3 12 306 https://www.globalhealthchronicles.org/files/original/1252ed2ed7412e9d77cc1179405a37d1.jpg 8321c310a65ae024da9b1ae2b28d6d6e Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Media Powerpoints, Recorded lectures, movies, training films, and interviews Player html for embedded player to stream video content <br /><iframe width="560" height="315" src="https://www.youtube.com/embed/IWlp31wIF-k" frameborder="0"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource MIRACLE IN TONGA Description An account of the resource Produced by the U. S. Department of Health, Education and Welfare, Public Health Service Audiovisual Center Production, Communicable Disease Center. Made possible through cooperation of the Department of the Army. CDC physicians; Dr. Ron Roberto, Dr. William Foege, Dr. Pierce Gardner, Dr. Peter Greenwald and equipment specialist Bill Higgins evaluate a new inexpensive and rapid immunization device called a Ped-o-Jet. Source A related resource from which the described resource is derived The David J. Sencer CDC Museum at the U. S. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333 www.cdc.gov/museum Date A point or period of time associated with an event in the lifecycle of the resource 1965 Identifier An unambiguous reference to the resource within a given context Miracle in Tonga.mp4 Creator An entity primarily responsible for making the resource Photographer Vachel Blair https://www.globalhealthchronicles.org/files/original/d6d8f6e0a7baee2ec152e3d916cdd917.jpg 9c82c9143b5028c1060873b6bb60a25f https://www.globalhealthchronicles.org/files/original/14c20f3205f97b3b2a9a23136d88498e.pdf 271551e47c57078b6293465233fdef7c Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> INTERVIEW Audio File: Vince Radke Audio File Transcribed: January 29, 2009 Interviewer: I'm Dave Sensor and I'm interviewing Vince Radke. Vince is an employee of CDC. It's April 1st, 2008. We're interviewing at CDC in the afternoon and Vince realizes that he's being photographed and recorded and he's signed the permit. First Vince in ten minutes or less... Interviewee: Okay. Interviewer: ...tell me about your early years. Interviewee: Okay, Dr. Sensor. Early years born and raised in Detroit, Michigan. Did my undergraduate at Michigan State University in biology and... Interviewer: Too bad. Interviewee: Too - yeah I know. Well, you know, these graduates from Michigan, you know. I always got to put up with them. But then after that - well while I was at Michigan State I put an application into the peace corps and about a year later I get a call from a gentleman and he said, "Vince would you come to Philadelphia? We'd like to tell you a little bit about Ethiopia and a little bit about smallpox." And I said, "Oh that would be great." Well the next thing I did, made a beeline for the library and got all the books I could on Ethiopia and tried to find out what smallpox was. To make a long story short, came down to CDC in nineteen seventy. They were having a training program for two weeks for the peace corps volunteers who were going to be going over to Ethiopia. So, the best, the best by far training I have ever had in my entire life was those two weeks here at CDC in smallpox. I had some great, great instructors. D.A. Henderson was one of them, Bill Fergie and others. It was just, just a fantastic time. Right after that then we flew off to Ethiopia and for the next three and a half years I worked in the smallpox eradication program there in Kaffa Province. Interviewer: What had you been doing before Ethiopia and after college? Interviewee: Well, right - I came in right in out of college. That summer is when I went to - I had just graduated from Michigan State. That was the summer of nineteen seventy and the - that July we were in Philadelphia for the first interview and then the summer I spent visiting some friends in Michigan. And then a call came in September to come down for the training at CDC and this was September/October of nineteen seventy. And then we were here for two weeks for that training in smallpox eradication and then we hoped the plane to New York and changed planes there and on our way to Ethiopia. And for the next three and a half years that's what I did. The two, it was only a two year original commitment but we were - I enjoyed the work. It was tough but I enjoyed the work so they asked me if I would stay for another year and I said yeah I'll stay for another year and then stayed for six months beyond that. And then came back and then I knew that I needed to get some more education. So I started at the University of Pittsburgh to get my masters degree in public health and while there I was contacted by D.A. Henderson and he said, "Vince we could use some help in Bangladesh for a short while." And I said, "D.A. I'd love to come," and so made arrangements and for six months I worked in the smallpox eradication in Bangladesh. Interviewer: In Ethiopia what were your main responsibilities? Interviewee: In Ethiopia we, my partner Mark Strosberg and I -- also a peace corps volunteer -- were assigned to Kaffa Province. That's in the southwestern part of Ethiopia and we were there to find cases of smallpox and vaccinate. We were told originally when we saw the reports that the number of cases of smallpox in Ethiopia, couple of hundred a year. I think the year before we arrived they reported like seven hundred cases. Dr. Sensor I think within the first couple of weeks we were there we had over a thousand cases of smallpox. We would contact, go to schools, go to market areas in Kaffa Province and we'd ask, show pictures of small pox and we would be inundated with people saying in their village or in their areas there was smallpox. And so we picked a couple of villages and I went one way and Mark went the other way. And so we were looking for cases of smallpox, recording them, we'd record each of the cases of smallpox, we'd record the number of people that we would vaccinate, names of the villages and then from there we would get reports that would take us on to the next village and every - inevitably we found some smallpox. So for the next about three years I did that. Interviewer: Was the work environment in Ethiopia a good one? Interviewee: It was good. We were - we had great cooperation all along the line from the Ministry of Health in Ethiopia, also the World Health Organization. Our two smallpox people there from WHO were Ciro de Quadros, Dr. Ciro de Quadros