Dr. Pascale Krumm

Dr. Pascale Krumm

Q: This is Sam Robson, here today with Dr. Pascale Krumm. Today's date is September 7th, 2016, and we're in the audio recording studio at CDC's [United States Centers for Disease Control and Prevention] Roybal Campus in Atlanta, Georgia. I'm speaking with Dr. Krumm today about her experiences with CDC's Ebola response, the Ebola epidemic in West Africa that spanned from 2013 to this year, 2016. Dr. Krumm, thank you so much for being here with me today. Can I ask you first to pronounce your full name for me?

KRUMM: Yes, Pascale Krumm.

Q: And what is your current position with CDC?

KRUMM: I'm a health communications specialist with CGH, Center for Global Health.

Q: Great. Can you tell me a brief summary of how you were involved in the Ebola response?

KRUMM: Yes. At the time, I was working for Dr. [Thomas R.] Frieden directly, I was his speechwriter. When Ebola, when everything started happening, and when we 00:01:00were starting to deploy people, there was really a great need for communication people, because that was a very important aspect of the response. Not only the epidemiology part, but Dr. Frieden always said that the two most important parts, obviously, are the epi [epidemiology] part, but then the communication part. I was asked to deploy because of my experience as a health comm [communication] person, but also more importantly, because I'm French, I'm a native from France, and they were really needing people to deploy to Guinea because there are not a lot of French speakers at all at CDC. Of course, I had to ask for permission from Dr. Frieden, because I was working for him directly, but he immediately said yes, they released me immediately, and I ended up doing several deployments. Almost like I would come, I would be away for four to six weeks, four, six, eight weeks. And I would come back for two, three weeks, and 00:02:00then deploy again.

Q: Am I right that you went to Guinea three times, and Mali once, is that right?

KRUMM: Yes, yes.

Q: Okay.

KRUMM: And then I also, on one of Dr. Frieden's last trips--just a tour of the countries last summer, I also accompanied him and was a translator for the Guinea part.

Q: Got you, okay. Thank you so much for that. We're going to back up a little bit now. Could you tell me when and where you were born?

KRUMM: Yes. I'm originally from Strasbourg, France, which is on the border with Germany. I came to the US to do my studies. I decided to stay, I got a PhD in French, and I became a college professor. But I did not really like this, and when I moved to Georgia to teach at North Georgia College, of course I found out about CDC. When I found out about CDC, I said, that's what I want to do. But I 00:03:00thought they're not going to hire some--CDC's not going to hire somebody with a PhD in French, so how can I get in there? It turns out that at Southern Polytech [Southern Polytechnic State University] in Marietta, they have a master's of science in professional--in technical and professional communication. While I was teaching full-time, I enrolled into that program as well. I did my master's there in a year, and as soon as I had that master's in hand, and as soon as I became a US citizen, I applied for a job at CDC, and the second position I applied for, I got.

Q: What year was it that you came to CDC?

KRUMM: That was 2000.

Q: It was in 2000, got you. Can I ask what it was like growing up in--did you grow up in Strasbourg?

KRUMM: Yes, yes.

Q: What was it like?

KRUMM: Compared to afterwards, when I compare it with what it's like living here, it was very cosmopolitan, very open, very liberal, and I felt I had a lot 00:04:00of freedom and a lot of independence. Even, for example, growing up, I never had to rely on my parents to drive me around. I was independent from an early age. I took the bus, I took my bicycle, and I just did everything without anybody's assistance. Which I think is a lot different from when I see children here, they're driven everywhere, because there's no other way to do it. But, yeah. I was actually very happy to grow up in France.

Q: What did your parents do?

KRUMM: My father was--he restored military equipment and vehicles, and old cars. He was in the restoration business. My mom worked for the post office. She was a civil servant for the post office.

Q: What kinds of things were you interested in, up through say, high school age?

KRUMM: Sports was not a big component of my life. In France, we go to school to 00:05:00study, but then afterwards there's not really any activities. I would spend a lot of time reading, and going to movies and being with my family, basically.

Q: Were there any literature interests that really got to you?

KRUMM: Oh yes, of course. English, because when I decided to go to college, I knew that I wanted to be an English major. Actually, in school, I was always a very good student in English. That was my big passion, and I read everything that I could read. As an undergrad [undergraduate student] in France at the university, there were literature courses, and I would sign up for one or two, but there were several. Every one had a reading list. Books to read. But what I would do--this sounds so nerdy--what I would do, I would not only read all the 00:06:00books for my classes, I would read all the books for all the courses that were taught. That was me.

Q: Well that's adorable, actually. That's what that is. Wow. Were there any books that stand out in your memory as, that was a formative experience? That was a great experience, reading that?

KRUMM: Yes. I liked [H.] Sinclair Lewis, I liked his books very much. Of course, [John E.] Steinbeck [Jr.], I liked him very much. And [Charles J.H.] Dickens in British literature.

What happened is, the way I came to the US was, I was an undergrad, and my major was English at university. As part of our education, we could, if we wanted to, spend a year working at a university, either in the US or in England. Actually, my university, the University of Strasbourg, we had an exchange program with Purdue University and Indiana University, where we had students from those two 00:07:00universities come to study in Strasbourg for a year. I met the director of the program, and he was--they were alternating between Purdue and Indiana. That year it was somebody from Purdue. He said, "Pascale, we really like you, would you like to come to Purdue for two years, be a TA [teaching assistant]? But you would have to get a master's in French." I said okay. So I did that. Then I ended up liking it so much that I ended up staying. It was not really my intention. My intention was to go back to France and become a college professor in English, actually. But I ended up staying and getting a PhD in French, and then I was a college professor for ten years.

Q: What did you like, or what did you think about life over here in the United States?

KRUMM: Oh yes, I loved it. I used to come as a small child--my parents had friends in the US. I used to come quite often as a child, so I was very familiar 00:08:00with the culture and the lifestyle.

Q: Did you first teach at Purdue? Is that--

KRUMM: Yeah. I was a TA, teaching assistant. I was getting my master's in French, but I was also being a teaching assistant at the same time. After I got my master's, then I enrolled at the University of Virginia for a PhD. The same deal, you get paid to teach and a tuition reduction, and you get your PhD, and you teach at the same time.

Q: And where'd you go from there?

KRUMM: Then I thought, what could I do with a PhD in French? The only thing you can really do is become a college professor. I did that, but I didn't really like it. I didn't really like academia, not really the students themselves, but just the atmosphere. I wasn't really feeling comfortable in academia.

Q: What about the atmosphere?

KRUMM: The colleagues, they were very--I felt they were very sort of self-centered about their disciplines, which was of course, French or British literature, and I thought in the scheme of things, it's not something that will change the world. I just didn't know what to do. As I said then, coming full circle, when I had the job here, and I found out about CDC and public health, I said, that's what I want to do. Actually, when I found out about CDC, I found out about this thing called the MPH, master's of public health. Really, if I had known about this at the time, I would have done that. I would not have done a PhD, I would have gotten an MPH. But I just didn't know at the time.

Q: What was it that so attracted you to public health?

KRUMM: Again, the fact that--I know it sounds idealistic, but I felt that as 00:10:00opposed to me being a teacher teaching French to undergraduates who basically, unless they were a major, basically they took it because it was a language requirement. It's not really because they wanted to. I didn't feel that I was really contributing to the world. But I felt that public health and working at CDC, I felt I could really contribute. Of course, in my minute way. But I felt that public health is very worthwhile, and I just felt that that's where I want to be.

When I had my job interview, it was at ATSDR [Agency for Toxic Substances and Disease Registry] at the time. They interviewed me, and then they asked me, why do you want to work for CDC? I said, "I know this is going to sound corny, but it is really the truth." I said, "From the moment I heard about CDC, I knew 00:11:00that's what I wanted to do, and actually, I became a US citizen so that I could work at CDC." They said, "Pascale, this is the best answer we've ever heard." [laughter] So, yeah. It's true, it's true, it's true.

Q: Wow.

KRUMM: Yeah.

Q: Can you tell me about your--was your first position at CDC with ATSDR, then?

