Dr. John Redd

Dr. John T. Redd

Q: This is Sam Robson, here today with Dr. John Redd. Today's date is December 19th, 2016, and we're back in the audio recording studio at CDC's [United States Centers for Disease Control and Prevention] Roybal Campus in Atlanta, Georgia. This is my--I suppose third interview with John after we did one individually and then one with Sarah [D.] Bennett also, and to listeners in the future, I recommend you check those out--really amazing interviews. So John, we are here today as part of the CDC Ebola Response Oral History Project, of course, mainly to talk about how you became an honorary paramount chief in Bombali, but reviewing your transcripts, I was thinking that we have everything up through Magazine Wharf covered really well, so mid-2015, I think?

REDD: Correct.

Q: But after that, details are a little sketchier. Magazine Wharf was what, your third or fourth deployment?

REDD: Let me think. [laughs] That would have been my fourth. I just finished my 00:01:00ninth yesterday.

Q: Oh my goodness, okay. I'm wondering if you can actually just take it from that point then, at the end of the Magazine Wharf cluster, how your involvement continues to evolve.

REDD: Well, what happened at the end of Magazine, Dr. [Thomas R.] Frieden came and visited, so I extended that deployment until early August of 2015. I will tell you one funny thing that I was just recollecting with people in Sierra Leone about Dr. Frieden's visit was when we lost him temporarily. I want to emphasize for future listeners that this was temporary and everything came out well. Of course, we had worked very hard on the itinerary for his visit, and he was coming down from Guinea. He was supposed to land at the airport. He was supposed to take a fixed-wing plane from Guinea down to Sierra Leone, something 00:02:00people have done many times. The airport in Sierra Leone is across the bay from Freetown, so you take a water taxi to get there and back. I'm sure you've heard loads of water taxi stories. This is not actually a water taxi story. We hired a nice, fast boat to go get the director and bring him back. We had a great trip over. It was me and Lorna [M.] English, and Dr. English was the Control Officer, maybe I shouldn't name her since we lost him, but all is well that ends well and it wasn't her fault. [laughs] Anyway, it was me and then Sara Hersey and Rodney Adams, whom I happened to see just in the elevator about fifteen minutes ago. We all were in this boat and it was a beautiful day. We went across the bay and we went to the airport to pick him up and the airport was cleared, basically. There were these two border health CDC employees who were there. They were very 00:03:00excited to meet the director. They got everything all ready and were waiting for him and waiting and waiting and waiting. His plane hadn't come, but that was not unusual. Then, Sara Hersey got a phone call from Oliver [W.] Morgan, who had also been in Guinea with the director. What had happened was instead of taking the fixed-wing, they put him in a helicopter--a UN [United Nations] helicopter basically gave him a lift. That wouldn't have been unusual except that the helicopter pilot, when he pulled into Freetown, he didn't land at the airport. The UN helicopter pilot took Dr. Frieden and everyone else in the helicopter into the landing pad at the military barracks in Freetown proper. Oliver called Sara and said, "We just landed, and I was looking out the side of the helicopter, and I realized we were not landing at the airport." The director had 00:04:00landed and he was in Freetown, so there wasn't anything we could do. We said, well, he landed safely and that's the way it goes, so we all just got back in the boat and honestly we laughed about it a little bit. You know, you can't make this stuff up. We did put the pedal to the metal in the boat and tried to get back across the bay as quickly as possible. The border health employees, they were sorry that they didn't get to see him, and they were going to introduce him to their work at the airport, which they had put a lot of effort into. In any case, then we found him, so he was fine.

Q: Great to know that we found the director. [laughter] That's funny. So, that's at the end of your time?

REDD: Yes, it's the end of Magazine. So at the end of that deployment, Dr. Marston, Barb [Barbara J.] Marston, asked me to swing through Atlanta on my way home--actually, much as I'm here in Atlanta as I speak, on the way home from 00:05:00Sierra Leone. Same kind of thing where they say--I always stop off to change planes in Atlanta anyhow, so they just said come by and drop in and have some meetings. When I came home and stopped in Atlanta in August 2015, Barb offered me a new position which would be with the Ebola Affected Countries Office, which was just starting up at that time. I think they liked what I had done with my deployments, so they basically decided to make it a full-time gig. I called my wife that night, and then shortly thereafter we talked about it, and Bernie said okay and was very supportive--that's my wife, Bernadette [A.] Redd. I told Barb that I'd go ahead and do it. So then my job changed a little bit, and you'll see 00:06:00as I go through the next deployments that my duties changed somewhat also.