and Dr. Kurt Weithaler. They led the program. You were - I was assigned to the Ministry of Health and you had an official government car and that helped very much. We went out to the Provinces and met with the governor and the local officials. They gave us good cooperation down there. Sometimes they would supply us with a guide and a translator even though they trained the peace corps in the local language in Ethiopia or the government language which was Amharic. In Ethiopia you have seventy different languages and two hundred dialects. So each time you would go cross another mountain range or move into another area you would be in a totally different language and so we had to have a translator with us and a guide. So the government officials were very, very helpful in doing that. Interviewer: Were you married when you were there? Interviewee: No I wasn't. I didn't get married until I finished in Bangladesh. Came back from Bangladesh in the end of seventy six and then met my wife at the University of Pittsburgh and then got married in August of seventy seven and then shortly after that went to Kenya to work on the smallpox eradication program. That was the last stages where we were trying to document that there were zero cases in Kenya. Interviewer: While you were in Ethiopia what was the most gratifying thing? Interviewee: Oh wow. That's a tough question because there was - Dr. Sensor there were a lot of gratifying times. To pick one. To me I remember one village I had been in Ethiopia and there was a number of cases of smallpox already in the village. Some children had had smallpox and we vaccinated and got good coverage, good cooperation from the local chief in the area and we felt we had a good job. And so we left that area and then moved on, on to another area. I went back a couple of months after and I was coming down the road one day and here was this chief that I had met a couple of months before. And he got off his mule and he came up to me and he said, "Thank you very much and thank Haille Sellasse for bringing you because you had saved much suffering for the children by giving them the vaccination." So that made me feel great and just knowing that we were beginning to stop this transmission. That was gratifying that indeed this plan that had been worked out it was working now, it was working and there were less and less cases as we went through the years. It was very gratifying. There was one time I had been out for about three months or so and I had reported - in a two week period I had reported over a thousand cases of smallpox I had recorded. It was just incredible and I remember talking to D.A. Henderson and he had said that at that time those two weeks that I had reported he said, "You and Mark Strosberg and the others that were working in Ethiopia at that time in Kaffa Province," said, "you had 10% of all the cases of smallpox for that period of time," so that was another gratifying moment. Interviewer: In some countries it's alleged that undue force was used to vaccinate people. Was that ever an issue in Ethiopia? Interviewee: No for the most part. I remember a few occasions when we'd be in the market vaccinating. We'd go to the market. Usually these markets they had once a week in an area so Wednesday was their market day and we knew this. So we'd go there into the market area and we'd do a couple of things. One we'd ask for cases of smallpox and the other one was that we would set up a vaccination for those that wanted it. Sometimes the local person in charge, the chief or whatever, wanted to make sure that everybody got vaccinated so they would drag some of the people to us to get vaccinated. So in that sense that was - but it was very, it was very rare. I think it was more often that if people didn't want to get the vaccination we didn't force it on them. And we knew just the methodology that we didn't need to vaccinate everybody. We knew if we got the majority of the contacts that we could break that transmission and indeed that was the case. So it really wasn't necessary for us to do that. I know all the volunteers that I worked with in Ethiopia, whether it was in Bangladesh I mean we never forced people to be vaccinated. Interviewer: Was there a big contingent of volunteers? Interviewee: In Ethiopia I think there were thirteen or fourteen of us that went over in the first group of peace corps volunteers and then every other year cause we were on a two year cycle, another group of peace corps volunteers would come in to replace those that were going. In the second and third year we got some other additional international volunteers. Some of them from Japan, some of them from Australia. We had volunteers there also. We had quite an international group of people in Ethiopia and Bangladesh from I would say twenty, thirty different countries. It was great to see the cooperation and working with all those different people. It was really great. Enjoyed it. Interviewer: Do you remember the name of the Director of the Ethiopian smallpox program? Interviewee: Well that was - the Director for the program he was an Austrian and that was Dr. Kurt Weithaler. Interviewer: The Ethiopian one. Interviewee: Oh, the Ethiopian. I can't remember Dr. Sensor. I worked with - you know the Ethiopians that I remember are the ones that I worked with. The sanitarians, the dressers that were down in Kaffa Province. Interviewer: The Director of the program was the director of the control of diarrheal disease in nineteen eighty seven after the government had changed and it was unhappy situation. Interviewee: Yeah, it was, it was. I talked and maintained a lot of my contacts over the years in Ethiopia and almost to the person they expressed the time after Haille Sellasse as a bad time, as a bad time, yeah. Interviewer: How long were you in Bangladesh? Interviewee: I was in Bangladesh for about six/seven months from April until November and I think that was seventy five or seventy six. I can't remember now. Interviewer: You were there as a peace corps volunteer? Interviewee: No, I was WHO short term consultant. Interviewer: WHO then. Interviewee: Yeah, at that time, yeah. D.A. Henderson said to me at the time, he says, "Vince," he says, "Yeah, if you're coming I'll tell you basically we're going to give you $50 a day," and at that time I thought man that's all the money in the world. So and - but more so than that just to get a chance of getting back to the smallpox program