Interview Transcript
Interview
Dr. Davida Coady with Interviewer Chris Vaniser
Transcribed: January 2009 | Duration: 0:33:21
Chris Vaniser: This is an interview with Davida Coady on July 11, 2008 at
the Centers for Disease Control and Prevention in Atlanta,
Georgia about her role in the Smallpox Eradication Project. The
interviewer is Chris Vaniser.
With this interview we are helping to capture for future
generations the memories of participants and their families
involved in eradicating smallpox. This is an incredibly
important and historic achievement and we want to hear about
your experience. I have some questions to guide you, but please
feel free to recount any special stories or anecdotes that you
remember about events or people. The legal agreement you signed
says that you are donating the oral history to the U.S. Federal
Government and it will be in the public domain. For the record,
could you please state your full name and that you know you are
being recorded.
Davida Coady: Davida Coady, and yes I realize I am being recorded.
Chris Vaniser: Thank you again for coming and sharing your memories about
the Smallpox Eradication Project or Program. I guess to start,
if you could talk a little bit about your early days before
going on to college and if you knew what you wanted to do with
your life, or what you wanted to be when you grew up; and share
a little bit of that information with us.
Davida Coady: I grew up in Berkeley, California in a family, none of
whom had graduated from High School previously. I was fortunate
enough though to be living in Berkeley, it had some good role
models and decided that I wanted to something worthwhile with my
life. I met two women doctors, pediatricians, running a camp for
diabetic children and I decided that I would try to go to
medical school and I did so. I read about Dr. Tom Dooley and his
work in Southeast Asia, and I decided I wanted to spend part of
my life in the Third World and went to medical school with that
idea.
Chris Vaniser: Were you thinking of being more of a clinician?
Davida Coady: I was thinking more about being a clinician. I went to
Columbia Medical School and of the acceptances I got, I chose
that school because they had an elected[inaudible0:02:49] in
Liberia in the fourth year, and I went there and I made a
decision that I would definitely go into pediatrics. I also
realized that I really loved working in a third world country. I
think up until that point I had kind of a moderate complex. I
thought I was going to die young of malaria or something, but it
hadn't occurred to me really that I would enjoy being in the
third world and working in places where you could be innovative
and where people really needed you, where the young people;
people who were being trained as nurses would be so eager to
learn, and any time that you would spend with them, they would
pick your brain about everything you knew, and I saw lots of
people getting well. I also became aware of the need for Public
Health. So during my Pediatric Internship and Residency at UCLA
I found time to go to Mexico and then to Guatemala where I met
Dr. Thomas Weller from the Harvard School of Public Health and I
talked to him about career development and he persuaded me that
I needed an MPH if I really wanted to work in Prevention which I
certainly did by that point. So I went to the Harvard School of
Public Health and then jumped into Third World work from there.
Chris Vaniser: So where did you go then after Harvard?
Davida Coady: I went first to Nigeria, only I was in the part that was
then called Biafra. I was there obviously during the Nigerian
civil war. I worked with a small relief agency run by Normal
Cousins inside of Biafra and got out the night that the country
collapsed. I was sent back to Nigeria on a Government assignment
shortly thereafter as part of the relief efforts for what had
been the former Biafran enclave and it was there I got really
acquainted with Bill Foege and Stan Foster and people who became
my heroes, my mentors, my gurus; and I became so interested in
smallpox campaign. I then went to work at the Peace Corps, first
as their Acting Medical Director and then as a Health Programmer
and it was during that time that I met D.A. Henderson and he
became one of my big heroes in life and I was involved in the
Peace Corps involvement in smallpox at that point. Then later on
I left the Peace Corps, I went to UCLA to teach and I went to
Bangladesh after their revolution and was working there when I
ran into Dr. Henderson in the airport in Dhaka. Actually he was
getting off a plane and I was getting on a plane. He said "Hey
Bill Foege is in India and he is looking for people to work on
smallpox on three-month assignments;" and I said "Oh wow, I am
interested!" and the next day I got a telegram from Bill Foege
asking me to come to Delhi and talk about it which I did and -
Chris Vaniser: Where were you based with at the time? You were with the
Peace Corps at that time?