The next time that I came back to Sierra Leone would have been around four weeks later, mid-September-or-so 2015, and at that time I was the acting country director for Sara Hersey. My relationship with Sara had been close before, but I would say that particularly from then forward got closer and remains extremely close to this day. She's my in-country supervisor, and we've had a really spectacular and extremely productive relationship. We complement each other extremely, extremely well. I was the acting country director then, and I was there for probably five weeks or six weeks or so, and a lot of new events were 00:07:00happening. Things had really changed. Magazine happily was the last instance of community transmission of Ebola in Sierra Leone, which of course, was great news. We did have one small flare-up subsequent to that, which was in early September, and that was what we called a singleton case, which was one young woman who unfortunately died in Bombali [District]. We never were able to establish exactly where she got it from, although it did look like her sequencing matched an earlier sequence. It was presumed to be through viral persistence, but we don't know from where it was persistent and in whom. That response to a single case, of course, spun up just a massive, massive, massive 00:08:00response with hundreds and hundreds of people placed in quarantine because it was after we'd had our last community cases. That was a big thing I worked on.

The other big issues in those deployments, one was the Household Transmission Study. Those results were coming out. I was not one of the primary drivers on the Household Transmission Study, but I was there when they presented the results. That showed that people who--to paraphrase it--people who were likely to become infected, or contacts who are likely to become infected, had what we would consider quite close contact. In other words, the fear of having more distant contacts infected was not born out. Which was as we had always 00:09:00suspected, but the household transmission study, which will be published shortly, was very helpful to show that officially.

What else was a big episode? We helped the Sierra Leonean authorities and WHO [World Health Organization] to set up semen testing for male survivors, which of course, has been a major issue. This was around the time also I was there when the [Sierra Leone Ebola] Virus Persistence Study presented its first round of results, and that was in a paper in The New England Journal of Medicine, which of course showed that virus can be detectable and persistent in semen for a long time. We had known that it could be persistent for around a hundred days in the past, but it extended and now has been extended even longer the number of days in which it can be persistent. So that, of course, was not an entirely 00:10:00surprising result actually, but was a very important result. It showed that the type of surveillance system that we were going to have to establish in Sierra Leone would have to be capable of detecting a new cluster for a long time. The Virus Persistence Study helped tremendously in terms of us understanding what type of a system we had to make sure Sierra Leone had, and it also had effects on our decisions about how long we had to have CDC personnel there. In other words, how long we could have people to help in the event of a response. That was a major event.

I was handling those things, and I also functioned as the epidemiology lead. That was an interesting time for being epi lead because we were in the process 00:11:00of basically deciding how to draw down support in Sierra Leone district by district. We were in the process of shutting down the emergency response offices, of pulling CDC personnel from the districts back into Freetown, basically. As you might expect, the very last place that we shut down was in Western Area, in Freetown. We were planning around all that, and coincident with those changes and very importantly was the United Kingdom was reducing its formal support of the District Ebola Response Centers, the DERCs, as we'd call them. The DERCs were planning on shutting down at the end of the year. December 31st, 2015, was a very big deadline in Sierra Leone, because that was when--the most important thing in terms of manpower basically or people in the districts 00:12:00was the change in the UK [United Kingdom] position. But it also coincided with the United States changing some of our personnel. As of January 1st, 2016, Sierra Leone, the Ministry of Health [and Sanitation], and their response structure in-country, they would be responsible ultimately for any subsequent clusters.

Q: What did you personally, in your capacity, do to help ready Sierra Leone's system for the impending British exit?

REDD: We had to put plans into place to support every aspect of it. One thing I worked on was the international rapid response plan. That was a major part of my deployment, which was around November or so of 2015, was essentially planning 00:13:00for what international body--WHO [World Health Organization], CDC, all the different UN [United Nations] agencies, [the UK] DFID, Department for International Development--what those different actors would literally put up in the event of another cluster. One principle that I really--I was the primary CDC representative on these meetings, and the principle that we stood by that we still stand by today is that we would rather vouch for contributions to the response that we're absolutely certain that we can provide, and we vow to do them well. We try to stick to things that we know we're good at and hopefully things that we're best at amongst the different groups, and want to make sure that we do them. We since that time have vouched for having five or six 00:14:00people--it's changed a little bit--in-country, able to respond within twenty-four hours of notification of a new cluster. We've maintained that posture since then, that was the policy. So there was a lot going on in-country, even though the last cluster happened in September. Then it was November 7th, was the date that had been marked forty-two days after the last person had been under observation. That was the celebration for the end of Ebola. It's also my anniversary. It's so easy to remember. So even though there weren't a lot of cases, there were a lot of big-ticket items I would say in terms of the subsequent planning for Sierra Leone and who would do what and all that sort of 00:15:00thing. Sierra Leone, to their credit, the government was busy standing up their new emergency services and they had a physical new emergency operations center, the EOC. They had a lot of new infrastructure and new experience to bring to bear for their planning, so it was really a process of their--we were trying to lead by example, but we really sincerely wanted and still want for capacity really to be improved in-country, and CDC really tries to live by that principal.

Q: So 2017 turns around--

REDD: Twenty sixteen.