KRUMM: Yes. In 2000, I was a writer/editor. And then, something, you know, at CDC. Unfortunately, we--there's always a crisis, right? We had Ebola, and that wound down, and now we have Zika. One thing winds down and then something--it's this circle. This cycle. In 2002, there was the--or was it 2000? The anthrax event.

Q: Right.

KRUMM: Yes, in--

Q: Two thousand two?

KRUMM: Two thousand one, 2001, yeah.

Q: Yeah.

KRUMM: I had been there like a year and a half, and anthrax happened. I knew 00:12:00somebody who was working in the office of the director, the communications office. He said, "Pascale, we would like you"--that was just before the events of September 11th. He had contacted me, he said, "Pascale, you're one of the few communications people who has a PhD. There's very few of us. You know how to do research. CDC wants to publish a style guide." You know what a style guide is, yeah? It's a guide that when somebody writes, you know how to write, how to write letters and stuff like that. How to spell out, how to.

Q: Right.

KRUMM: They asked me if I would be interested in writing the style guide for all of CDC on a detail. I said oh yes, of course. My supervisor let me, because of course, it was for the office of the director. He could not really say no. I was 00:13:00working, I was going to start working on that, and then 9/11 happened, and anthrax happened. So they said, "Pascale, we still want you to do this, go ahead and do this. But also, would you be interested in jointly also helping us with the anthrax and 9/11? Working with us?" Like for example, in the morning, because I always come in very early, and at the time we didn't really have--the internet was really very new. They wanted me to, because I came in very early, to sort of scour the web and see what had been written in all the major newspapers about the recent events. And then do a summary. That's one thing I did. I did that. And then, the office of the director again said, "Pascale, would you be interested in staying with us? Because we need somebody at your level." I said yeah, of course. I transferred to the Office of the Director, and 00:14:00then after that, I was there for like four years. After that, I worked for global health for five years. And then, Dr. Frieden's office contacted me. They said, "Would you be interested in becoming Dr. Frieden's speechwriter?" Of course, you can't really say no. I mean I could have, I guess. But I thought, this would be really such a great opportunity for me to grow professionally, and what an honor to work for the director. Then I did that for five years. Basically, I used to joke that I only have one client, and that's Dr. Frieden. And basically it's true, I got very few e-mails; all my interactions were with him directly. I wrote his speeches, and I did his PowerPoint presentations for conferences. I did that for five years, and then Ebola hit, and then I was taken 00:15:00aside to deal with that. After that, my old job became open again. The job that I had vacated to work for Dr. Frieden. They said, "Pascale, your old job is open again, would you be interested?" I said, "Sure." So I've been doing that for the past year.

Q: Got you.

KRUMM: Yeah.

Q: [laughter] Thank you.

KRUMM: Yeah, so that's my whole career at CDC.

Q: [laughter] Beautiful. I appreciate the--

KRUMM: Yeah, and I did, besides the style guide, the CDC style guide, I also wrote lots of other manuals. I wrote one for correspondence, I wrote one for software that we used for correspondence. I wrote one for visual design. I used to joke that it's really weird that I'm French--I'm French and English is not my native language, and yet I am writing all those books about--it's strange, I agree.

Q: I think it's neat. Are there any, looking back, speeches that you remember putting a lot of work into for Dr. Frieden?

KRUMM: Oh, all of them really. I mean yes, it's just, it was--I don't know if you want to keep that in, or if you want to edit it out. It was the hardest job I've ever done. It was very hard, like you have to be available twenty-four--I knew it when I came in, it's not like oh my God, you know, I knew it. But it was very intense, you have to be available for him all the time. There's no weekends. I guess he used to be home and do his thing, spend time with his family. You may have heard about the routine. Then at nine o'clock, the emails start hitting. He would spend time, I guess, with his family from six to nine, and then nine o'clock, go back to work and then, so that's--I had to start work again. Not always, but many times.

Q: Nine o'clock AM?

KRUMM: PM.

Q: PM, got you.

KRUMM: Yeah. It was very hard. But also, it was gratifying. I used to joke that the process was sometimes painful, but the end result was always good. I do think he appreciated me, because I'm actually the one who lasted the longest of anyone. I always say that's going to be on my tombstone. "She lasted the longest."

Q: [laughter] Oh my gosh.

KRUMM: Yes, yes, yes.

Q: How do you get involved in Ebola? I mean, are you still working in the capacity as his speechwriter, and--

KRUMM: No, no. As I said, after a year ago my old job--I mean, working for Dr. Frieden in that capacity for five years, it's just, it's not something that you can--

Q: It's not sustainable.

KRUMM: No, it's not sustainable.

Q: Sure.

KRUMM: One of my former bosses said, these are the sort of jobs that have a limited shelf life. Again, my supervisors in OD [Office of the Director], they 00:18:00were very--they knew. They knew and so they were very supportive. They said, "Pascale, if we let you go on a detail"--provided that it's not a detail just to do a detail. "If there's a detail, but there's a strong possibility that it becomes permanent, we'll support you and let you go." And that's what happened then. My old job became open as a detail, and then it became permanent. But yeah, they knew I wanted to leave.

Q: Got you.

KRUMM: Because it was just too intense.

Q: Yeah, I hear that. So, what were you doing immediately before Ebola? You were still doing the speechwriting at that point?

KRUMM: Yes. Yes.

Q: Right? Okay.

KRUMM: Yes.

Q: Got you.

KRUMM: Yeah. And of course, once Ebola hit--we started really working on this, starting I guess in April or something, right? Of course, I did a lot of the 00:19:00speeches and the presentations, and so I was familiar with the whole--I had a good, big picture of what was going on with Ebola. I knew what was going on, I knew what we were doing and stuff. Then, as I said--so my first deployment was, let me think, in--look at the date. It was I guess September. September was my first deployment. And I think it was officially declared by WHO [World Health Organization] a public health emergency of global importance like in August, I think?

Q: I think that's correct, yeah.

KRUMM: Yeah. Yeah. So, I think in August is when we started officially deploying people.

Q: Right, right.

KRUMM: And so like a month later then, I deployed.

Q: Got you. Wow. What was that process like? Did you know what you were getting into?

KRUMM: Yes, yes. Unlike a lot of people--there's a lot of people who were then 00:20:00involved with Ebola who did not know the language. They did not know about global health. They were not familiar with global health, and they had never traveled with CDC, especially not to Africa. I am sure that for those people, it was a huge shock and everything else aside. Then you piled that on; I'm sure it was very difficult. But for me, I did not feel it as being difficult, because when I was working for CGH for five years, I did that all the time. I deployed many, many times. I did training. I worked for the FETP, the Field Epidemiology Training Program, and I conducted training for our residents on scientific communication. Telling them how to write manuscripts for publication, how to write abstracts, and things like that. I knew Africa inside out. I had been, of 00:21:00all the countries where we work, Africa is the one where I would go more often,

Q: Where would you go most often?

KRUMM: Again, the countries where we have FETP, so I would go to Nigeria, Kenya, Tanzania, South Africa, Uganda, Rwanda, Namibia. Burkina Faso once. But a lot of them very, very often. Yeah. So nothing like, nothing was really a shock to me. Like when you've--if you've never been and you first land, and you see--you really see the poverty and the people and the--it can be a little bit like a shock to the system. But it was not a shock to me. In that regard, I'm sure that the deployments were not as hard on me as it would be on some of the other 00:22:00people who went.

Q: How did you--did you volunteer to go? Or were you called at one point to--

KRUMM: Well I met--I actually ran into the head of health promotion, what's his name?

Q: Oh, Craig Manning?

KRUMM: Yes, Craig Manning. I ran into Craig Manning, and then he's the one who contacted me. He said, oh Pascale, da, da, da, would you like to deploy, and everything? As I said, I had to ask permission, and they said yes right away.

Q: What role did you imagine you were going to have there?

KRUMM: Oh, I knew it. The lead for health communications. We had different groups on the different teams. There was the health promotion team, there was an epi team, there was all those teams. There was an infection control team, and so on, and so forth. When I went, I was always the lead for health promotion, for 00:23:00the health promotion team. Of course, in the beginning, the teams were very small. Sometimes it was just me or me and two, three people. But as the response grew of course, the number of people on the teams grew.