Davida Coady: No, I was still - I had gone to UCLA at that point to be
an academic, but I am not an academic, I don't like it. I like
teaching, but I didn't like the rest of it, and by that time I
was a part time academic, but mainly working on my own. For
years then I taught one or two Quarters a year at UCLA and did
international work the rest of the time.
Chris Vaniser: So you got this telegram from Bill Foege asking you to
come and talk to him in Delhi?
Davida Coady: In Delhi-and I was actually on my way home and I did; and
I arranged to go back a few weeks later. I was getting married
at that point and my husband - I thought it would be much easier
to work out in the Boonies in India with a partner, and he was
interested and we went back to India; Bill sent us to Gorakhpur.
So I was the first woman field epidemiologist and there were a
number who followed me. They were watching me very closely and -
you know, it was a real highlight of my life, it was just such a
wonderful thing to be part of. I've been part of lots of
different Public Health initiatives of one kind or another, but
this was something that was so clear that you could see the
results. So we put a 1000 miles a week on our Land Rover, a lot
of it on dirt roads going around to the villages in India and
many villages there, in those Northern districts of the Uttar
Pradesh, they had never seen a white woman. In fact they had
really never had any women visitors and all kind of rumors would
go around the villages about who I was. The one I liked best was
that occasionally the rumor would go round that I was Indira
Gandhi and so I - that was kind of fun; and I would tell them
that I was not, but I -
Chris Vaniser: How long did you go over for? What was your - ?
Davida Coady: I think we were there for a three month assignment and
then we were extended for several months after that and then we
went back to Los Angeles for a couple of months, and then went
back for a second assignment, and the second assignment was in
West Bengal. I had asked particularly to go to Calcutta, I love
Calcutta, and so we were based in Calcutta in charge of the four
districts to the North and the East, East - No I am sorry, it
was actually the North and the West of Calcutta and then when
Calcutta - when West Bengal was free of smallpox we were
transferred to Bangladesh.
Chris Vaniser: Going back to Gorakhpur again, which was your first
assignment in India and your first smallpox assignment, can you
tell me a little bit about your team that you worked with?
Davida Coady: We had an Indian doctor, Dr. Rao[inaudible name0:10:14],
who was from South India who worked with us, and he kind of took
two of the districts and I took two of the districts. We had a
wonderful paramedical assistant and a driver who we became very
close to; and we went touring around the countryside. I think
one of the things that I did was I realized that the people
working on it in the villages, the doctors, the health workers;
they had no idea when I got there that this was part of an
international effort. So I managed to get a map of the State of
Uttar Pradesh, and another map of India, and another map of the
world. These were not easy to come by in Gorakhpur, but I got
them. Now we would take them around to the districts and we'd go
through and I'd show them what they were part of, and hundreds
of people would gather around and listen to this and they would
get so excited and then when I'd go back weeks later or months
later, they'd say what is happening now in Ethiopia. Are we
going to beat Bihar, are we gong to beat Bangladesh or are we
going to beat Ethiopia in eradicating smallpox; and they'd get
so excited and the quality of work would improve tremendously.
Chris Vaniser: How were you received as a Caucasian woman working in that
area of India, which I am sure that most of the physicians you
were dealing with, I assume, were male?
Davida Coady: Right.
Chris Vaniser: At least most of the other people.
Davida Coady: I think fairly well-very well in fact. I think in India
there were no problems really. You know, I dressed appropriately
and all, and got my legs covered and all those things, and in
Bangladesh it was a little harder. If I went somewhere without
my husband, people would say well bring your husband next time,
and they didn't my traveling without him, and we'd often split
up and did different parts of the work. But in India there was
none of that. There was a village character in one of the
villages who wrote a song about me and evidently the chorus - he
was a man suffering from tertiary syphilis and was quite crazy -
the chorus was translated to me saying: "Dr. and Mrs. Coady is a
wonderful doctor, she's the best doctor in the whole world
because she carries herself like a doctor and she acts like a
doctor." So I thought that was very, very nice.
Chris Vaniser: Very nice-Yeah respectful. Did you have any special
challenges or events that happened when you were in that
Northern part of India that kind of stand out as very memorable
events during the smallpox?