Q: Twenty sixteen, excuse me. [laughs]

REDD: That's okay, 2017 is coming soon enough. What happened to me, which I don't mind being a matter of public record, is that I unfortunately had a 00:16:00training accident when I ruptured my hamstring. This becomes pertinent--pertinent to the response, not just to my musculature. I was in the FACT [Foreign Affairs Counter Threat] training, which is a mandatory training, and was in the duck-and-cover drill, so I was down behind this barrier. My job was to scoot from one barrier to the next. So I started running and felt this tearing in the back of my thigh and I had ruptured my hamstring. I had to have it reattached, and I had it reattached on the 14th of January. Usually you get something like that done, you get it fixed right away. I had it done, and everybody of course, all my old buddies in Sierra Leone, knew that I was getting it done, and so of course I was under anesthesia. My wife couldn't make it 00:17:00because she'd had a death in her family, so my brother came to help me. He picked me up after the surgery, and he drove me back, and we got home, and Sara Hersey sent me an e-mail. The subject of the e-mail was, "While you were sleeping."

Q: Oh no.

REDD: [laughs] It was somehow poetic, but that Ebola decided to make its comeback in Sierra Leone when I was under general anesthesia. That's what had happened. While I was getting this thing reattached and under anesthesia, they had confirmed the next case, which was mid-January 2016. It was confirmed in Tonkolili District, and was confirmed because the index patient was a young woman who had died, and she had had her Ebola swab done. We had a new cluster, which turned out to be really, really challenging because she had been--while 00:18:00symptomatic, she had gone to a lot of different districts. Eventually, we had to stand up responses in Western Area in Freetown, Port Loko [District], Kambia District, Tonkolili, and a smaller response in Bombali, she had been in Bombali as well. It was a very, very complicated response which ultimately had two confirmed cases--the woman and her aunt. Again, we saw, as just in the past September's outbreak, that the size of the cluster at this point in Ebola history has very little to do with the complexity of the response. Because now, of course, just as it was back in 2014 when the first cases of Ebola happened, even a single case of Ebola now, it's a maximal response. During that response 00:19:00though, I was unable to deploy to Sierra Leone because I had this injury. I had my surgery done in San Diego, so I wasn't sleeping much anyway, but I was in this pelvic brace in which I couldn't flex or extend my hip. But I had my phones and I had a computer and I was pretty connected. I would get up very early, I wasn't really sleeping much anyway, and would help with the response from far away, but had calls on a daily basis with the field teams. I was able to stay very connected, and certainly gave me something to do.

Q: With that cluster, did it act in any way as a kind of test of the systems that you had been trying to set up come the end of 2015 with what the obligations of the US are going to be moving forward?

REDD: Absolutely. It was a very, very direct test. It came a lot more quickly than we thought it would. It was incredible. It was only two weeks into the 00:20:00Ministry's literal ownership of the response, and they did very well. It was much more complicated because of the different districts being involved than we thought it would be. We had a lot of challenges. There were some contacts in Kambia District who had escaped into the bush, which is literally a common MO [modus operandi] for people who don't want to be monitored, or get scared, or all kinds of reasons that people would want to flee. But that made things very complicated in Kambia. We were able to--and all this has now been published, so it's in the public record. We were able to match the Ebola RNA [ribonucleic acid] sequencing on the young woman who had died, with--it most closely matched two samples from many months before from Western Area. I'm not remembering the 00:21:00date off-hand, but I think it was from late 2014. In fact, I'm sure, it's from November 2014. Now, that does not mean that she was in any way directly associated with the two people who had those isolates. It meant that those were the closest ones. Of course, there could be intervening people. The point was though that it did appear that her Ebola was most likely to have come again from viral persistence. We knew a lot of very important things from the sequencing. We knew it hadn't come again from the wild, it had not been reintroduced from animals, it hadn't come from Guinea, it hadn't come from Liberia--all those things were very important.

That response was a huge test, and to their great credit, there were loads of 00:22:00people who responded very quickly to come help because we didn't have sufficient in-country resources. A lot of people answered the call and were able to help--they came from Atlanta and deployed there. Lots of people who had been involved in the first place, which is really a very cool thing to do. Cynthia [H.] Cassell, Dr. Cassell, was in Atlanta, but she and I spent a lot of time along with Dan [Daniel W.] Martin working on the logistics of who was going to be where, for how long, what their duties would be, so there was a lot of organization. Overall, that response I considered a big success. The poor young woman had traveled through multiple districts when she was symptomatic, and it really could have been much, much worse than it was, but thankfully it wasn't. So that went pretty well. That response also included use of the experimental 00:23:00Ebola vaccine. That was brought to bear. That also, I should say, the vaccine was brought to bear in the previous fall also in Bombali.

Q: The same vaccine that was tested in the STRIVE [Sierra Leone Trial to Introduce a Vaccine against Ebola] trials?

REDD: Correct. The same vaccine but under different auspices than in STRIVE. So STRIVE, the emphasis was on healthcare workers, broadly defined healthcare workers, but healthcare workers--people who were judged to be particularly high risk. We used vaccine trial in both instances, so that was another big level of complexity.

Q: So after this response--when would you say that wraps up?