you know. Interviewer: Where were you in Bangladesh? Interviewee: I was in Sylhet district. When I got there at the airport, Stan Foster, Dr. Foster was there and he met us. First of all we went to the office and then he took us to this house they had. I think they bought the house and it was for the consultants that were coming over to work on the smallpox program. And we had I think two days of orientation and then they - he says, "Okay you're in charge on Sylhet district." And so went up to Sylhet district and worked there for the entire time except for those occasional times we'd come back to Dhaka for a meeting or something. A couple of interesting stories there. Since you were in charge of the entire smallpox program in Sylhet district, you'd have to pay the vaccinators and translators and other people that would help you in the smallpox program and we had to pay them. So we'd come down to Dhaka, we'd have our monthly meeting or every couple of months we'd have a meeting and the other thing was to collect - get the money so when we go back we could pay the people for the work that they had done. Well the denomination in Bangladesh was taka and I forget what the amount was. I think it was like fourteen or fifteen taka to the dollar or something like that. So I'd have this suitcase of money okay and I probably had sixty or seventy taka in it and I'd feel so uneasy with the suitcase of money, throw it in the Land Rover and drive up to Sylhet district with all this money. And I couldn't wait to pay the people so I could get rid of all these thousands and thousands of taka that I had to operate the program but... Interviewer: And [inaudible 16.00] Diego was back in Dhaka worrying about the receipts. Interviewee: Right, absolutely. Receipt for everything. I mean you signed your life away you know, even though at times having the Bangladesh money, the taka there it sometimes was like monopoly money. I didn't really think it was real but I did want to get rid of it because I knew - for them it was very important, you know for the vaccinators and the other people that were giving us a hand. Well, a couple - I could tell you [inaudible 16.29] there are a couple of other stories here. Interviewer: Go on. Interviewee: One story which I'll never forget. I'd been in Bangladesh for a couple of months already and they had this - one of the problems we had was we of course had to document that there was zero cases. So any time we'd get a case of rash we'd try to collect this specimen, get a scab specimen from abrasions, send it off to the lab but we would still do containment even though clinically it might be chickenpox and not smallpox. We'd do containment cause we wanted to be sure. So we'd have to do that containment until we got the lab report back. Well, they had come on with a new test, a rapid test for smallpox which we thought was great because we wouldn't have to do the containment for so long. And so I collected a couple of specimen, sent them down to Dhaka for testing and they came back positive for smallpox and I said well there's no way that this is smallpox. I said this was chickenpox. These were two chickenpox cases. So I called up Stan, Dr. Foster and I said, "Stan," I said, "I'm sorry but they screwed up with the lab here okay." And I said, "These are not cases of smallpox, these are chickenpox." He goes, "Well," he says, "See if you can get some other scabs and ship them down but still do the containment." So I did and then a couple of weeks later had another case of reported rash, did the same thing and it came back positive again for smallpox. So I called up Stan again and I said, "Stan this test is no good. I mean we're getting false positives here. I mean I can't - these are clinically, these are not smallpox cases." He goes, "Yeah," he says, "Yeah we've been having some discussions about that here." He says, "But I want you to continue to what you want, to continue to collect the specimens and send them down." So I thought to myself you know what I'm going to send him some specimens but they're not going to be scabs of chickenpox or whatever. What I went ahead and did was to vaccinate myself with the smallpox vaccine. Once I got a scab - I vaccinated myself a couple of times in the arm and I collected those scabs from the vaccine and I put those in the container and falsified the records and sent them down to Stan Foster and they came back positive okay for variola virus. And I said, "Stan," I says, "You know that's vaccinia virus." I said, "That's what's on there." And he goes, "Okay Vince." He says, "I knew you were up to something because when you falsified that report the name that you put on there was a very common Bangladeshi name and I just knew that wasn't the true case." So later on that test indeed was no longer used so we went back to the old testing methods. The other story in Bangladesh that was, that I'll always remember was my last case of smallpox in Bangladesh. We had gotten a report that there was a person with smallpox on a public launch. This was a boat that would go from village to village in Bangladesh up the river and we heard reports that this person had gotten off this launch at about three or four different villages okay, but in one of the villages he had spent overnight. So we went out and visited all those villages where we had gotten reports where he had stopped especially the village where he had stopped overnight to visit. Well it turned out that the people that he was visiting were relatives of his and indeed from all the descriptions that we had this was a smallpox case. And we had gotten there -- I don't know -- maybe about a week after he had been there and there was a small child. It was a female, she was two or three years old if I remember correctly and the mother had told us that she had a fever and I go, "Okay." So I said, "Well we're going to have to keep you in the house and we'll supply you with food and water. We'll go out and get things for you but we need for you to stay here." And so we did that and that - even though the child had fever we vaccinated the child because we weren't sure if this was going to be smallpox or not. Well indeed it did turn out to be a very mild case of smallpox but it was smallpox. And a little funny story - and the child did well and recovered and everybody was grateful. But what's interesting, on the form that we had we had to put date of onset and date of discovery. Well, in