Davida Coady: Just that it was terribly, terribly hot. We were there in
the pre-monsoon season and I don't remember anything really
frightening. Our driver and medical assistant, and many other
people were very kind of cautious when we first got there and
they - the person before us had made an error in trying to
vaccinate a woman - this is a male epidemiologist - without her
permission and the villagers had come very close to throwing him
down the well. So they told me, they lectured me, but after
about a week they said, "It is fine. We know you are not going
to cause any problems like that." But that always made me just a
little bit wary.
One thing we noticed was a - my having worked in Africa before
where people loved to get immunizations and loved to get
vaccinated; was that the Indians, they wanted some conversation
before they were vaccinated. They wanted an explanation and
their views of the goddess and her role in all this varied
really from village to village, and sometimes - in one village
they wanted us to come back next Tuesday because that's what the
goddess wanted us to do instead of vaccinating people then. I
think we finally agreed to do that, it was just easier, but many
times they would say, "No, the goddess doesn't want us
vaccinated;" and we'd sit down and go through all the
explanations and just at the point when we were convinced they
were never going to let us vaccinate anyone, they'd say, okay
now we understand that it's a disease and it's not a goddess and
please vaccinate us." I remember one elderly man, he said, "No,
I don't want to be vaccinated because I'm getting ready to go to
God;" and my husband looked him right in the eye and said, "I
really think God would like you better vaccinated;" and I was
just thinking "Oh my!" And the man said "Oh, alright fine," and
he said, "Please, please vaccinate me." So a lot of it was just
listening and realizing that nothing worked fast in India.
Chris Vaniser: Now did you speak Hindi or did you have a translator with
you?
Davida Coady: We had a translator. Our paramedical assistant was our
translator. I learnt a little bit of Hindi and just enough to
get around, just a little to ask where ask directions and where
people were, and of course the word for smallpox was
Bashanto[0:16:56] which is also the word for springtime; and I
relied a little bit less on my Hindi after one of our fellow
epidemiologists, a man from France whose name I forget; he got
very good at Hindi, but he spent a long time, he had a sprained
ankle at the time, walking to a village looking for - he'd asked
if there was any Bashanto and everybody said: yes, yes. "Where
is the person with smallpox?" And after he walked a long, long
distance he finally found this man out on the field. It turned
out that the man's name was Bashanto. So I was
[crosstalk0:17:57]
Chris Vaniser: A little bit more [crosstalk 0:17:56] after that about
your Hindi. Was your husband a physician as well, or in the
health field?
Davida Coady: No, my husband at that time was not, he was not a -
Chris Vaniser: But he was - he sounds like part of the team?
Davida Coady: Yeah, he helped.
Chris Vaniser: In terms of going out and-
Davida Coady: He liked to write and he was collecting information and
stories.
Chris Vaniser: Interesting. So then it sounds like soon after that you
went to Calcutta? Was that the same trip?
Davida Coady: Right, we came back to the United States for a couple of
months and then we went back and went to Calcutta.
Chris Vaniser: How did that differ from Gorakhpur?
Davida Coady: Well, we were in the city and Bengal was much more
sophisticated, and there was much less smallpox. I saw hundreds
and hundreds of cases of smallpox in Uttar Pradesh and many,
many ...[inaudible0:18:58]. We were doing the last of it and the
reward was being offered by that time and the amount of the
reward was going up, and we went around to different groups
asking them to help us. One of the interesting things was, we
went to see Mother Teresa to see if she would have her nuns help
us in looking for and reporting any smallpox; and Mother Teresa
like she always did - I went back and worked for her later
actually - she turned it around on us and she got us to agree to
bring our staff on our day off and vaccinate everybody in her
feeding lines; and our driver and our paramedical assistant were
just so thrilled to meet her and to be part of that, they took
their day off too, and we did that, so that was kind of fun.
Chris Vaniser: Did she also agree to have her nuns help with identifying
any cases and reporting them?