REDD: That wrapped up, it would have been end of March I think. No, later in 00:24:00February, but the following of everybody went deep into March. Then the next time that I was there for a long period of time was June 2016. I was there for quite a long time. I was there from June 15th or so until early August, so I spent a couple months back there. I spent some of my time again as acting country director for Sara. I would say by that time, in terms of my own personal role, I feel like I've been her right hand essentially since then, would be a good way to say it. I fill in for her when she's not there. One time she had a family emergency and I chipped in. The big themes for the office during this time very, very much was in building up the country office and in standing up 00:25:00what was going to be a supportive office for the Ministry of Health and for the nation of Sierra Leone. We were pivoting very deliberately from Ebola response to responses in support of the Ministry for all kinds of things. I have to say, Sara has done what I think was a magnificent job of setting up a country office in the face of huge difficulties, huge. The most obvious one was the health system, which was weak even prior to the Ebola outbreak, had been decimated by the Ebola outbreak. Her job was to stand it up in a place with a lot of difficulties like Sierra Leone, so I give her really immense credit. The tasks really changed, and that is kind of a theme as we've talked these different times is that the tasks at hand were constantly a moving target. Actually, 00:26:00that's kind of what I liked about it honestly. [laughs] I liked many things about the response. I know that sounds odd to say I liked it, but the truth is I did--or I should say maybe not liked it, I should say found it interesting and satisfying and fulfilling.

Sara has set our clear priorities for the office, which we're still operating under today. We decided to support big categories of activity that have a great likelihood of helping the country in terms of its public health system. We don't view it strictly in terms of bucks, but almost bang for the buck, like what activities are going to do the most good? We emphasize surveillance, public health surveillance is really one of our primary areas that we've helped. We 00:27:00were able to recruit Regan [R.] Hartman, which was a coup. Regan and I had worked together during the really bad old days early in the outbreak in September 2014. I'd been in Bombali, as you know, and she was in Port Loko. She had done really a magnificent job. She's a fabulous field epidemiologist, and she's persistent, and did a great job. Sara found out that she was thinking about moving overseas full-time, and I said, hire her. That was my strong advice. So we got Regan, and Regan's been working on IDSR reporting, which you've heard about, Integrated Disease Surveillance and Response. IDSR is the framework under which we're putting all of our surveillance activities now. What 00:28:00Regan has been supporting is the efforts to do public health surveillance on lots of different conditions. Not as many as in other jurisdictions, it's relatively simplified for the African region, but it's practical and it's something that we all believe in. We're tracking measles, certainly viral hemorrhagic fever is one of them. Most of the conditions are, they have laboratory confirmation, but they are based on syndromes, so on clinically recognizable syndromes. Regan's been working on that. We support laboratory, which up until now has been supported primarily by Michael [S.] Friedman who lives in [Sierra Leone] full-time. The theme is that all these people are full-time. We work on emergency response. Those are the kind of themes that we are working on.

Q: And that was through early August of 2016 is when you were there?

REDD: Right.

Q: I'm sure some of this lasts or continues to be a focus. What happens after early August of 2016?

REDD: Since I joined the Ebola Affected Countries Office, Ebola in Sierra Leone has really been all I've been working on. I've done some work with Guinea and Liberia, but even when I'm in the United States, that's what I work on. Sara named me associate director for science, the ADS, which is a position I've really enjoyed, and that's my position as we speak. In that, I'm responsible for reviewing research proposals and looking at papers and approving them. There's a formal part of that job, but it really has been much more than that as the job 00:30:00writ large is to try to guide the science portfolio and keep things moving in directions that we think will be helpful.

Q: These proposals are coming from whom?

REDD: All kinds of people, but I primarily work with CDC researchers. It's all very--well, most, not all--it's almost all applied research.

I should mention one thing. One additional thing is our fourth priority--I realized just now I only mentioned three before. The fourth out of four is workforce development. Something that I've been thrilled to contribute to is that we're working on the Field Epidemiology Training Program, FETP. That's a fabulous, fabulous project. It's pertinent to my deployment over the summer in 2016 because the epidemiologist, Dr. Tushar Singh, who is now running it, he 00:31:00finished EIS [Epidemic Intelligence Service] just this past year, 2016. He's now in-country as we speak. He's moved so Sierra Leone with his wife and his son, and he's running the FETP, but he had problems getting permission to move to Sierra Leone so I had to cover him quite a bit over the summer. We're also working on another project called CHAMPS, which is a project with the CDC Foundation, CDC Sierra Leone, and the [Bill & Melinda] Gates Foundation, which looks at determining causes of mortality in people under five, so pediatric mortality. But the theme with all these things is that they're not Ebola, right? Ebola is part of it, but we've moved on, as is only fitting.

Q: I know you fit in at least one more trip because you just came back from 00:32:00Sierra Leone. When do you go back after your deployment that ended in August?

REDD: Let's see, let me think. [laughs] I was home until maybe the third week or so of September, and then went back for about four weeks. I was acting country director again for Sara, so that's a supervisory position. She did her at home leave, so she was gone for a month. I was in contact with her every now and then as needed. In that case, it's hard to say specifically what I worked on because I just sort of ran the shop. [laughs]

Q: Overseeing everything.

REDD: Overseeing everything, yeah. Then I went home for a little bit and then bounced back in November until yesterday.

