Interview Transcript
Interview
Mr. Peter Crippen | with two Interviewers [unnamed]
Transcribed from audio: January 29 2009 | Duration 0:22:41
Interviewer1: This is an interview with Dr. Crippen, April 2, 2008 at
the CDC in Atlanta. I guess we will start where you'd just do an
introduction. Who you are and how you became involved with
Public Health and smallpox, and why you became involved with it?
Peter Crippen: Okay. First of all, it's Mr. Crippen.
Interviewer1: Mr. Crippen. Okay.
Peter Crippen: And who I am is a Public Health Advisor, that's for those
of us who are public health advisers, that says a lot. Right
now, I'm still with CDC, I've been with them for more than 40
years. I was in the Peace Corps in Thailand right out of
college, right out of bachelor's degree, and didn't have
anything to do with public health. I was a teacher, but when it
became time to come home, I needed a job and there were a lot of
postings that came through for Peace Corps volunteers who were
about to return. Most of them were teaching jobs and I wasn't
interested in a teaching job, and the only other one that seemed
interesting was being what we used to call VD-a VD investigator.
So that sounded interesting to me, and I applied for it and I
was interviewed and got the job. It was very easy at that time
frankly. If you had a bachelor's degree in almost anything
whatsoever, they would hire you and you could walk, you know;
you could get a job as, what became, Public Health Advisers.
At that time, we were not public health advisers; we were what
was then called, Cooperative Employees, which meant that they
could fire us at will for the first year or so. But after a
year, we became Public Health Advisers. I started out in Chicago
and then went to Detroit; and when I was in Detroit there were
opportunities to go to West Africa for the Smallpox Program
which interested me a great deal. From my Peace Corps experience
I hadn't been to Africa, but I knew what it was like to work in
a third world country if you will, and it sounded fascinating.
So I applied for that and I was selected and went to Nigeria.
What had just recently been Biafra, the war was over, but just
recently over. That would've been in 1970, and we stayed there
for two years in the Eastern part of Nigeria in Calabar and
Enugu. Enugu was the capital of Biafra at one time, and I saw a
lot of interesting things. I saw monkey pox for instance which
was misdiagnosed as smallpox at the beginning, but what I did
not see in 1970 was smallpox. There wasn't any in 1970 in
Nigeria; and we looked very hard. We didn't know that there
wasn't any. Everybody assumed that it was mostly gone, but
people wanted to be sure that it was really gone, so we looked
very hard and we found monkey pox. We did some good things, it
was combined with the measles control program and we did a lot
of measles vaccination, saved I think a lot of children's lives
with measles vaccine.
But I didn't see any smallpox which kind of nagged at me. So we
came back after a few years, 1972, went back to Chicago this
time with the Immunization Program and routines went on, had
children, things like that, like people do. Then heard about the
opportunity to go to Bangladesh and so I threw my name in the
ring again for a temporary duty assignment to Bangladesh, and I
was selected. I think I was the first public health adviser to
go to Bangladesh. Before that, I think it was all physicians who
were there. Immediately following me was Jean Roy. I don't know
if you've interviewed him yet, but I'm sure you will, if you
haven't. But he, I think was the second public health adviser in
Bangladesh. So we flew over on the plane to New Delhi with Mike
Lane who, if you haven't interviewed, I'm sure you will, and we
stayed in New Delhi for a couple of days, had dinner at Bill
Foege's house; and Mike Lane stayed in India. He was working in
India. I got on the plane to go to Dhaka and arrived sick as a
dog in Dhaka, interviewed with Nick Ward who was a British
epidemiologist who is very famous in smallpox circles and I
worked with him again in WHO in Alexandria, the Eastern
Mediterranean Regional Office a few years down the road. We were
working on diarrhea and acute respiratory infections. In any
case, Nick Ward was there in Bangladesh. Stan Foster was
essentially - Nick and Stan; I'm not sure who was on top, but
Stan was certainly the American in charge although I think Nick
might have been overall in charge of the WHO project. The other
person of note was Stan Music who later on established some of
the field epidemiology training programs at CDC; and Stan Music
gave me some medical advice which was basically, drink a lot of
water and get some sleep, it would feel better in the morning,
here're some aspirin. Eventually I did feel better; a couple of
days later I was out in the field, and at that time we spent, I
think, 20 days in the field straight, and then five days back in
Dhaka.