most cases your date of discovery was a few days after the date of onset of rash. Now, in this case when I filled out my report, I put the date of discovery a couple of days before the beginning of rash. And I thought this is really great, this is good work. We're getting ahead of the disease. I said we're going to - we've got this down. So I was very proud of myself. I was going down to Dhaka to turn in my report to Stan Foster. He'd gotten my report and then he said, "Mr. Radke I've got your report here." And I go, "Yeah, I'm very proud." And he goes, "You've got the date of discovery wrong." "No that was the correct date." "Mr. Radke you cannot find the disease before it happens." I says, "Well we did." I says, "We were right on top of it." And he goes, "No we're going to have to change the date of discovery at least to the date of onset of the rash." So I had to change my report for the date of discovery but what was really important to me was at that point I knew we had gotten a handle on the disease and we were - we had broken that transmission then so that made me feel good, it made me feel real good. Interviewer: What were some of the main obstacles to your work in Bangladesh? Interviewee: Oh, the monsoon season was really tough Dave. It - and that was, for me that was one of the roughest periods because it was hard to move during the monsoon season. The rains were intense, sometimes the winds were very intense so you couldn't get out as much as you wanted and what would happen in Bangladesh when the monsoon hit, the entire land would just flood out. The rice fields and everything would just be covered in water and some of the water could be fairly deep, eight, ten, twelve feet deep. And the only thing you have then in Bangladesh were these built up villages and those were the only things that showed and the people couldn't - they didn't have a lot of boats so they couldn't leave the island. And sometimes if the people or the cows got too close to the edge of the water in these villages, they would slip into the water. And you would see - there would be bodies that would be floating, there would be dead cows would be floating down the water. And it was just - it was tough to work in those conditions, it really was. It was a really rough time in the monsoon season to get around and then to see the death as a result of the monsoon season. It was bad. Interviewer: How would you say your work in smallpox influenced your future? Interviewee: Oh man, it set me on the road to public health. You've got to imagine, I was graduating nineteen seventy from Michigan State. I got to put this a little bit in context here. The killings at Kent State had happened that spring and I along with a number of other students organized to shutdown the campus at Michigan State and we did okay. We shut it down for a couple of days and then the president of the university got smart, gave the school a day off and by the time they came back from school we had - the strike had dissipated. But I didn't know what I wanted to do. I thought well because I hadn't heard from the peace corps yet and I thought well I'll go into graduate school and continue with biology maybe work in a lab or something. So when that call came about to be a peace corps volunteer in Ethiopia and work in the smallpox program, I was excited. And then when I got into the program and to see how a public health program could indeed benefit many people, to me that was very gratifying and I have been in public health in one aspect or another very since, ever since nineteen seventy. It sets me - that's where to get my masters degree in public health and I've been at state and local health departments ever since I got back to the United States in nineteen seventy eight, seventy nine and now I'm in environmental health but it's still it's a practice of public health. So I think there was only a short six month stint in my entire work history that I was in the private sector. So it's always been public sector and it's always been public health so I haven't left it. Enjoyed every moment. Interviewer: Why did you pick University of Pittsburgh? Interviewee: I had applied to a number of schools and Pittsburgh was one of the schools and at the time I'd gotten some financial aid. They were the only ones to offer some financial aid and as a peace corps volunteer even though they set aside some money for you every month while you're a peace corps volunteer, it wasn't a lot of money. So I didn't have a lot of money. In fact when I got to the University of Pittsburgh with a little bit of - it was a U.S. public health traineeship that I got. I also got - had to do some - I had a work study program so that's why I went there. The other schools were a little bit more expensive so I chose University of Pittsburgh. Good school, good school. Interviewer: Did you know Dr. Cutler? Interviewee: Oh my goodness! Did I know... Interviewer: Yes. Interviewee: Dr. Cutler was my advisor. John Cutler was my advisor. He was an inspiration to me. I know some of his past but he was a true gentleman, a true scholar. He guided me on my masters papers that I did and I - I'm always grateful. And he was the one that I approached after D.A. Henderson had asked me to come. I went to him and I said, "Dr. Cutler I have a chance to work in the smallpox program in Bangladesh. Do you mind if I break my education here for a little bit?" He goes, "Vince take all the time you want. In fact we probably can even give you credit for it," for some of that and so I was very grateful. Stayed in contact with him and his wife until his passing but I knew John - knew Dr. Cutler and just a wonderful - just a wonderful man, just a wonderful man. Oh man, that brings back memories. Interviewer: Maybe we better stop then. Wow. Interviewee: You know I've been very lucky. I have met some of the top leaders in public health that have guided me and I just can't - I just can't say enough you know. That I've met either at the school of public health in Pittsburgh or in the smallpox program. It's just tremendous, just tremendous. You can't put a price on that, you can't put a price on it. Interviewer: The smallpox program brought forth an awful lot of good people. Interviewee: Oh, oh my goodness. I can't say enough about Don Millard, D.A. Henderson, Bill Fergie, Joe Breman, yourself. I don't want to embarrass you. You guys were just - were just great, just great. And the support, I