Davida Coady: Yes, yes they did. I can remember that they did. But then
in those times we spent a lot of our time with people coming to
us, being brought to us with everything from scabies to chicken
pox to hives, with people trying to tell us it was smallpox and
they wanted the reward. So I spent an awful lot of my time
saying no that was not smallpox; and it was interesting, one man
particularly who came to us; and I still have his little
advertisement. He was an Ayurvedic Doctor of some kind and he
had a little advertisement which I have still, with a picture
that he'd drawn of somebody with smallpox and he introduced
himself as a specialist in smallpox from a part of our district,
North of Calcutta, and he had a man whose scabs were just
falling off, or just forming I guess; and we said, "Why didn't
you bring him sooner," and he said, "Because he just ran out of
money," and we said, "Well, explain this." He said, "You see I
charge people when they come with the fever, I charge them and
they pay, I have a medicine to make the rash break out, I have a
medicine to make the macules..." - He knew the terms - "...the
macules form into papules, and the papules form into pustules,
and then for the scabs to form, and then for the scabs to fall
off and for the scars to go away. They come back and I sell them
each of these medicines. But he has run out of money, so I came
to get the reward." Then we talked with him further and he was
able to tell us every case of smallpox, maybe then 25, 30 cases
in that district, in that outbreak over the past two or three
months, and he was able to tell us everyone of them and who got
it from who and it corresponded exactly to the reports that we
had gotten from the health workers. So he knew the whole thing.
Chris Vaniser: But of course, he didn't have the vaccine. He was missing
that part he had medicine to make -
Davida Coady: He had no interest in the vaccine.
Chris Vaniser: That's right; it destroyed his business I guess.
Davida Coady: Right.
Chris Vaniser: How did you find the conditions?
Davida Coady: They were difficult. Gorakhpur: it was hard to eat; we ate
at the hotel where we stayed which was - and then later we found
a Chinese restaurant, but we didn't find that for about a month,
and we ate at the hotel and everything was so terribly, terribly
hot. I am used to hot food, but this was really, really hot. So
we would just try things. Of course, we couldn't read the menu
so we would point to things on other people's plates and they
would get those for us, and it was challenging, but we were
young. Life was easier in Calcutta, there was indoor plumbing
and -
Chris Vaniser: When you traveled up in Gorakhpur, were you out overnight
sometimes in the neighboring districts?
Davida Coady: No, we were always able to get back when we were in
Gorakhpur. In Calcutta we did, we had these four districts; we'd
stay in the districts, we found places to stay. In Gorakhpur we
never - [crosstalk 0:24:17].
Chris Vaniser: It was always maybe a long day trip, but you would always
get back. How about any problems with getting safe food, safe
water?
Davida Coady: We would find that we'd buy bottled water and Coca Cola,
and I think there was one time when we bought some cokes and it
was adulterated and we all got very sick.
Chris Vaniser: Any other events that stand out from your time in India?
Now you came back to the States before going back to Calcutta
and then [crosstalk0:25:01] from Bangladesh also?
Davida Coady: Then we went directly from Calcutta to Bangladesh. I know
it was before Christmas because we spent Christmas in
Bangladesh.
Chris Vaniser: Then, how was that in comparison to India?
Davida Coady: It was very different. In Bangladesh they didn't have the
structure. In India they had the structure, these Health Centers
and there was always somebody who was in charge that you could
work with and some of them were wonderful and some of them were
not at all interested; but at least there was a structure. In
Bangladesh we were in the North in Saidpur, which is a larger
Bihari City and which was good because they spoke Urdu which I
could understand; I never really got hold of the Bengali
language at all, and the Urdu I could understand from the Hindi
that I knew. There was no structure, we just had to do the work
and hire the vaccinators and find the epidemics and it was much
harder and you had the feeling that you weren't teaching that
much. You were just trying to get the cases and get the work
done.
Chris Vaniser: When you say you had do the work, it was actually you and
your team that was more - not the Bengalis that were there as
counterparts?
Davida Coady: Right. We didn't really have counterparts, we had
vaccinators that we trained and hired to work for us.
Chris Vaniser: What year was that, when you were in Bangladesh?
Davida Coady: That would have been '75; in late December '74 and then
into '75.