So they just put me in a land rover, and off we went out to my
station which was Faridpur. Nothing much to recommend Faridpur
to anybody; by road, by land rover, it was about four hours from
Dhaka. It was a long drive, not very far, but it took a long
time to get there. Met the team, and I thought I knew what I was
supposed to do. I'd been briefed. I knew what I was supposed to
do, I was supposed to find smallpox. You know, go out with the
team and search and follow-up rumors and vaccinate around the
cases that we find. Do forward tracing, and that was the big
thing that time. Not to look back to where it had come from but
to look forward as to where the disease might have gone. Find
the close contacts and see where they may have gone and then go
to that place and see if anything had happened there. It didn't
take long for me to see my first case of smallpox in Bangladesh.
I think that first trip out, I saw my first case and she was
dead. I remember the man - a woman about I don't know, a young
woman 18, 19, something like that, and we said we heard there
were smallpox here and he said, "Yes," and I said, "Is anybody
here with smallpox?" He said, "Yes here." He pulls back a
blanket and there is this corpse of this young woman there and
it certainly looked like smallpox to me. Finally, I had seen my
first case. I was hoping it would not be a dead case the first
one that I saw but there she was.
That was the beginning; we saw many cases after that. Thankfully
many of them were still alive. It became clear that it's not
really easy to catch smallpox. You really have to be in the same
house with somebody who has it. Close within the same hut, and
sleeping in the same place, eating in the same place, living in
the same place, and then it's relatively easy to catch it; but
outside of that kind of closed environment, we, I at least,
didn't see much transmission in market places or buses or things
like that or casual contact. So I stayed there not quite three
months, more than two months, less than three. Others were
staying there from January 1974 to I think early March of 1974;
then I came back to routine in Chicago. Going around to catholic
schools and making sure everybody had their shots. That was my
job. The way I got into it was a fascination with working
overseas, it just never left me; I've stayed in it one way or
another since that time, and the public health aspect is
certainly rewarding. You see fewer bodies when you left than
when you arrived, so that's one way of measuring success.
Interviewer2: What was your first thought when you arrived in
Bangladesh?
Peter Crippen: Well, it is not really different from some things as I had
seen in Southeast Asia, but I guess my first thoughts were that
I was too sick to do anything. But I was glad that I knew Stan
and so I felt things would probably be alright as long as Stan
was around there giving me some advice. When I was back in Dakha
out of the field, I stayed at Stan's house so it was kind of a -
and of course he had his whole family there, had all his kids
and his wife so it was a nice way to be in the field with
essentially nothing, you know, and then to come back and be in a
family atmosphere before you went out again. I was trying to
think before coming, how - right now we communicate all the
time, people have Blackberries and cell phones; and I can't
remember that we communicated at all when we were in the field.
We were there, that's it, and nobody essentially knew where we
were, and I don't remember getting instructions from anybody or
inquiries from anybody. We just did what we did; we kept records
of things that we were suppose to keep and we came back and
during those five days, we shared what had happened; but in
between, there was nothing. There was no contact whatsoever that
I can remember. Most of Bangladesh is water. Water with a little
bit of ground in between and that's the why the people make
their living, is fishing and rice-But in any case, we would take
the land rover to Faridpur town and then from there we usually
go by speed boat some place, named or unnamed, and then get out
of the boat and walk. We would walk for hours to wherever it was
you were going, to some small village where there was a rumor of
something happening.
So the boat was very important and the land rover less important
and walking was extremely important because that was the only
way you got to know where you were going. But I remember on
time, we were in the boat and our driver wasn't the best I
guess, a boat driver. Anyway he hit another boat and we all-
myself and the team member that was with me anyway, fell out of
the boat from the crash. This is a Ganges, a tributary of the
Ganges. I lost my glasses and my wallet was wet and all that
stuff; and the team member that was with me, he broke his arm. I
didn't break anything but I lost my glasses. I had sunglasses
with me but that kind of thing, if it were to happened now in
some place, I mean, there would be all kinds of support and
running back and getting things repaired. There was nothing, I
mean you'd just put on your sunglasses and keep on going until
you are back in Dakha, where you can get some things repaired
and get something done. Now that I think about it, it's pretty
amazing there weren't more injuries than there were. There
weren't things happening that couldn't be retrieved, maybe there
were, maybe you'll find out about them but I never heard about
them and we just seemed to do it.
Interviewer2: How old were you?
Peter Crippen: Well that was 1972, no '74, I was born on 1942 so what is
that, it's 34. Yeah-what's 42 from 74? Whatever that is that's
how old I was. I wasn't a kid. My second son had just been born
in October or September of 1973. So he was less than six months
old when I went and my wife was not thrilled although she
understood, I mean, she had been with me in Nigeria and I think
she understood that, the call of the pox or whatever, I don't
know.
Interviewer1: What would you say was the most frustrating part of your
job while you were there?
Peter Crippen: My favorite what?
Interviewer1: Most frustrating part.