mean Dr. de Quadros, Dr. Weithaler, tremendous, tremendous people. Larry Brilliant another one. I can go on and on. I could go on and on. I mean they're just - it was just - it was an honor. At the time of course you don't know it. Actually they're just one of the smallpox guys but later on I come back, it was a real honor and privilege to work with them. And you know Steve - oh I could go and on. Interviewer: You know Larry Brilliant had these tee-shirts made in Bangladesh that said eradicate chickenpox. Interviewee: Pox, right yes, yes. I have a shirt and I'll wear it when I come in July that my wife knitted and it has on the back of it, it has the smallpox target zero on it. So I'll wear that. Interviewer: You can still wear it? Interviewee: Huh? Oh yeah. I don't wear it too often because I don't wear it out but I have it hanging up in the closet and I bring it out occasionally so this will be - I should have worn it here. Interviewer: We'll look forward to it. Interviewee: Yeah, yeah, yeah. Because she even after we got married she knew. While we were married we went over to Kenya for that last year for the smallpox program and she knew how important this smallpox program was to me. So when she knitted that shirt so I'll... Interviewer: You've been fortunate. Interviewee: Oh my God. Interviewer: Another country has been fortunate to have people like you. Interviewee: Oh. No, I am fortunate to have known a lot, a lot of good people in the smallpox program in the public health. And you know another story. I had - when I came back after I got my masters degree at the University of Pittsburgh I had also tried to get into CDC and the EIS program. Well at that time they wanted doctors and you had to have an MD or DMV and so I couldn't get in and I was always - I was always sad about that because I had remembered the training I had gotten here at CDC and the great people. And I thought boy what an institution to be a part of but I didn't okay. So I thought well you got to go on with your life, you just can't do nothing. So I stayed in public health but at the state and local level and that dream of getting into smallpox that faded until one day I got a call - I got an email from two colleagues. One at CDC who I had worked with on food borne disease outbreaks earlier and another colleague in Minnesota that I was working with and both of them said to me, "Vince there's an ideal job at CDC for you." They were looking for a sanitarian for their program there, the environmental health services branch. And I go, "Well." I says, "Guys I'm not interested now. My wife and I are in Minnesota, we're doing great." And the one guy at CDC who was an EIS officer said, "No, Vince you owe me okay. You need to at least apply here." So make a long story short, I applied and got in. To me Dave CDC was always the temple, the public health temple on a mount and so I'm so grateful to be here. Just so grateful. This is a great place to work. Great place to work. Interviewer: On that note we better quit. Interviewee: Yeah. </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/kInVdz_LBis" frameborder="0" allowfullscreen></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource RADKE, VINCE Subject The topic of the resource Smallpox Eradication Description An account of the resource Vince Radke, MPH., describes his early life, his decision to join the Peace Corps, his work in Ethiopia and Bangladesh during the smallpox eradication programs in 1972-75. Explains how this changed his life and career path. Interviewed by Dr. David Sencer Source A related resource from which the described resource is derived The David J. Sencer CDC Museum at the U. S. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333 www.cdc.gov/museum Date A point or period of time associated with an event in the lifecycle of the resource April 1, 2008 Format The file format, physical medium, or dimensions of the resource 7336560000 bytes video/x-dv Language A language of the resource English Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16s37 emory:16s37 https://www.globalhealthchronicles.org/files/original/2c6fb3841eba06514830b5afa9ab4e7c.jpg b5827d1853179cc0066bca6e00375bc6 https://www.globalhealthchronicles.org/files/original/f421a75005a3047326938af9b1370218.pdf b92bbc1092439c0b5f12d28f0f22136f Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/ZXXH576_UWw" frameborder="0" allowfullscreen="allowfullscreen"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource MACK, THOMAS M. Subject The topic of the resource Smallpox Description An account of the resource Dr. Tom Mack discusses epidemiologic observations in Africa and Pakistan. Tom had not been part of the formal Smallpox Eradication Program team but has researched areas of smallpox epidemiology. Interviewed by Melissa McSwegin Source A related resource from which the described resource is derived The David J. Sencer CDC Museum at the U. S. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333 www.cdc.gov/museum Date A point or period of time associated with an event in the lifecycle of the resource July 11, 2008 Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of Southeast Asia and East Africa Smallpox Workers (2008 : Atlanta, Georgia) Format The file format, physical medium, or dimensions of the resource 8188560000 bytes video/x-dv Language A language of the resource English Type The nature or genre of the resource moving image Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16s23 emory:16s23 https://www.globalhealthchronicles.org/files/original/53da523d4271248d7d65d8b6a75dc881.jpg b32364351a5ca7f3b07fdf5fff40a688 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/vGm3xkyWv9o" frameborder="0" allowfullscreen></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource FITZGERALD, STEVE Subject The topic of the resource Somalia Description An account of the resource Steve Fitzgerald describes his experiences in India, Somalia and Ethiopia during the Smallpox Eradication Program as well as, an outbreak of yellow fever in West Africa Interviewed by Melissa McSwegin Source A related resource from which the described resource is derived The David J. Sencer CDC Museum at the U. S. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333 www.cdc.gov/museum Date A point or period of time associated with an event in the lifecycle of the resource July 10, 2008 Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of Southeast Asia and East Africa Smallpox Workers (2008 : Atlanta, Georgia) Format The file format, physical medium, or dimensions of the resource 12417840000 bytes video/x-dv Language A language of the resource English Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16s1z emory:16s1z https://www.globalhealthchronicles.org/files/original/0843abd88cc294f90db33766f4b7c825.jpg 734a6e2a6c9efd7069a6aa95d953dcdc https://www.globalhealthchronicles.org/files/original/3384eae5eb6f0643c7cd40f8547f017b.pdf 422a478224aa92acdf2b855c7dce12da Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong>Interview Transcript </strong> INTERVIEW Audio File: Stephen Jones Audio File Transcribed: January 30, 2009 Interviewer: This is an interview with Stephen Jones on July 11th, 2008 at the Centers for Disease Control and Prevention in Atlanta, Georgia about his role in the smallpox eradication project. With this interview we're hoping to capture for future generations the memories of participants and their families involved in eradicating smallpox. This is an incredibly important and historic achievement and we want to hear about your experiences. 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're being recorded. Interviewee: Full name is T. Stephen Jones and I acknowledge that I'm being recorded and agreed to that. Interviewer: Very good. Thanks for coming in today Steve and I guess [inaudible 01.15] good place to start would be before you ever came to CDC and I'm curious about have you - did you always want to be a physician? And so think back to your early days and when you went to college and if you could talk a little bit about what you wanted to do when you were getting out of high school? Interviewee: Well I had a great interest in science and math and at the time of the Sputnik there was a big U.S. government response including setting high school students working in engineering companies and I went to work at the Salvenia Company near Boston and pretty quickly came to the conclusion I wasn't really interested in engineering. And I had always been interested by medicine and that just took over my future planning. So that's how I got into medicine basically. Interviewer: And then did you intend from the beginning to go into public health or did you see yourself more as practicing clinical medicine? Interviewee: Well when you go to medical school and you - and I was trained in medical medicine, you're in a world where all the values are academic medicine and practice. And so I knew relatively little about public health until I was an intern in nineteen sixty nine at the Stanford, [inaudible 03.01] Stanford Hospital and had to take into consideration that as a healthy male doctor I was going to be drafted into government service and probably spend a year in Vietnam. And at Stanford there was Dr. Tom Merrigan a very good infectious disease doc, talked about the communicable disease center as a potential option and knew about this program called the epidemic intelligence service. So I applied for EIS and Mike Greg was my interviewer and although it was a little bit - I applied late and it wasn't clear I was going to get in. Then I - so I was in the EIS class of nineteen sixty nine and I was posted to Alaska and had an extraordinary experience there. But finishing there I wanted to live and work overseas and I went to Guatemala and worked as a primary care doc for a year and a half. And was in the process - and was living in Texas in early nineteen seventy four and intending to probably work for LARASA as a clinician in south Texas. And then I received a letter from Lyle Conrad which was sent out I guess to former EIS officers and others and said that CDC were working in cooperation with WHO and trying to recruit people who would be willing to work for three months in India as part of smallpox eradication efforts. And that was such an extraordinary offer it took me only a small fraction of a second to make the decision that I wanted to do that. Interviewer: And were you still with CDC when you were in Texas or were you working with the... Interviewee: No, I had ended my connection to the public health service when I left Alaska and... Interviewer: Okay, and EIS. Interviewee: And EIS, yeah. I was a private citizen. Interviewer: Okay. And so you got the letter from Lyle Conrad inviting you to participate in the smallpox eradication program and about then what was the time frame in terms of how much longer before you - did you come back to Atlanta then for training or? Interviewee: No. There was no - there was nothing - I didn't go to Atlanta. I basically agreed to go and then had, I don't remember what the interval was between the letter and my departure. I went in early to mid June. I flew from Texas to the west coast and then from the west coast to New Delhi and arrived on June fourteenth of -- or sixteenth I can't remember -- of seventy four at the New Delhi airport at two or three o'clock in the morning. Was met by Bill Foege. Interviewer: And then had you ever been to south east Asia before or India? Interviewee: I had - because I lived in a developing country namely Guatemala I sort of assumed I was a seasoned, experienced international traveler or worker or whatever but I found India to be totally overwhelming at least initially partly I'm sure because it was the middle of the hot season and I was substantially jet lagged. But it was an extraordinary experience and much more challenging then central America. Interviewer: Interesting. Where did you - where were you posted in India? Interviewee: I was posted in Bihar and we had some training in New Delhi and then we traveled by train from New Delhi to Patna and it was - this was a coal fired train and I learned about how people who used to travel in trains in those days became covered with the grimy soot of the coal burning engine even though we were in first class. Interviewer: Wow. So were you part of a team in India when you went over as the smallpox? Were there others that were kind of in your cohort or? Interviewee: Yes. There was a group of something on the order of ten to fifteen people who had all been, I guess had responded to this letter from Lyle and other reasons and we were in a group that was trained and we had training from Larry Brilliant and Bill Foege. And when we got to Patna we had - we went to the field where I saw the first person I had ever seen with smallpox and Bill Foege was training us in the basic parts of identifying smallpox and