Q: When you arrive in-country, do you overlap at all with the person you're taking over?

KRUMM: Sometimes, sometimes not. Sometimes one or two days, sometimes it's vacant because they have a very hard time, again, finding people whose boss will let them go. Because I think at one point also, there was an issue with releasing your staff, and the office had to release the person, but they were not getting--they still had to pay for that person, so there was nothing really in it for those people. Right? They have to let somebody go, yet the work piles on, and I think they changed that afterwards. After a while, that was changed. 00:24:00There was a lot of reluctance from some of the supervisors to let people go. Again, for me, there was no reluctance. I think one of the reasons was because I had been with CDC as a health comm person for like sixteen years, so I was very experienced, I was French, I was working for the director, and the director, he would send out emails every three weeks, mass emails. "We really need"-- to supervisors--"We really need you to release the people, this is important for the"--you may have seen some of those that went out. He would send those periodically. I think it would have been really hypocritical for him not to let me go. Say hey, you're asking everybody else to release and sacrifice, and yet you have somebody who's very qualified and who's French, and you're not letting her go. I'm not saying that's why he let me go, but, you know.

Q: Right, there's logic in that.

KRUMM: Yes, yes. [laughs] Yes.

Q: What was the situation like as you found it in September of 2014, when you arrive in-country?

KRUMM: I think maybe I was the second person there from health comms. Again, it was very new for us, and a small team. It was intense. It was very intense. But everybody worked well together. The team lead, I think, was Ben [Benjamin A.] Dahl at the time. He was a team lead, and you may have interviewed him. You should.

Q: I have, yeah.

KRUMM: Okay. He's great.

Q: I know.

KRUMM: Yeah, he's great. We worked very closely together. But, it was hectic. It was hectic, and we worked long hours, at least twelve hours [a day]. At least six days a week, six and a half days. But on the other hand, there's not really 00:26:00much to do anyway. So you might as well take advantage and work. But sometimes it was frustrating because Conakry is--it's chaotic, it's dirty, it's--traffic is terrible. Sometimes, for example, I would have--I worked very closely, I was very fortunate, as a comm person, we worked very closely with the US embassy, with the public affairs office. Wonderful, really. Great people. I worked very, very closely with them. Sometimes I felt like I was really an employee of the State Department and not a CDC employee, because I did everything with them. Sometimes, I would have to go to the US Embassy, for example. Because of traffic, sometimes it would take one and a half to two hours just going. Sometimes you'd do things, and you'd end up spending, in the day, four or five hours just in the car. Or if you have to go outside of Conakry, to the field, 00:27:00that's even worse. And the roads were terrible. It is what it is.

Q: Got you. What are some of the initial things that you were working on?

KRUMM: So again, a lot of outreach with the community.

Q: With the community?

KRUMM: You know, trying to educate people. For example, one of the things--I felt very comfortable being in Guinea for all of the reasons that I mentioned. The ambassador was very, very committed. He was very hardworking and he was very committed, and I worked with him a lot. Because he worked, he did a lot of outreach and communication. Meetings, meetings with university groups, with anybody that wanted to meet, he would meet. What I did several times, which I had never done, and it was really outside of my comfort zone--radio is very big 00:28:00in Guinea, right? If you leave Conakry, most people don't have electricity, and certainly no TVs [televisions]. But everybody has a radio. One of the things we did, we organized, we went to the different radio stations and talk shows. We would go to the DJ [disc jockey], and it would just be a Q-and-A [question-and-answer session] with the DJ. It was usually me and somebody like the ambassador, or maybe Ben Dahl, an epi person, and we would do radio interviews. I remember when I went with Ben--I organized those things too, right? With Ben, I organized it, and we went. It was the DJ and then Ben and me in the booth, getting ready before the interview. I said to the DJ, "I'm just here to provide support for Ben, and to help translate if something--but I don't 00:29:00really want to be on the mic [microphone]." So, "Oui, oui." But then of course, the first thing he said, he introduced me and then he started asking me questions. I thought, oh. But then it turns out, once I started, it was very easy. Again, it was something that I never thought I could do, because I'm actually very shy. I like to be behind the scenes. That's one reason I loved my work for Dr. Frieden, because I was like this little mouse behind the scenes, and then he was up front. So yeah, that's one of the things--one of the things I think a lot of people maybe were not willing to do is go out of their comfort zone. That's one example. It's a small example, that I felt very uncomfortable being on camera, on the radio, and on TV. I went on TV too, and I didn't think I could do it, but then hey, I was able to do it.

Q: What were some of the common questions that you would get?

KRUMM: Always, we always had questions about the rumors. I don't know if you--during your interviews, that--

Q: Tell me more about it, yeah.

KRUMM: Crazy rumors. Like it was a plot by--so they have of course ethnic groups in Africa, very common, and so the president belonged to one ethnic group. Then the other ethnic group, they would spread rumors like, this is a plot by the president to annihilate this ethnic group. There was another common one: this is a plot by the white people and they're killing the blacks to sell the organs. Yeah. That was one of them. Just crazy rumors. We had to deflect a lot of those rumors.

We also did a lot of education. For example, the hand washing part. That yes, 00:31:00Ebola is a terrifying disease, but really the only way to catch it is if you touch a person who is symptomatic. You always want to be sure to wash your hands as often as you can with soap and water. That turned out, I think, to be very efficient. It was a message that went well, because after a while--so everywhere you went in town, they had those buckets with the water. That was a message that passed successfully. I think also that afterwards, they had lower cholera outbreaks. Because again, people washed their hands more often.

Q: I'm wondering how one goes about deflecting those rumors, because I imagine that they're not just random but come from some sort of historical context of experience with colonialism--

KRUMM: Sure. Of course, of course.

Q: --and violence. So--

KRUMM: Sure, sure.

Q: --how did you--

KRUMM: Well, so what we tried--again, it was one of the hardest things. People believe, people have beliefs. How can you--and a lot of times they were not very educated, either. I think that also made it more difficult. Because they would believe things that we know it's not really possible. That a person with any kind of education would know that's not really possible. Then also, the superstitions, the religious superstitions. That was very difficult to deal with. One thing we tried to do is because a white person, yeah, a white person says that then, what do you know? What we tried to do is to involve locals, community leaders, as much as possible, to get their buy-in. The local imams, the leader of the village, etcetera. We tried to get their buy-in, so that they 00:33:00could deliver the message.

Q: Can you tell me about some of these people you formed relationships with, you found, that could relay these messages, imams or whoever?

KRUMM: Yeah, so I worked--as you may know, WHO has this system where when there's a public health event, they have different parts of WHO who are the lead. For example, when there's a public health crisis, the lead agency for communication is UNICEF [United Nations Children's Fund]. I worked very, very closely with UNICEF, and of course they already had an office on the ground. They already had a lot of local contacts. So that worked very well. But I can give you a specific example of my work in Mali.

Q: Oh, great.

KRUMM: Although Guinea, I felt, if I have to give an overall picture of Guinea, 00:34:00I felt the Guinea response, for me, was very frustrating. Because I would go, and then I would leave for two weeks, three weeks, four weeks. And I would come back, and I would go to meetings with partners, and it felt like it was just yesterday. It didn't feel like I had left a month ago. It felt like it was the same discussions and things weren't really moving. In French, we have something called the theatre of the absurd. It's a twentieth century movement, and it's just absurd. Sometimes, I felt it was the theater of the absurd. But still, you have to go on. No matter what, you have to, like the doctor from The Plague, you just have to go on. But yeah, and I wasn't the only one who felt that. One of my 00:35:00friends who was with me, Lisa, did you interview her?

Q: Lise Martel?

KRUMM: No, not Lise Martel, another Lisa, and I can give you her name. She was really good. [note: Lisa Moorhouse]

Q: Oh, great. I'd love that.