Q: So now we should really get to what we met here to discuss probably.

REDD: But that's it, we've now run through all nine of my deployments. [laughs]

Q: And that's wonderful, and that's exactly what I wanted, so thank you so much for doing that. I know it's kind of a mental exercise.

REDD: Remembering the dates is challenging.

Q: Actually, let's take a quick break--

[break]

REDD: It is funny, as you ask me the questions and move through things, to think about how many different things we worked on. The number of different tasks is incalculable.

Q: Yeah, I know for me, at least, hearing about it, that huge portions of it you could just accidentally leave behind because there's so much of everything else. [laughter] Okay. We're back with Dr. John Redd, and we're talking about how John became an honorary chief in Bombali, the area he first served in Sierra Leone. 00:34:00How did this come about?

REDD: From my point of view, I first heard about it over the summer from a man named Sorie I.B. Kamara. He was one of the surveillance officers with whom I'd worked in Bombali way back, you know, the times I talked about being there with Brigette [Gleason]. In September and October of 2014, which of course were very heady times and difficult times. It came about as a way that--it's going to be hard to talk about myself in all this--as a way for me to be thanked by the locals. It came about because I've been out in the chiefdom, which is called 00:35:00Paki-Masabong chiefdom, which is one of the chiefdoms in Bombali. It's a chiefdom that's adjacent to the chiefdom that contains the village of Pate Bana, which is someplace we discussed. It's just barely over the chiefdom border, so the point more is that this was a part of Bombali, which is rural. It's villages that are separated from one another, sometimes by many miles, but not terribly far outside of Makeni, which is a pretty big town. These were basically rural villages that were in places that we wanted to work--I shouldn't say we wanted to work, that we were working at that time. There would be Ebola clusters in these villages, and I had helped out with some clusters in this chiefdom. I 00:36:00didn't realize it until I met him in person, but basically Sorie told me that the chief of that chiefdom, Masa Paki Kebombor, that he wanted to speak with me and that they were thinking of offering me an honorary chiefdom. Caught me by surprise, but I said that sounds good, that's great. So I went up there. This would have been maybe late July 2016, maybe August. But went up for the day to Makeni and went to the chiefdom, just me and my driver, and we picked up Sorie in Makeni, and went up to the chiefdom and basically it was an interview. I didn't know this when the chief had initially contacted me through Sorie, but he and I both recognized each other by sight. We had met each other many times, but 00:37:00at large meetings. He knew me and I knew him from the response because he was the chief. That was mostly from meetings in Makeni, actually. I could not remember meeting him out in the chiefdom before, but I'd met him in Makeni. We got along. He's a great guy, I've talked to him many times now, and we set things up, and then during my next deployment in September, I went up and saw him again. He explained what the procedure would be and we set a date. We set a date in November, on the 18th. I think it was Friday the 18th. Yes, that's right, because Veterans Day was the 11th, the previous Friday.

It was a great honor, of course. It was actually one of the greatest days of my 00:38:00life. They call it a crowning. I guess probably the word would be coronation, but they'd call it a crowning. It was wonderful. It was really, really wonderful. We invited everyone from the office to come on the part of CDC. In September, he said, "How many people from CDC are going to come?" I said, "I don't know, maybe a half dozen." He said, "Okay." Because we're planning around food and stuff. Then it ended up, everybody wanted to come, so it was really fun. It was a lot more people. We ended up having five cars' worth of people. That's the lead-up, so that's how it was all set up. I confess, I knew--and Sorie helped me a lot. I thought I knew what to expect, but first of all, a lot 00:39:00of these are traditional practices, cultural practices. I didn't entirely know what to expect, but I did know that they were going to make me a set of clothes to wear, so robes, chiefs' robes, which I did wear. I knew the time I'd have to come into town and that we'd have a meal afterward and celebrate, but otherwise, I didn't really know what to expect. I can't say that I had been to a traditional crowning ceremony in Sierra Leone before. This was a Temne--the tribe is in the North, so it was a traditional Northern ceremony for Sierra Leone.

I went up to Makeni on the Thursday night before, and then a lot of people joined for the day on Friday morning. On the day of the ceremony, Sorie texted 00:40:00me in the morning and said, "The chief doesn't want everybody to kind of dribble into the village." He wanted us to come--he said, "Bring in your entourage." I thought to myself, that's the first time in my life I've had an entourage, but now I've got one. [laughs] He said, "We want you to come in all at once." So we all met at the hotel in Makeni where I had stayed the night before, and then all went out en masse. One really cool thing was we have a lot of locally employed staff, the acronym is LES. I don't know if it's the majority of the office yet, it's getting close though--actually, probably so. I bet the majority of our office there now are locally employed staff. I really, really wanted them to go, and they did, so that was really wonderful. They are great folks, and it was very meaningful to me to have them there.

Q: Were any of them from Northern Sierra Leone, or Temne?

REDD: Oh yeah, lots. But even if people come from different traditions within Sierra Leone, it's an incredibly culturally and religiously tolerant place. To take another example, Christians make it their business to know Muslim religious practices and vice versa, which is something I really appreciated there. They take very seriously tolerance of that type. So someone who's Mende say, from the South, would still know about Temne traditions.