doing the surveillance and containment activities. Interviewer: And was that still in the New Delhi area? Interviewee: No. That was in - that was near Patna. I don't remember where exactly. Interviewer: Okay, okay. And then what do you remember about your early days kind of getting involved with the program, figuring out who your counterparts were going to be? Interviewee: Well I - basically we had this couple of days of training in Patna and then each of us were derived - almost all of us had no prior experience with smallpox or India. We were - and we had a driver, a jeep and a paramedical assistance, a PMA who was basically a translator because most, almost none of us knew any Hindi. And we were sent off to a district to start working with the civil surgeon and the district medical officer and the - I'm now forgetting the chief administrative officer. And I was assigned to Muzaffarpur district which is one district south of the border with Nepal and at that time it was a very simple place. Muzaffarpur town had one restaurant and I stayed in one of these old British empire dock bungalows. And it was quite an experience to get started there because we were - in the beginning the expatriates were - the amount of support that we had at that point was quite limited. It was the PMA, the driver with whom you always had to have this game of trying to make sure the petrol wasn't stolen and then making connections with the local officials and then going out to the basic walks, places where the local medical officers who were in government service were providing family planning and curative services to people and finding the smallpox that was there. And there was plenty of smallpox at that time. Interviewer: You mentioned making sure that the petrol wasn't stolen. I know that Bihar has a reputation of being a I think the lawless state and I'm wondering if it was like that back in the seventies as well and... Interviewee: Well it... Interviewer: ...was it harder than some of the other places in India? Interviewee: Well the - Bihar's reputation in those days was particularly as a place that was very conservative and very quote unquote backward. And when Mrs. Gandhi in an introduction to the history of smallpox in India and eradication she said something like smallpox is a disease of underdevelopment. And in India the places which had better government services and a higher - things worked better such as all of the south, had basically eradicated smallpox already. So smallpox had remained in India was in the places which were more traditional, where there was less economic development, where there was less education. And so that was Bihar, Uttar Pradesh and West Bengal were the primary areas where smallpox was and that contributed to the pattern of where smallpox was at that time. Interviewer: How did you find out about the smallpox cases that were out in the field? Interviewee: Well, one of the things that had been instituted was a reward system so that people in the general public and health workers could earn and I don't remember what the level was when we started but it was quite low, a small amount of a number of rupees for reporting a case or an outbreak of smallpox once it was confirmed. And so that was one mechanism and the other was that there was an increasing sense among people in India that smallpox was a problem that ought to be dealt with and confronted so there was a - people had a desire to report the smallpox and also presumably to try and get some help dealing with it. Interviewer: What was the reaction of the people who were in the field in the remote rural areas when you showed up with your few colleagues to give the immunizations and to investigate the case? Interviewee: Well, you know the smallpox had been in India for a long time and was such a part of everyday life that there was in fact a deity Sheetla Maha, was smallpox and sort of infectious diseases that involved a rash but more smallpox than anything else. And that was - so there was some belief that smallpox was a blessing or came from deities but on a day to day basis when you - when we would go to a place where there was smallpox, a village where there was one or more cases of smallpox, people were very cooperative and we did a process of finding cases. We had a set of forms for listing cases and then in the beginning doing only a relatively small number of houses, the nearest houses to the home where the or the home or homes where the people lived who had smallpox, enumerating all the people that lived in those houses and vaccinating everyone and keeping track of the evolution of their smallpox vaccinations and finding out where people had - the cases had traveled and giving notifications to other areas that might be affected because someone had traveled to another place. It was a fairly easy to operate system. Interviewer: Do any of your trips back to the villages stand out as exceptional, remarkable, perhaps unique in what you encountered there or the reception of the people to you? Interviewee: Well it was - in the beginning it was all unique and exceptional and extraordinary because here I was, we were dealing with this classic killer. And I guess that the ravages of smallpox and what it could do to people and how it killed people and in particular this form known as flat smallpox where there was just a confluent rash so that people were just all pox, rash. And there was a way that you could particularly with a person who had flat smallpox there was a certain odor that you could smell that you could identify and you could almost make a diagnosis of smallpox based on that. But it was - the devastation to people and families of smallpox was extraordinary and it contributed to my feeling that smallpox was an unmitigated evil. There was no apparent good side to smallpox that I ever could find so it was a worthy adversary. Interviewer: How did they react to use of the jet gun in the little towns, any problems? Interviewee: Now you - I'll help you know the proper history. By then nobody used jet guns. We just used the famous bifurcated needle and so smallpox being historically present in India and a huge problem there people were very familiar with vaccination and vaccination had been done by a variety of methods. So vaccination itself was not really a problem. I mean there was some - there are many schools or ways of medical care including ayurvedic and homeopathic in India. And the people, the