KRUMM: We used to joke about the theatre of the absurd, and we used to write little notes, "This is the theatre of the absurd." For example, I can give you an example. It's not really Ebola related, but just to show you. We were deployed in the Forest Region, where the outbreak had first happened. We were in a small city. We were staying in, like a rooming--like a hotel, but not really. It was a house with rooms. Of course, there was no reception or anything. It was just the house boy who would clean and everything. Then we arrive, and my friend Lisa, she's American, so her French is not, of course, it's not like me. I 00:36:00remember talking to the person that--at the hotel, and I was telling him something in French--I forgot, da, da, da. He just looked at me. Then my friend Lisa told him in her more limited French, and then he understood.

Q: What?

KRUMM: So we thought this was just the theatre of the absurd. They don't understand a fluent French speaker, but then a person like Lisa, who's not fluent in French--but of course, the reason is because once you leave Conakry--and that's another problem, in Conakry, everybody speaks French. But once you leave Conakry, they have their local dialects. French, yes, they know, but maybe not as well as somebody in Conakry. That's probably what was going on, that person wasn't really fluent in French, but we had a big laugh about that. He did not understand me, who's French, but he understood my friend Lisa.

Q: Oh my goodness. Do you remember what deployment that was?

KRUMM: I think that was my second deployment. I can send you the information.

Q: Okay, yeah.

KRUMM: Yeah, yeah.

Q: I'd appreciate that. Thanks. Can you remember--going back to the first deployment, were you still--did you have time in that first deployment to be reaching out to local community members, and trying to do education and everything?

KRUMM: Yes, yes. Definitely, yes. From the beginning, yes. Absolutely. And then I would go on deployments to different areas, and do that.

Q: So the first deployment wasn't just in Conakry?

KRUMM: No, no, no. No, we always traveled all over. Yes. For sure. I think the third deployment is when--so the schools had been closed for a while because of Ebola. I think during my third deployment, I happened to be back there the week the schools reopened again after being closed for like a year. One of the outreach [activities] we did, as health comm people, we went to different 00:38:00schools in Conakry and also out in the rest of Guinea, to talk to the school kids. They loved it, so that was very gratifying. That was great. We did it in Conakry, and then we also did it out in the little villages.

Q: What were you talking about?

KRUMM: Again, in very simple terms, tell them about the disease and how to protect yourself and simple messages.

Q: The basics of Ebola.

KRUMM: Yeah, wash your hands. We showed them and--but very, very basic, of course, because they were small children. I have a funny story about that. We were in one of the villages, again, during the--and we of course, we had to ask for permission from the school board. Of course they always said yes. So we went. We would--I would go, for example, me, to one school, and then I would talk to several classes. In Conakry, the hotel we were staying at was a really 00:39:00nice hotel, the Palm [Camayenne] Hotel. What they did at the Palm Hotel, every day, when the maids made the room, the Lindt truffle chocolates, you know them? We would get a Lindt truffle on the bed. Of course, I didn't want to eat them. I knew I was going on those deployments, so what I did, I collected them, I kept them, to give. To give out. Like when you have show-and-tell, and the child answers, you give them a piece of candy. I was on one of those deployments, and that's what I did. I asked a volunteer. And this little girl came to volunteer. When she gave a good answer, I gave her this chocolate. I'm sure she had never seen a Lindt truffle chocolate in her whole life. I gave her that. Then, I asked another question, and the student who answered, same thing. And then the school 00:40:00director, the woman, came up to me and she says, "Now we're going to do this demonstration with the teacher instead, not with the students." I thought, okay. The show-and-tell with the teachers. Okay. I thought for me, that is kind of weird because it's good to involve students. Then she told me later that what she was afraid is, God forbid, that student that I gave the chocolate to, and touched, God forbid that child comes down with Ebola, and she goes home, and then she would say oh yes, a white person came to school, and she touched me, and she gave me chocolate. So of course, then there could be rumors the white person gave her--I never, of course, it never entered my mind. But then afterwards it made sense. After that, the school director--she always, before we left, she always said to the students, every class, "Did the white person touch 00:41:00you?" "No, she didn't touch you." "Did she give you anything?" "No, she didn't." Again, to reinforce that a white woman came, but she never touched us, she never gave us anything. So that they cannot come back and say--I mean, that's how crazy. I thought I was doing good. Yeah, I thought I was doing good by giving a piece of candy, and it turns out I was not.

Q: Was this in Conakry, or outside?

KRUMM: No no, outside, in a little village outside. But yeah, in Conakry I didn't--I had just arrived, so in Conakry I hadn't saved enough chocolates to give out. [laughter] But when we went into the field, I had enough chocolates to give out. But yeah. That's sort of what you have to deal with. Things you never think about, you would never think, but then oh my God, yes. In this crazy situation, yes, I can see how this makes sense.

Q: What are some other challenges that you remember having to overcome?

KRUMM: I did not have that challenge myself, but most CDC people had the challenge with the language, definitely. Because when we had meetings with partners, everything, everything was conducted in French. Everything, one hundred percent of the time. Of course, I did not have any problems, but a lot of CDC people, that was a huge challenge for them. For me, I was not--so a lot of people were also afraid to be out there, and they were afraid of catching it. But I was not. I felt that I was safe. I felt that if something did happen, I felt confident that CDC would really take care of me and do the right thing. I never was afraid to go out into the field, or to meet people, or to do anything like that.

Q: I want to follow up on one thing you mentioned earlier, which is that you 00:43:00were at least, especially in the first deployment, or maybe even second and subsequent ones, I don't know--that you worked so closely with the embassy.

KRUMM: Yes.

Q: And felt almost like you were part of the State Department.

KRUMM: Yes, embedded. I was embedded with them, yes.

Q: Right.

KRUMM: Yes. [laughter]

Q: Can you just describe some of the individuals you worked with there?

KRUMM: In Guinea, I worked very closely--so the ambassador, Alex--

Q: Laskaris?

KRUMM: Laskaris, Alex, yeah. [note: Alexander M. Laskaris] We called him Alex. I never thought that I would call him Ambassador Alex. [laughs] He was very committed, so whatever the----the public affairs office, they have a schedule, and they said okay, we would like to do A, B, C. And Alex always said yes. Because he knew he was the face of the US government, and he commanded a lot of respect. He was always willing and open to do anything that needed to be done. 00:44:00The two women that worked there, Kim [Royston Phelan] and I forgot the other person's name [note: Emily Green], it was Kim and another one, they're again very committed. They were very committed. We ended up working very closely together, and when I left after--so again, coming back and forth several times, and they were also towards the end of their mission. The last time I met them, Kim gave me a mug, a coffee mug with "US Embassy Conakry" on it. I also got there, and in Mali, too, they gave me a badge. Not a visitor badge, but like an employee badge. So that I didn't have to sign in every time, it's just like I could go back and forth just like a regular employee. I have to say, they were--I don't know that we could have done such a great job if it was not for 00:45:00the public affairs office. A lot of the radio interviews, they scheduled, or they had something already on the table. They could have just done it by themselves, but they called me and said, "Pascale, we're doing that, would you like to be involved?"

Q: Can you describe the--I don't know how to say it, kind of like the mood or the environment once you arrived in Guinea in September? I think it was September in which those aid workers were unfortunately killed.

KRUMM: Yes, I arrived a few weeks afterwards. Those aid people that were killed, yes, I arrived. As I said, again, I never felt threatened, I always felt safe, and we always had a driver who was very, very good and everything. But yes, I know that a lot of the local people were afraid. The community leaders and 00:46:00sometimes, the public health people in the communities were, yes.

Q: Afraid of community resistance?

KRUMM: Yes. Yes, yes. Because we heard--it never happened to me personally, but we heard a lot of times, oh yeah, they went to that village, and they got stoned. The people threw stones at them or blocked their way. But I never encountered anything like that. And I went many times to the remote villages--not just like a small town, but really, really remote villages, and we were all--of course, not by myself, with the local public health officials. But I was always welcomed, and actually with Lisa, we went to one village, and the reason we went is because when there were cases, there was a quarantine sort of. There was this quarantine, and that had just ended. Like two days before, the 00:47:00village had been declared Ebola-free. They were sort of celebrating, and we were there to sort of celebrate with them, say, look what you've accomplished. But you need to be careful, don't let your guards down, you still need to keep--blah, blah, blah. They were so grateful, they welcomed us like dignitaries. They would give us--this is so funny. They were of course very poor, but they were so generous. They would always give us bananas or mangos. We would go, we would leave, and we would have bananas or mangos as presents. We were told at CDC, of course, don't touch. No matter what, don't touch. But in that particular village, because they had been declared Ebola-free, then we decided to have pictures. Then of course, then all the kids came, and they 00:48:00touched us and we thought oh my God, if CDC sees that, they're going to freak out. But they were so happy and so enthusiastic. So there were good stories. But of course, there were also--we did go to certain villages where I looked like one hundred meters, and there was the Red Cross, who had come to pick up somebody who finally they convinced to go to the Ebola treatment center. Yeah, I saw the whole range. I never witnessed any violence, but I know some people have. I was just fortunate it didn't happen to me.

