Health Service and further studies in Epidemiology. Don went on to complete his residency in obstetrics and continues to practice as a clinician. Language A language of the resource English