Peter Crippen: The most frustrating part? Ah boy! Part of it was
interference, there wasn't a lot of it but there were some. The
person in charge of that area under the British system is called
a civil surgeon and he was a little unusual. Of course they were
all Bengali, that was the ethnic group and they should've all
been Muslim because of the partition in 1947 and that's why
Bangladesh had been East Pakistan, and then in 1971 became
Bangladesh. Well this is 1974 so it wasn't that long that they
had been independent. They were still using the British system
and the civil surgeon was a Hindu and everybody I worked with
was Muslim but he was a very high class kind of self-important
person as some people tend to be, and there were of course goods
that came in to support the program, among which were
motorcycles that came in to be used by the teams for going
around searching and things. He sort of appropriated one for his
son and I took it as part of my responsibility to disappropriate
it, but it was clear that you can't offend this man because he
controls everything. He controls the petrol I'd use in the land
rover. He controls all of the personnel that are on your team, I
mean, you can't do anything without him so we just had a little
conversation and I just had to let him know that I was aware of
the fact that there should have been 20 and there's only 19
motorcycles; you know, that his son just happens to have a new
motorcycle. So this would be embarrassing if it became well
known and surely he understood that within a month or so after
the newness had all worn off, we might be able to use his son's
motorcycle for what it was intended for, sort of a veiled
threat, if you will, of embarrassment. Nobody likes to be
embarrassed like that. So we got it back eventually but that
kind of thing can be frustrating because you know - you can't be
quite as upfront as you would like to be, or as Americans tend
to be about some things, you have to work within the culture as
it stands and within the personalities that you're confronted
with, you know. I guess that not really frustrating, it's part
of the job, it's what you learn how to do if you want to get
things done.
Interviewer1: So from between the time you left for Bangladesh and the
time you came back, how do you think that you changed as a
person and as a public health worker?
Peter Crippen: Well in terms of public health, I think I learned how to
get along in another environment. I had been in other
environments before but each new place you go to teaches you
something specifically for Bangladesh, I'm not really sure but
it certainly enforces, or reinforces your ability to be
flexible, to take things as they come and to work within the
constraints that you are given and to just try to do the best
you can with what you're given and keep on going. So those
skills I think they are valuable wherever you happen to work. As
a person, I'm not really sure how it changed me. I'm sure it
must have and I guess I may be more resilient than I had been. I
don't think I was any smarter but I think I knew how to bounce
back better anywhere.
Interviewer2: How many other assignments overseas did you have?
Peter Crippen: Oh gee! A lot-in terms of temporary duties, after that I
was with yellow fever in Gambia with Tom Monahaff[inaudible
name0:19:36] and others. I did something again with Nick Ward
in Indonesia for WHO for looking at their immunization program
in Indonesia and went both to Indonesia and to Bangkok to look
at the - and then I was with WHO for six and a half years in
Alexandria office which is now in Cairo, as I said for diarrheal
disease and acute respiratory infections; and then I went from
that office to Hanoi for HIV-AIDS and spent a year and a half in
Hanoi. Then came back to CDC and went to the Western Pacific for
three years. There were six US jurisdictions in the Western
Pacific: three countries and three territories. Came back to
headquarters and there was a Global AIDS Program, and I don't
know how many countries in South East Asia and West Africa,
South Africa and Central America, Brazil, and now I'm with the
Emerging Infections Program and with them I've been to China and
to Kenya. So once you get the bug, you sort of keep it I guess,
and if you know of any other opportunities, I'm ready.
Interviewer2: Any words of advice you'd like to give?
Peter Crippen: I guess my only advice would be that CDC needs to keep
doing this sort of thing and needs to keep up its reputation as
a world leader in global health. People around the world, as
you know, Dr. Sencer, I mean you came to - when I was in
Alexandra, you came as a consultant to-was it Yemen or Qatar or
some place anyway because I don't remember why which country it
was-but they wanted somebody to come who could give them advice
about their public health system. Well that sort of thing
happens all the time; sometimes if it is high level advice like
that, or if it's very nitty-gritty: What do we do now? This is a
disaster-and the world looks to CDC to be able to provide that
kind of expertise and the only way you develop that kind of
expertise is by doing it, by continuing to do it and having your
personnel used to performing the job in an odd place with little
or no assistance.
Interviewer2: Thank you Peter.
Peter Crippen: You're very welcome.
[End of audio - 0:22:41]
Peter Crippen Oral History
Peter Crippen interviewed by
April 2, 2008
Peter Crippen describes is life and career leading to his assignment to Bangladesh to work on the smallpox eradication program. Prior to that he had been in Nigeria at the end of the smallpox eradication program there.
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