We rolled into town, and it was incredible. Already there were people dancing in the street and drums going and singing, and it was incredible, it was incredible. We went into the community center, and sat me down, and then I found 00:42:00out that they decided to--I was going to make a joke and say it was an upgrade, but I don't even want to joke about it. I guess it was an upgrade. They decided to make me an honorary paramount chief, which is a little broader category. Then we had what really was the most moving part of the day for me. I found it very difficult because it's not really my desire to be the center of that much attention, but I was, obviously, or necessarily. One really cool thing that made me happy was that it was very clear that while this was an honor that they bestowed upon me for services back in the early part of the outbreak in Bombali--what was so wonderful about the day was that it really generalized very quickly. There was dancing and singing and all kinds of love really between the 00:43:00CDC people there and the Sierra Leoneans who were there. It was magnificent. It was really a celebration of shared effort and joy and friendship. It was really cool, it was really cool.

They had people come and talk about what their relationship had been to me. It was really testimony. Officially, the way it went that day is I was dressed just in my regular clothes that I had shown up in, and they had testimony, and then they had come to a decision to make me an honorary paramount chief. Once they'd made that decision, I went away, and I'll tell you about this in a minute, but then I was dressed and given a brief lesson on how a paramount chief is supposed to dance, and then led through the village for some more celebration and the 00:44:00official crowning and then a meal. The whole thing took probably three or four hours. The really cool thing about it, there were several things that were--cool doesn't even do it justice, but things that were so moving because it brought back a lot of memories and things that I've spoken about when I talked to you before. It was actually very--"validating" is overused. It was sort of healing because some of the times that had been most difficult back in the early part of the outbreak, people had really noticed the effort and remembered those times as I do, which is as very difficult, but also simultaneously representative of the best type of shared effort and shared experience and feeling like a band of 00:45:00brothers. It had all those types of experience wrapped up. Some of the district surveillance officers that I spoke to you about before, who were just wonderful people, spoke about things. And they remembered some of the stuff that I told you about. The time that we got them gas for their motorbikes, for example. One big event, which we'd spoken about before, was when we thought that that young man was infected. I think that that was probably, if there was one thing that they really thought to give honor about, it was that. It made me very happy because what they said was that when things got tough, that CDC didn't run away. They said that things got personally tough and we thought one of our own was 00:46:00infected, and that we didn't retreat. We hung in. I have to say that I was really happy that that was noticed, and it made me really happy because that was a terrible time. At the time, I don't think it crossed our mind to take off. But certainly the locals had viewed that as a time that I and others, as I told you before, there were other people there, had really hung in with the locals. I would have said, what else would we do? But that was appreciated, which was nice. They spoke about other big events. I'd helped obtain some ambulances, which were a big need then. And that driver, or the lab [laboratory] man that I 00:47:00had spoken to you about before, Emmanuel Menjor, he spoke, which was really lovely. He remembered those events and how I had helped him out. It was just interesting because I didn't know at all what anybody was going to say about any of these things. So, it made me happy that the things that I had found most meaningful were the exact same things that the locals had found most meaningful. It really cemented this feeling of shared experience. Luckily, the whole day wasn't maudlin or sad at all. I mean a couple times we recollected things, but 00:48:00it switched very quickly to a celebration, so that was cool.

Q: Was there anything that was shared that surprised you?

REDD: Not really, actually. I guess I was surprised by how well people remembered things. Let me try to explain that better. At the time, when I was there in the first place, there was really no time to dwell on a decision you just made because there was another one coming up. Things were just flying by. It was like sticking your head out the window when your car is going about seventy-five miles an hour. Things were just flying by, so again and again and again we're just doing things, making decisions, boom, boom, boom. I was a 00:49:00little surprised by all the recollections that people had. That's about the only thing.

We walked through the village, and I wasn't in my robes yet, but that was fun with all the drums going. I was with the other chiefs, and there were some paramount chiefs, so some of the higher chiefs from the whole district of Bombali, and there were some ceremonial chiefs. We walked over to this side area where I got dressed, where they dressed me. They had made robes for me, which were these beautiful, long, white robes. Like most of my other experiences in Sierra Leone, it was a very hot experience, but I've gotten used to that part. [laughs] Actually, there were women in the room, and I thought, geez, am I supposed to take off my clothes? I didn't know what I was supposed to do. But, 00:50:00no, they just put it on over what I was wearing. I thought, whatever, it's a local cultural norm, I'm okay. We put that on and it was funny because it was very private because Tushar Singh, the guy we mentioned a minute ago, he's got a nice camera. He followed me to take pictures of them putting on my robes, and they kicked him out. They said, can't do it. There were words spoken in Temne, and we talked through things, and they officially put the robes on me, which was very cool. It was lighthearted though, it was happy and lighthearted. Then they gave me a quick tutorial on how I was supposed to proceed through the village after I'd been dressed in my robes, and to go back to the same room where we had started for the official crowning. That was wonderful, and that's the picture I just showed you. We were walking through the village and dancing and that was 00:51:00really wonderful. All the people from CDC were there dancing and it was amazing. It was a unique feeling in my life, actually. I would say that that was a unique day and a unique experience in my whole life.