Q: I like hearing that side of it too. The side of sure, it's something that you heard about, but it's not something you experienced, and in fact, people were grateful, and people were kind and--

KRUMM: Yes, yes, yes. For example, even for the radio interviews--we have 00:49:00callers. The DJ would ask us questions, and then after that, it was open, and anybody could call in and ask questions. We never had any confrontational questions, or, why isn't the US doing more. It was always very scientific questions: what can I do to protect myself? At the end, they always said thank you so much for what you're doing for us. That was my experience; I'm not saying the other side did not happen.

Q: What were your thoughts about the French government's more limited involvement in Guinea?

KRUMM: That's interesting, because actually we did not really have any involvement with the French government at all. I don't know why, that was a little strange to me. On my last deployment we did, because after a while, the French government built an Ebola treatment center for healthcare workers, did 00:50:00you know about that one?

Q: I don't actually.

KRUMM: Yeah, so what happened is, of course there were a lot of healthcare workers who got sick, and--

Q: Oh, of course.

KRUMM: --unfortunately, a lot of them died from that. The French government's contribution in Guinea, they built a state-of-the-art Ebola treatment center inside the Air Force base in Conakry. There was a huge hangar and they built all of that. What was interesting about that is that CDC made this agreement with them that if any of us came down with anything, we would go to that French Ebola treatment center and be treated there. Of course, we didn't advertise it, but that was the deal. Of course, because I'm French, I contacted them and said, "This is so interesting. Can I come and visit?" They said sure, and I went, and they were very gracious and open, and they showed me, it was amazing. And so I 00:51:00met them, and then that was, I think, on my second deployment. On my third deployment, which is interesting, I had met one of the Ebola--we also did a lot of work with the Ebola survivors. Did you hear about Marie Claire [Tchecola]? She was the one who won the [International] Women of Courage Award.

Q: Tell me about her.

KRUMM: Oh, yeah. What happens is the State Department, that is not--has nothing to do with Ebola, by the way. But the State Department has this program, it's called the Women of Courage Award. And every year, it's awarded to I think ten women around the world. They're nominated by US embassies. The US Embassy in Conakry has nominated Marie Claire Tchecola, who was a nurse who came down with Ebola while she was working at the city hospital. She survived, and she was 00:52:00very--a lot of people, as you may know, even after they were--they did not have Ebola. After they survived, they wanted it to be hush-hush. They didn't want to be public, because even though they survived it, there was still the stigma attached to that. But Marie Claire, she did not have that. She said, what can I do, I want to help, and I want to be the voice of--and I worked a lot actually with Marie Claire. I became very close to her, with her. We even went to a conference in Ghana on Ebola that was sponsored by the Institute of Medicine [National Academy of Medicine] in New York. They nominated Marie Claire, and she won. She actually came to the US, and she met Michelle [L.R.] Obama, and then she came to CDC. Look her up, because we wrote in CDC Connects, there was an article written--

Q: Is there an article in CDC Connects?

KRUMM: Yeah, yeah, yeah. She was here, and she was such a wonderful, courageous, 00:53:00wonderful person. Every time I went, I did a lot of work with Marie Claire, and of course we all gave her support. We brought her things, and obviously money also, because that's what they need most. I lost my train of thought about that.

Q: Working with Marie Claire?

KRUMM: Yeah, with Marie Claire.

Q: It's okay, I actually--I think I need to turn this machine next to us is--

[interruption]

KRUMM: Coming back to Marie Claire, she was an Ebola survivor, a nurse, and she got the Women of Courage Award, and I worked very closely with her every time I went. On my third deployment, I called the French Ebola treatment unit again and I said, "Could we come and visit?" Of course, also with other CDC people, not just me. I said, "And I would like to bring Marie Claire, who's an Ebola 00:54:00survivor." We went, and of course, Marie Claire, this is not where she was treated. But that was very moving. Because of course it brought memories to her, and then they actually met Marie Claire, who was a survivor. It was just a very moving story. Marie Claire, she was Catholic, most people in Guinea are Muslim. But there are some, so she--Marie Claire was Catholic, and actually her uncle is very high up at the Vatican. So she's very religious. They found out about that, so they showed us--on the way out, they showed us when the survivors were released, they had the little care package with T-shirts and things. Just a little care package. One of the care packages had a rosary, and they gave Marie 00:55:00Claire a rosary from a care package. I thought again, it's a small gesture, but it was just very moving. That was again, one of the highlights, the good--a small little detail, but a good thing.

Q: Thanks for sharing that with me. I know when you're communicating, of course, you want to know what the understanding of the issues is, of the people you're talking to. How did you learn about various Guineans' conceptions of Ebola, and how do you know what to say when you're communicating?

KRUMM: That was a little bit rough. If I could just give you a perspective, it actually was the same thing in the US. Because just again, to come back to the US, to give you perspective. After every deployment, I would not tell anybody, 00:56:00like my neighbors or friends, "Oh, we haven't seen you, where were you?" I did not tell them. For example, I go to the gym here, and I never told anybody at the gym because I knew that they would be--I would be like a pariah. Again, they should know better, right? They should know better. But, I felt that if people knew that I had been to Guinea, I would be a pariah. So I never told anybody here. You can imagine, if that's the reaction here, what is the reaction in Guinea? Also, as I was mentioning the survivors, it's really tragic, but most of them, when they survived, they had lost everything, of course, by then. They lost their house. Marie Claire lost her house, she was thrown out by her landlord, she didn't lose her job because she was a civil servant. But a lot of them lost their house, they lost everything, because when, you know, they take 00:57:00everything and they burn everything. You lose your job; if you're married, your husband will probably leave you. You have all of this, and you survive, and then instead of being welcomed back in the community, you're ostracized again. It's just a terrible, terrible situation. Trying to convince those people, that you--and that's something we try to do very much is to try to convince the people that when somebody survives Ebola, they're actually safer than anybody else in the community. Because once you have it, you're cured and you cannot get it again. We didn't go into the details like yeah, maybe another strain. We just said once you had it, you cannot get it again. We were trying to impart those messages. But again, it was very difficult to convince. Because people believe 00:58:00what they want to believe.

The other problem with this, and I think it's totally cultural, is that we would say something, and they would say, "Oui, oui, oui, oui." But then we found out, they always say--even if they don't understand, they say yes anyway. For example, the driver, just to give you an example. We had drivers, and in a lot of places, even in Conakry, there's not really a street sign like 1600 Clifton Road. When you want to go somewhere, there's not really a street address. It's just oh yeah, it's on the corner of this and that, and whatever. A lot of times when I went to meetings, and if it's a place we've never been to, not just me, everybody, we would ask the driver, do you know where it is? "Oui, oui, oui, oui." Even though he would not know, he would always say yes, and then afterwards you're lost. I learned to be very insistent, and to, is it yes, 00:59:00really yes, or is it no? I felt it was a little bit the same thing when we talked to the communities. They would say yes, or they would agree. And then they would either still do what they wanted to do, or maybe they didn't understand. You never knew, did they not understand? In Conakry, most people spoke French, but outside, it's not that obvious. And sometimes I would have somebody with me to translate, but it's not the same thing. So it was difficult to communicate the messages, because no matter what you said, and how simply and clearly you said it, you never knew how much of it came across. It was a challenge.

Q: Can you tell me about Mali?