Chris Vaniser: So I guess - it sounds like you also had just an
incredible time as part of the Smallpox Program and you had
brought to it lot of experience, international experience,
specially from Africa and other places, Guatemala and other
international locations that you had worked in. How did the
smallpox experience affect your future career and your
involvement in Public Health?
Davida Coady: I became very, very convinced that the idea of eradicating
infectious diseases was very doable and feasible and helpful and
everything right about it; and I have been very disappointed
that other diseases have not been eradicated. I thought surely
the lessons would be learned. We had this wonderful seminar this
morning that I thought surely guinea worm and polio and measles
and some of the others would be gone by now with the lessons we
learned, and I think people made such valiant efforts to promote
the principles. Dr. Henderson and Dr. Foege, Dr. Foster; and all
of them; they had such a wonderful plan to really use all these
principles to eradicate other diseases and it's been very
disappointing that there wasn't the political will and the
finances - the political will to do it.
Chris Vaniser: [cosstalk0:29:05] the difference perhaps?
Davida Coady: Yeah; and I think the idea that an international effort
like that could work, has kept me going through some hard times
and some of the battles I fought are harder than that and you
have more foes, there weren't too many people against smallpox
eradication. There were a few people who made money off
smallpox. I remember one very overweight politician in India
railing at me one day, when we drove up with the smallpox
vaccines - with the smallpox van; and he said then: Why don't we
foreigners and smallpox people go home and let our people die of
smallpox before they starve to death from overpopulation; and
this man was fat and he was eating a plate of food, and he was
one of the few people I ever met that said: eradication of
smallpox is not a good thing to do. It just seemed so clear;
one of the battles that I fight today in my hometown in
Berkeley, is we are fighting the tobacco industry very hard and
the pharmaceutical industry and the illegal drug industry; and I
work in the addiction field now and you have these giants, the
Alcoholic Beverage Industry and the Tobacco Industry, and all
the rest, are such hard foes that I look longingly at the time
when I was fighting smallpox which didn't have those big
interests against you.
Chris Vaniser: [crosstalk 0:31:01] with lots of money to -
Davida Coady: But it has given me - I had training in epidemiology, but
the smallpox work gave me the field experience to see what
epidemiology could really do, and it of course greatly
influenced my teaching at UCLA - but really the way I look at
everything. I am in the addiction field now because I looked
around my own community with the tools I learned as an
epidemiologist and said: The biggest cause of homelessness and
crime and misery and violence and child abuse in my community is
the substance abuse, which is not being treated. So that's why I
made that decision.
Chris Vaniser: That's a pretty big decision to have ended up - it sounds
like you had spent time in international health and trained as a
pediatrician. Correct?
Davida Coady: Right.
Chris Vaniser: And now you are working in smoking and addiction control
because of lessons learned through the smallpox eradication.
Davida Coady: Right.
Chris Vaniser: Well, thank you very much again for sharing your stories.
This sounds like it must have just been - again an incredible
experience.
Davida Coady: It was a peak experience; it is something that I just
wouldn't trade for anything. I am just so happy I was part of
that.
Chris Vaniser: And it sounds like you made quite a few friends along the
way that are legends in their own right in the area of Public
Health and -
Davida Coady: I did.
Chris Vaniser: Not just smallpox, but Public Health in general.
Davida Coady: Right; and I just loved India and Bangladesh, but
particularly India. I loved working there. I loved the people. I
love to look now at pictures of Indians and see that nobody
under 30 has got smallpox scars. That just chokes me up.
Chris Vaniser: There's nothing else that you can really say that of-that
has been so eradicated and know that you had a part in all of
that. It was just a huge accomplishment. Thank you again.
Davida Coady: Thank you.
[End of audio - 0:33:21]
Davida Coady Oral History
Davida Coady interviewed by
Chris Zahbhiser
July 11, 2008
Davida Coady was a field epidemiologist working in the Smallpox Eradication Program in India from 1974-1975
Information regarding the reproduction and use of this resource may be obtained by contacting the Centers for Disease Control and Prevention, Office of the General Counsel, 1600 Clifton Road N.E., Mailstop D-53, Atlanta, GA 30329, USA. Phone: 404-639-7200. Fax: 404-639-7351