Then we went back into the community center, and this time I got a throne, so I was up in the front of the room and had a throne, and they did the official ceremony, which was really a naming ceremony. They named me basically paramount chief healer, which is Masa Paki Orbolonbah, like I sent you in the e-mail. The head ceremonial chief was really funny, and they were smiling about this too and they were translating, and a lot of emphasis was clearly placed on the name and they talked about why I was a healer, and they make sense. He said, "And his 00:52:00name is," and they translated "And his name is," and then again he said, "And his name is," and they translated again "And his name is," and then they finally said it. I got my name, and they gave me a beautiful staff, which is really just amazing. It's got a carved lion's head, and it's just beautiful. I had on a ceremonial crown made out of wood, and then a necklace, and my robe, which is white and has gold inlay. Once we had those done, I had the chance to make a speech, which I appreciated. I'd taken notes before and thought about what I was going to say. I didn't write it but I had notes about things I wanted to cover, so I wanted to make sure and cover thanks for everyone. We had a moment of silence in remembrance of everyone whom we'd lost, and then I was able to thank 00:53:00everyone. But I had the floor, so I realized I was able to put it in whatever order I wanted. I did something on purpose, which was I--second-to-last, I thanked the district surveillance officers, the guys with whom we had worked, a few women, but "the guys" we used to call them, because they were our main place that we worked. And, ah--sorry, I'm already thinking about the next group. Then, I was able to have the last word, and I saved the last word for the burial teams because they did a necessary, unimaginably difficult job, and half the time they weren't getting paid, and I just have the greatest possible respect. I can't 00:54:00even describe it, what those guys went through, what they put up with. For a long time they were actually suiting up in the room next to us--with their clean clothes, I just want to say, not with the dirty ones. They would suit up and then head out in their pickup trucks next to us, so we got to know them a little bit. Some of them had trouble when they went back to their villages because of their job. So, I had the chance to give the last word to somebody as a new chief, and that's what I wanted to do, so that's what I did.

Q: Were some of them present that day?

REDD: Yes, they were in the back. Yup. That was great, and then we went back to Freetown. It was very moving. I got emotional some of the times, but I didn't cry. I was worried that I would, but I didn't. Several parts were very 00:55:00emotional, particularly when people were recollecting events from the whole effort. It also made me feel like the parts that I had found moving and memorable and emotional to this day were also the same parts that the local people had found the same way. I guess we had the same opinion on that, on what the big-stake items were. That was really cool.

Q: It sounds really cool. Thank you for sharing it. It's a privilege to hear about it. Can you tell me about them teaching you how to dance?

REDD: Sure. I can say categorically that--I know this is audio, but I'm not much of a dancer. [laughter] That part was very, very, very funny because they 00:56:00were--like I said, it was joyous, and I think making fun of the chief dancing is a little bit a part of the whole ceremony. My shoulders were extended almost like if I were doing two high-fives maybe is a way to say it. You sort of keep in that position and twist back and forth. Oh, the other thing I didn't mention, and luckily I knew about this ahead of time, was the chief shows generosity afterwards, so you give candy to the kids in the village. Sorie had told me about that before I left, he said, "Bring sweets for the kids." So I went to Costco and bought this big, I don't know, ten-pounds or something, it was tremendous. It made my luggage very heavy, a whole bunch of lollipops. I gave those out, one of the pictures in there is from that I think, and that was really kind of a mob scene, actually. There was nearly a lollipop stampede. But that was fun. I went through the streets giving candy to the kids. It's a 00:57:00ceremonial way of showing generosity afterward. But we had a really funny thing happen with the lollipops. I wasn't going to carry this big bag around with me, so we put it on the portico of the chief's house where we'd met initially. Right when I knew things were about over, I said to Regan, who was there, "Cue the lollipops, it's time to go get them." She went over, and she came back, and she said, "They're gone." [laughter] The candy was missing for a few minutes, but then it showed up in the same place. That was a problem averted, but had a few nervous moments. Then we had a meal with palm wine, which I'd never had before. It was really fun. Everybody from CDC really, really enjoyed it, too. It was 00:58:00just a great kind of feeling of fellowship with everyone, I would say.

Q: I know this is an honorary paramount chief role, but are there responsibilities that come with the job?

REDD: There are some responsibilities. I have to alert people when I'm going to be in the area, and I'm expected to go by the village. When I come back in February, I'm going to bring a couple computers for the library. Part of the responsibilities are to be generous, which I'm happy to do. There's a little, tiny library. It was so moving, I met with the chief there--he doesn't know that I noticed this. We're in the library where the kids go, separate from the school, but the kids go there to study. They've got a couple computers there, and there on the bookshelf was a kid's book, but maybe for fifth or sixth 00:59:00graders--a relatively advanced kids' book about the American system of government. I'm in the middle of this rural area in Sierra Leone in this tiny village, and there in the library is a book on the separation of powers. I actually found that very meaningful. People really pay attention to us and to the United States. It actually made me very proud to see that. I thought, well, we should make sure we live up to it.