KRUMM: Yeah, oh yeah, Mali. As I said, as frustrating as Guinea was, that 01:00:00theatre of the absurd--you come back, and it's the same, it's like you never left. There's no progress, visible progress. In Mali, that was a very, very gratifying experience. What happened is, I had come back from my first deployment in November of 2014, and I had literally been here less than a week, literally less than a week, and the Mali outbreak happened, with an imam that infected eight people, I think. I forgot the details. They asked me, they said, "Pascale, I know you just came back, would you be willing--we really, desperately, need"--it's a very small team, and put together very urgently. I said, "I'm willing, but of course you need to ask Dr. Frieden." He immediately said yes.

A small team, we started at like ten, and then people trickled in little by 01:01:00little. But a small team compared to all the others. I was home, and then ten days later, I was in Mali. We didn't even have visas. They gave us special permission because there was no time to get visas. But what happened there is, we came right away. As soon as the case happened. Not like in Guinea, where we arrived literally seven months after. Because it started in December, and then we deployed in August. This literally, as soon as this was found out, we went. As soon as possible. We were able to really get a handle on the situation right away. We were there initially for four weeks, with the understanding that if 01:02:00this is not under control, of course we'll stay as long as we need to stay. We were very, very anxious because you never know. It turned out we were able to actually stop the outbreak in four weeks, which was unbelievable. Really, really unbelievable. Speaking about the French involvement, there, we worked very, very closely with the French government. It turns out that I went with another one of my colleagues and our dear friend, Pierre Rollin. Have you interviewed him?

Q: I have, yeah.

KRUMM: Oh yeah, he's great. Can I tell you the story of how he got involved?

Q: Please do. Please do.

KRUMM: When this happened, he was supposed to go back to Guinea, for another deployment to Guinea. Then this happened, and he was not supposed to go with us because he was already supposed to go to Guinea. Dr. Frieden, like two days 01:03:00before I left, Dr. Frieden said, "Pascale, I want to talk to you before you leave." I talked to him and he said be careful and thank you, very nice things. Then he said, "Is there something you want to tell me, something that you need, some advice, something?" I said, "Yes. I think it would be great if Pierre Rollin came with us. I know he's supposed to go to Guinea, but it would really be great if he came, because he's very famous, he's very competent, he's knowledgeable, he gets along well with everyone. He knows the situation, and I think he would be an invaluable addition to our small team." And sure enough. I couldn't believe that. I said that to Dr. Frieden--I mean, I'm a nobody, right? I said, "Dr. Frieden, I think Pierre Rollin should come," and next thing you 01:04:00know, Pierre Rollin is coming too. I thought, oh wow. That was really impressive for me. It turns out it was a great suggestion because Pierre's role--I don't know, did he tell you about Mali?

Q: He actually didn't tell me too much about Mali.

KRUMM: Okay, yeah. His role in Mali was actually--we all had a role. I was the team lead for health comm, I was the only person for health comm. And then we had team leads for epi, Ryan [T.] Novak was the team lead for epi. You should talk to him if you haven't. Ryan Novak. Great person. Jeff Hanson was the team lead overall, but he's the CDC director in Ethiopia, so I don't think that you can get a hold of him. But Ryan Novak, for sure. Anyway, we all had a specific role assigned to us. Except for Pierre Rollin. He was sort of the floater. He was not really assigned to a team, he was sort of the advisor for all of us. Sure enough, he pitched in with all of us. Everybody just loved him, all of us, 01:05:00we loved him. And then everybody in the community loved him. He had that special touch. We went to that one place in Mali, you know how they have compounds because they're Muslim and they have several wives and lots of children, so often they live in a compound. There was this one family in the compound, and there was Ebola. They were complaining, of course, that they cannot go out and everything, and they had small children. What Pierre Rollin did, on his own dime, he went to a bookstore and he bought books, textbooks for children, like twenty, thirty textbooks, and then he brought them, and he gave them to the children. Again, it's a small thing, but it shows them, somebody really cares about us. He has that--I mean, if you know him, you know he's just so easy to talk to. He's no-nonsense, he's not pompous, he's very relatable too. We felt 01:06:00like he was our father almost. He was a little bit of our prophet. That worked out great. We worked, it turns out that--Pierre is French, like me. We worked a lot with the American Embassy, but then we met somebody, we met the head of the--there was a doctor who was working at the French Embassy, and we met him. He invited me and Pierre to a working breakfast with the French ambassador, who--they had hired their own experts, Ebola experts from France. He invited us, me and Pierre, to a lunch, to a breakfast to meet the experts. Afterwards, we actually worked closely because the French had--in Mali, in the north of Mali, 01:07:00in Timbuktu, they had an operation, Operation Barkhane. Because there were the Muslim terrorists in the northern region. Still are. The French forces were actually there, working on behalf of the Mali government to push away the rebels. They're not terrorists, they're rebels. What happened is that contingent came to Bamako to work on the Ebola response, and they were medical officers, French military medical officers. We actually worked very closely with them, we went to the border town together, and we did a lot of activities together. That was very good to work closely with the French government on the response. We also worked closely with MSF [Medecins Sans Frontieres]. MSF, they don't really--they like to do their own thing. In Guinea, of course, I met the team lead for comm in MSF, and they said, working together--she said, "Let me think 01:08:00about it." And then she said no. Because they want to do their own thing. But in Mali, in Bamako, "Oh yes, come." They had us visit the Ebola treatment center. They wanted to work with us. As opposed to in Guinea, they wanted to do their own thing.

One of the best things we did in Mali was working with the Muslim community. You know that one of the ways that Ebola spread was during funerals. If you're a Muslim, there's this ritual where the body has to be washed, and then everybody hugs, and touches, and everything. That is how Ebola was spread. In Guinea, we were never, ever really able to work with the high Muslim leadership on that 01:09:00issue. We would work one-on-one in the villages, with the imams. But on a national basis, we could never do anything with them. However, in Mali, I decided--I had sort of a strategy, which was to work with the imams to get their buy-in on this. I contacted the highest leadership council, it's called the Islamic High Council of Mali, it's like the highest Muslim leadership. I contacted them and I said, "Could we meet? I would like to help if I can, so that we stop the spread of the disease during funerals and all that." So, I went. They said, "Yes, come see us at the office." I was the only woman, of course I had to be covered. I felt like, I don't know if you watch Homeland.

Q: I don't.

KRUMM: Okay. But anyway on Homeland, you know Carrie?

Q: I've seen the pictures.

KRUMM: Carrie, when she's out in Pakistan, she wears that scarf. I felt like Carrie on Homeland, wearing that scarf over me. It was really funny. Anyway, so I went. I told them what I would like to do, work with them on activities. The leader of the council after the meeting said to me, "Thank you so much, we'll contact you again." It's like, don't call us, we'll call you. I said okay, well, that's right. They're not going to--they just humored me. They're not going to contact me. But lo and behold, two days later, he calls me and he says, "Yes, let's work together." I said, wow. Me and then Pierre helped too. What we did, it's a long story, but to make it short, what we end up doing, I ended up 01:11:00working on a fatwa. You know what a fatwa is?

Q: It's a decree, is that right?

KRUMM: Yes, a decree. An official decree that is--it's an official decree from the High Islamic Council, and whatever that decree says, they have to follow. Everybody has to follow. We worked on a decree that said that during this time of crisis, when somebody dies, you are not allowed to wash the body. You are not allowed to touch the body. It has to be handled a different way from the way it normally is. Which was very hard for people to change those beliefs. What I did, I worked with a person who--a locally employed staff from the US Embassy, who also happened to be an imam. Because of course I don't know much about Islam. What we did, we looked at the Islamic, at the Quran, verses in the Quran that 01:12:00talk about quarantine, and there are some. This is where it comes from, from Islam, yes? There is actually an edict that says in the Quran that if you are sick, you are not allowed to travel. You have to stay where you are. Basically, it's a quarantine. I can forward that edict to you if you--

Q: I would love that, yeah.

KRUMM: --email me, yes, that I created. I wrote it in French, and then we translated it in Arabic as well. What we did is, we found passages in the Quran where Mohammed said, you are not allowed to leave your--when you're sick, you have to be quarantined. And also, there was--[coughs] sorry.

Q: I have water here, if you need any.

KRUMM: Oh, thank you, yes. There's also this edict--sorry, I feel like Hillary 01:13:00Clinton--that said about the burials, that you have to be buried a certain way. But there's this thing that says that if you're a martyr, if you die on the battlefield, it's okay not to have the rituals that you have to go through. To be washed, etcetera. When you're a martyr to the cause, you do not have to follow the ritual. The burial, the regular burial rituals. We decided this qualified, this is like war and everything. Again, we looked at the passages of the Quran that would support what we wanted people to do: not wash, not bury the bodies, not touch the bodies. Then we created the fatwa. And then there was a huge ceremony, the prime minister attended, the minister of health, all the big 01:14:00imams of Bamako attended. Pierre Rollin gave a presentation. It was huge. It was a huge deal. They formally announced that fatwa that said from now on, you are not allowed to do A, B, and C by law. And that helped. Then what we also did then afterwards in Bamako itself, there were like one thousand imams. Of course, Bamako is sectioned off into quarters. What we did, we went with the High Islamic Council, we had community meetings with the imams--I think like four meetings of three hundred imams each, in the different sections of the city. Where we brought them together, me and Pierre, or just me, if Pierre wasn't there, or Pierre if I wasn't there, or the two of us, we would go and we would give a presentation about Ebola. What to do, what not to do, Q-and-A. Talk about 01:15:00the fatwa again. Then, provide them with food and drinks. The idea was then they would go on Friday and preach to their community about that. Then we were going to also--we did it for all the imams of Bamako. Then we were planning to also do it in others, but then there was no need to because the outbreak stopped. I don't know that there's scientific proof that this thing that we did had an effect, but we did something that we were not able to do [in Guinea]. We did something in one month in Mali, I guess one week, because we did it right away. The second day I was there, I was working on that. We did something in one month in Mali that we have been unable to do in Guinea for the whole time of the 01:16:00outbreak. But I think it also had to do with, it had nothing really to do with us, with me and Pierre. It had to do with them. Because they were committed. The government was committed, the minister of health was committed, the head of the response was committed, and the High Islamic Council was committed. You had to have all of those working together. They did, and it worked. So yeah, that was something we were very proud of.

Q: You said in Guinea, you were not able to reach that kind of national level of coordination.

KRUMM: No, no, no, not with--I mean because that was, time and time again, one of the biggest ways the disease spread was during the funerals. We kept repeating that when the body is--when the person is dead, that's when the body is the most contagious. But we were never able to break through on that. They would secretly, of course, they would say yes, but then in secret, they would 01:17:00still do the ceremonies. But in Mali, we were able to get that under control. Yeah, yeah. It was so strange because again, I felt like I'm a woman, I'm white, I'm obviously not a Muslim. Yet they were so receptive and so kind, and it was very gratifying for all of us.

Q: Any other memories from Mali that kind of stick with you?

KRUMM: Yes, so another thing, I talked about cooperation, but of course, there's always the one person who doesn't want to cooperate. There was the local head of the epi, in charge of the people who worked in the communities, who went out every day to do the recording. The temperature recording twice a day. There was a woman, a local woman, of course, in charge of that. She sort of I guess was 01:18:00jealous of us. She thought we were encroaching on her territories and all that. Ryan [Novak] said, "Pascale, we need to do something because things are not going very well. What do you suggest?" I said, "Ryan, what we can do"--because they worked very hard. "What we could do is maybe every Saturday, around eleven, we could have a little training session, like an hour training session, and we talk about different things of concern." Because of course, one of their concerns was getting contaminated while doing. I did a little PowerPoint and job aid on--so every week I would meet with Ryan and say, "Ryan, what's your concern this week? What's going on?" He would tell me, and I would develop a little training for that Saturday. The first time we offered that, and there were like 01:19:00fifty or sixty people who did temperature checks. A big group. We go there Saturday at the meeting, and oh--the other thing we did, we thought because it's Saturday, and they have to work all the time, but still we need to do something. What we did is every week, we got another partner to pay for catering of the lunches. So they're not just coming to listen to a PowerPoint, but they're getting lunch, they're getting food, so it's a little bit of a nice thing. And they feel appreciated.

The first week we do this, and I give my little talk, and then at the end, Q-and-A. And the woman who was the lead for the Mali team, she stood up and she was furious, she said, "No, this is unacceptable, they don't need training," da, da, da. It really got very heated. But then, a local person--of course, we 01:20:00couldn't say anything. But a local person intervened and said, "No, you're the one who's out of line. We're doing this, this is helpful, this is useful, they want it," and etcetera. Eventually, she calmed down. And then, our proudest achievement is that she actually did a total turnaround and by the fourth [training session], by the end when it was the last one, she stood up and she said, "Thank you so much, we're so grateful." In the beginning, she didn't want to have anything to do with this, she didn't want to do this. And then gradually we won her over, and she was very grateful. That was also something in the beginning, you think oh, this is not going to work. We won't be able to do anything, they're not--but in the end, everybody was cooperating. That was--yeah. It was really great.

Q: So Guinea was in November of 2014?

KRUMM: September-November 2014, yeah. And then I went back in January of 2015. So I was in Mali November 11th or whatever, November 20th, maybe to December 20th, something like that. In January, I went back to--

Q: To Guinea? Sure.

KRUMM: To Guinea, and then again in March, April. Because in the beginning, we could only go like twenty-nine days because the State Department would not allow it. But after that, they waived that restriction, and so we were able to deploy for longer amounts of time.

Q: Do you remember when they waived it?

KRUMM: No, I don't remember.

Q: That's okay, I can look it up.

KRUMM: Yeah, yeah, yeah.

Q: That's okay. When you were in Guinea, your March, April trip, was that with

Dr. Frieden, or was that still--

KRUMM: No, Dr. Frieden came in--I think in July. July, August. He did a tour of the three countries. He did a tour.

Q: Sure, sure.

KRUMM: Guinea, Sierra Leone--

Q: In the summer of 2015?

KRUMM: Yes. By that time, I knew that I was going to leave my job and work for 01:22:00CGH. But then Craig Manning said, "Pascale, one more thing. Can we ask you to do one more thing? I was supposed to start my detail, but Dr. Frieden's going. Would you mind?" I said, "No, of course not." So I went with him. But that was short, that was like ten days. Then at the end of this trip, actually, it turns out that the IOM [Institute of Medicine, now the National Academy of Medicine] had an Ebola conference in Ghana, and they asked me to--since I was there, could I go with Marie Claire? So I went to the Ebola conference with Marie Claire.

Q: That's right, that's right. Okay.

KRUMM: Yeah. But that was my last time. Yeah.

Q: What was it like being the translator for Dr. Frieden and officials in Guinea?

KRUMM: It's hard because obviously I cannot do simultaneous, yes, because that's a skill you learn. It had to be one after the other. It's a little bit hard, but 01:23:00one meeting we had was with the survivors. He basically--what was nice, it was really funny. He would ask a question, and he said, "Ask them, when did they get sick?" I would ask, and they would answer. But the neat thing about that is I would not have to translate the answers back for him because he said to me, he said to us, in French, he said, "I do not speak it, but I understand it," which to me was weird. [laughter] I had to translate the questions he asked, but when they answered in French, I did not have to translate them, because he understood.

Q: Right.

KRUMM: He said, I don't speak it, but I understand everything.

Q: I've heard--

KRUMM: That was funny.

Q: --I've heard that his French dramatically improved over the course of the response.

KRUMM: I don't know, I've never really heard him. I know he's good in apparently Spanish.

Q: Yes, fluent Spanish.

KRUMM: But I have not heard him speak French. But apparently, obviously he understands because I didn't have to translate that part. I only had to do one 01:24:00of the translations, from English into French, but I did not have to translate from French into English.

Q: How did people receive him, typically?