Q: John, is there anything else you'd like to say today regarding your whole experience?

REDD: I don't think so. We've worked our way through until yesterday, basically. I'm sure something will come to me later. I skipped over one three-million-dollar project before, it slipped my mind. [laughs] No, I'm good. 01:00:00Thank you.

Q: Dr. John Redd, thank you very, very much for your contributions to this project.

REDD: My pleasure, thanks Sam.

[break]

Q: This is Sam Robson, I'm back with Dr. John Redd. We were talking about John's ceremony, becoming an honorary paramount chief of health in Bombali, and John also brought a gift with him for the ceremony. Please take it away.

REDD: Sure. This was something that Sorie had let me know ahead of time, which I actually was going to do it anyhow, but then he told me that was also a normal thing to do. I give a lot of thought--I live in New Mexico, and I spent a lot of my career working with American Indians and Alaska Natives on Native health, including time with the Indian Health Service. So I decided to bring a traditional American Indian pot. I went to Albuquerque and I bought a pot that's 01:01:00Hopi, and it's beautiful, probably--I don't know, four or five inches tall. It had to be small enough I could hand carry it there. I was terrified it was going to break because they're fragile.

I had the chance to talk about the gift when I gave it to the chief. I told him that the way it's traditionally made is the potter takes the earth, and it's just mixed with water, and those kind of pots are not turned on a wheel, they're made entirely by hand, sometimes shaped with a stone to make it smooth, but they're coiled. It takes the earth and water, and just through a lot of human effort, combines into something that's beautifully shaped, and then it's fired in heat. That part, I talked about how their relationship between the United 01:02:00States and Sierra Leone is represented, and that day was taking something very difficult and through hard times and through skill and effort was taking difficult times and making it something beautiful and enduring. And furthermore, the way the pot was painted had symbolism that I liked, which is part of why I chose it. It had rain on it. Of course, it rains all the time in Sierra Leone, particularly some parts of the year. It had feathers and birds on it, which was also something that I associated with the North of Sierra Leone. I explained what those symbols were and how they related to the Ebola response.

Q: Did they appreciate it?

REDD: Yeah, actually, I think they did. I'm sure they hadn't seen anything like it. I think that they fully understood the symbolism. So then I gave it to the chief.

Q: That's beautiful. So now, I thought we'd flip through some of these photos that John--feel free to just--

REDD: The first one is the assembled group who went to the ceremony, so this is when we were meeting before we left. I'll say from left to right who everybody is. That's Laura [K.] Shelby, Regan Hartman, Sara Hersey, Michelle Sloan, Yelena Gorina, [Osman Sesay, Alimamy Kamara, Ansumana Kamara, Dauda Sowa, Faith Washburn, Jadnah Harding, Brima Bangura, Hassan Benya, Karifa Koroma, and Tushar Singh.]

Actually, there were even more people who came subsequent to that, but that's everybody--so the first photo, in summary, is everybody who came to travel to the village. Then the second photo is when we pulled into the village. It's a typical village for Sierra Leone. It's largely one main street with houses on 01:04:00both sides. The party had already started, so that's everyone beating on the drums. The drums were cool because they weren't just percussive. They had tone to them. When they hit the sides of those long, tubular drums--there were cutouts in the drums. This just struck me. Almost like a big xylophone. It had tonality to it, not just percussion. Then there's some ladies in the street. That picture was taken by Laura Shelby, and that was people greeting us. Everyone was dressed up. It was very, very festive. Then the next two are of me trying to dance like a paramount chief, and that's why we're smiling because they were making some fun of me which was all very good natured. This was after I'd been dressed, and then as we promenaded through the town with everybody dancing and singing around us and playing music. There was a tremendous amount 01:05:00of dancing. We literally danced back and forth through the town. The next is me with two of the ceremonial chiefs, and the man in the front was the person who actually put the crown on me and gave me my staff, which was the symbol of becoming an honorary paramount chief. The next one is Masa Paki Kebombor, and he's speaking to me before giving me the staff. Then that's me accepting it. I'm the pale guy on the left. [laughter] Then that's me handing over the Hopi pot that we just spoke about. Then the next one is me--oh, and that's Sorie, the one of me and the children. That's me handing out the lollipops, but off of my right shoulder is Sorie I.B. Kamara, the man who helped me so much. Great. That's 01:06:00Alimamy Kamara, Alhaji Kamara, and Osman Sesay, who are all full-time, locally employed staff, and they're full-time employees at our office. Then the last one is everyone at the office, and then the very last one is--[laughs] that's Sorie trying in vain to control the crowd of kids who were there to get the lollipops. That's a funny picture. I suggested that we try to line them up in two queues, but that didn't go that far.

Q: Well, I know it was a memorable event for you, John, and a meaningful event, and I'm just so happy that we have it recorded here.

REDD: My pleasure.

END