KRUMM: Oh yes, I mean, great. He's a very modest man and he doesn't want to be really at the forefront. If he's doing the work behind the scenes, that's good enough for him. For example, one thing he does not like is [police] escorts. But they gave it to us anyway. Especially in Sierra Leone, we had escorts with the motorcades, and the police, and everything. He didn't really like that. But he had that. Actually, one time we had to go to--it was a mobile lab that was donated by the DoD [Department of Defense] in Sierra Leone. Where was it, in--maybe it was in Guinea, I forgot. I think it was in Guinea. We were supposed 01:25:00to be there. Of course, the schedule, everything is to the minute. But then there was a traffic jam. We were just not moving, but we were very close. We were a five-minute walk to the lab. Dr. Frieden said, "Okay, let's just walk." He goes out into the traffic and everything, and we're all scrambling to run after him and follow him to the lab. So, yeah. He's very dedicated, for sure. [laughter]

Q: Is there anything that we haven't gotten to, regarding your experience? Any memories that you have, you'd like to share?

KRUMM: Well another funny memory is, so you have to be--you're sort of the voice of CDC, literally. On my third deployment--remember, it's the one where school started again. School had been out, and the same thing, all levels, university as well. There was a medical school there. Dr. Frieden had donated some science 01:26:00books. French science books. But because of the outbreak, the school was closed, and so, da, da, da. The embassy asked me, "Pascale, since you're here," and school started again, first week, "the university has asked if you can come and give an official delivery of the books for the med [medical] school library." The embassy said, "Don't worry, you don't have"--it's like, you don't have to do a lot. It's just a five-minute, just, you know. I said, "Okay, yeah, I'll do it." I go there, and it's literally the med school amphitheater, and literally there's [hundreds] of people, it's full. The amphitheater is full, the university president is there, all the deans, everything. Again, the embassy said it's just a low-key, five-minute thing. I go there, and the room is packed. 01:27:00Then, I look at the schedule. They had me give a talk, a forty-five-minute talk. Yeah. Of course, I did not know. The woman who accompanied me from the embassy said, "Oh Pascale, I'm so sorry. I'm so sorry." She felt so bad because she said, "I had no idea, I had no"--because I was literally thrown to the wolves. Yeah, yeah. I did not think I had it in me, but I stood there for forty-five minutes and I gave a speech about Ebola, about CDC, about everything, in French, for forty-five minutes. I never thought I could. Again, it pushes you to your limits, but in the end you can do it. In the end, I was able to do it. After that, that was not the end. After that, they had an orchestra, and a stage, and everybody started dancing. I'm not a good dancer at all, I'm stiff as a broom, 01:28:00and I had to dance. I just thought, oh my God. But again, I did it. I never thought I could, but I did it. But then, afterwards, I get an email from a former student of mine. When I was working for FETP, he was a student of mine, he was in Togo. He emailed me, he said, "Pascale, I saw you on TV last [night]"--I said, "What, on TV? What did you say?" Because he's in Togo. I'm in Guinea. I said, "What's going on?" He said, "Yes, they had a show about the ceremony and I saw you on TV." I had no idea that this was televised, not only in Guinea, but all over West Africa. [laughter] Actually, the following week, I met--I saw countless people say, "Pascale, we saw you on TV." It was really strange.

Q: Now this was your speech that was broadcast, or your dancing?

KRUMM: I don't know, I don't know, I have no idea. But he saw me on TV, so 01:29:00anyway. All of this for CDC. Things that I never thought I could do, like going on the radio, on TV, giving a speech at the university, working with the imams. I never thought--and talking to a room full of three hundred imams, I never thought I would do this.

Q: Another thought that crosses my mind is, I know that outreach work with the imams was so important. Were you able ever to reach out and make connections with traditional healers?

KRUMM: Well, not myself. I did meet them, but on a casual basis. But yes, that was also part of our outreach is to get the traditional healers involved, yes. But personally, I did not. I did not work on that myself. But yes, that 01:30:00definitely was on the table, for sure.

Q: But you've met some personally, you said?

KRUMM: Yeah. The reason I knew that is because I was actually--it was in front of the UNICEF building, we were waiting to deploy. The healers were there, and just like you see on TV, they had the face painted and they wore the feathers, bare chested, and they had little grigri, they call them grigri, little--like what we would call the lucky rabbit's foot and all that.

Q: Oh sure.

KRUMM: Things like that. They call them grigri. You had that, and yeah. So I actually saw what they looked like. Yeah. But yeah, they were also part of the problem because a lot of people went to see them, and of course, the healer, there's nothing the healer can do. A lot of the healers actually got sick themselves and spread the disease.

Q: Even though you weren't personally working with them, did some of your communication that you did revolve around them?

KRUMM: No, not myself. I never did that, but I'm sure that other people, because we did identify that group as a very important group to reach out to. Maybe some of the other people who worked on Ebola, but yeah.

Q: Sure, sure. That's neat. So for the last year then, you've been with CGH, is that--

KRUMM: Yes.

Q: What are you working on now?

KRUMM: Again, FETP. But actually, I'm involved in something called the Bloomberg [Philanthropies] Data for Health Initiative. Mayor [Michael R.] Bloomberg, he has a foundation and there's several arms to it. He has a foundation for education, one for arts, and he has one for global health. He created two years ago, this thing called Data for Health Initiative--it's trying to use data to improve health outcomes. They chose twenty-one countries around the world to 01:32:00work in. CDC submitted a proposal to work with them. They accepted the proposal, and it turns out the proposal is in my office, and so that's what--half of my time is working on that Data for Health Initiative for Bloomberg. The other half is, of course, working with regular FETP training and things like that.

Q: Just jogging my memory again, I don't know if you ever happened to work with the FETP grads who came to Guinea from the DRC [Democratic Republic of the Congo]?

KRUMM: Yeah, yeah, sure, yeah, yeah.

Q: Oh, you did?

KRUMM: Not closely, but yeah, they were the biggest contingent because we--as you know, it was very, very difficult for CDC--Guinea was really, for us, I think the hardest. One reason was, in other countries, they found people all the time to go. But Guinea, we couldn't. We had to resort, we had to be creative. As 01:33:00you know, we hired people from Public Health Canada, and then we hired FETP graduates from DRC, and actually, remember the guy I told you about from Togo? He ended up coming.

Q: Oh, he did?

KRUMM: Yeah, he did. I met him [note: Pato Steed] during one of my deployments, and he was stationed in one of the villages. He worked out great.

Q: Okay, neat. Well, I think that's all that I have. But I want to ask you, looking back, are there any final reflections, or any memories that you want to share about your experience for the historical record?

KRUMM: That it was like Dickens, it's the best of times and the worst of times. It was like that. It was the best of times because, like in Mali, I felt we really made a difference. But then also the worst of times when you go and you tell, you try, you try to--but nothing, you try everything but nothing seems to 01:34:00be working. It was frustrating, it was infuriating, but then it was gratifying. You meet many people that you never forget. Like Marie Claire, the Ebola survivor, and all the partners, and the team leads for the response. Did you meet last week when he came, the Ebola head for Guinea?

Q: Dr. Sakoba Keita?

KRUMM: Yes.

Q: I did, yeah.

KRUMM: Sakoba, yeah, of course you met him, because you interviewed him. And Samba Sow, who was his counterpart in Mali. Those are people that--yeah, S-O-W, Samba Sow.

Q: S-O-W.

KRUMM: Samba was his first name, S-O-W his last name, yeah. And the First Lady from Guinea came, and I met her. Working with all the different partners, I felt that everywhere I went, CDC was in high regard. When we had meetings with all 01:35:00the partners, WHO and all the different partners, CDC was consistently one of the highest ranked and most respected of the partners that was working on the response. As you know, WHO was criticized heavily. But I don't think that CDC was ever criticized in any way for anything we did during the response. So yeah, it was the highs and the lows, the good and the bad, it was all mixed together. But in the end, like working for Dr. Frieden, the process is maybe painful but the outcome is good. I'll never forget it. I'm glad I could help, because I always joke, I literally had to wait fourteen years at CDC to be able to use my French skills. Because we don't really work in Francophone countries. Most of 01:36:00our work is done in Anglophone countries. I was very, very grateful that I was able to be deployed so many times, and my husband also works at CDC, so he was very understanding. It was good in the end. I would do it again. If you asked me, "Pascale, knowing what you know, and the frustration, would you still do it?" I'd say yes, I would still do it.

Q: Okay. Well thank you so much for being here.

KRUMM: You're welcome.

Q: Appreciate it.

KRUMM: Thank you.

END