practitioners of those types of medicine at times had opposed vaccination for one reason or another. And I can remember having some sort of a debate with a homeopathic doctors about smallpox vaccination. But there were always people - there was always a small number of people who refused to be vaccinated and one of the rules of the expatriates was to help convince people that they ought to be vaccinated. Interviewer: To follow up on one of the comments you made, one of your roles was to convince people that they needed the vaccine. How did you go about doing that? Interviewee: And I was going to extend on that. It became a - it was clearly something that as an expatriate, as somebody from obviously outside of India that the expatriates had a particular possibility of being influential with people that were declining to be vaccinated. And I remember I had many, many, many conversations with people who were declining to be vaccinated. And I remember in particular at least once and I'm sure it was many times, a sign of respect was to touch someone's feet or shoes and I did that multiple times in trying to convince people to be vaccinated. And another thing that you did was to vaccinate yourself so I in the process of a few months in India was - I was - I had vaccinated myself hundreds of times as a way to show people that it was a trivial thing to be vaccinated, a minor process. So those are some of the things. Interviewer: How did your relationship with the translator? Do you - it sounds like you always went in the field to the villages with your translator. Interviewee: Yeah. Interviewer: And how did that develop over time? Interviewee: Well, it - many people - obviously because of the history of India as being part of the British Empire there were many, many people who spoke good English and in particular the government servants and medical officers and all were fluent in English. So it was possible to function a lot without a translator but it was also essential to have somebody who could help you with Hindi. In the end I got to be moderately competent with Hindi and perhaps over estimated my ability to communicate and understand. And it was an important relationship. Your PMA was - the degree to which the PMA was interested, aggressive, concerned, involved was a big deal, while if you had a more passive PMA then expatriate was much less effective obviously. So it was a very important relationship and... Interviewer: When you went out in the fields, excuse me, when you went out in the field did you go for several days at a time from village to village or were these more long days in the field and then back to your headquarters in the evenings? Interviewee: Well, headquarters didn't really exist in those days. We had - I had a room in a dock bungalow which was basically a - if I remember it was a single living space with a bathroom and that was all the office we had. It was very low key and not very well supported in the beginning and as I stayed in Muzaffarpur for probably something on the order of five months and then gradually we got additional resources and we had more staff, more vehicles. We had local young medical officers from India who joined in and medical officers from other parts of India and so it became a much more elaborate operation and a much bigger team as those resources were added and they made a big difference. And so I couldn't tell you exactly when we ended smallpox in Muzaffarpur nor exact - we had - when I arrived it was - there were probably a hundred outbreaks and within four or five months it was essentially taken care of part of which was the weather and the fact that we got into the poor transmission season. But the surveillance and case finding and then containment activity was a very effective tool for slowing and then stopping the spread of smallpox. And what happened is as the number of outbreaks dropped the amount of work that we did with each outbreak could be increased substantially and to some extent that was measured by how many houses we would include in the containment activity. So in the beginning it was a relatively small number of ten or fifteen or twenty and as we got more resources as there were fewer outbreaks it became fifty, a hundred, hundreds of houses. Interviewer: That you would go out and vaccinate at the reporting of one case? Interviewee: We would put a number on and then the houses and household would receive a number and there was a regular thing in which we put the number of people in the household written on the side and the vaccination status of how many of them had - cause you had to - you vaccinated and then you went back to see that - you had a vaccination take and monitored that. So that was part of the containment activity. Interviewer: How long after did you return then? Interviewee: Well, it would be - depending on what was going on you might stay in the local area if you have the time and there were other dock bungalows and other places that you could stay around the district. But when you have a hundred outbreaks you can't visit them, each of them for very long and the typical way that we worked at that time as we were in the field for probably twenty five days out of the month. And then we went to Patna for a couple of days of state level meetings in which we reported on our progress and heard from our colleagues about what was going on and had people like Mahindra Dhata or M. I. D. Sharma from the Indian health side and Bill Foege and Larry Brilliant and others from the WHO side inspire us not that we needed much inspiration. Interviewer: So were you pretty much working seven days a week when you were out in the field? Interviewee: When you're living in the country side in India particularly in nineteen seventy four, there was nothing. There were - I suppose there was some cinema but there was nothing to do and one of the things that always struck me about smallpox is it was an awful disease and it caused tremendous suffering. And so there was a kind of a feedback loop of encouragement or inspiration and so that - because as you could see that if you worked hard then you could reduce the number of cases of smallpox and if you worked even harder you could do that sooner. And then as you got the number of smallpox cases went down then you were sort of getting to the point where you were going to have local control, local eradication and you knew that that was part of a grander plan of eradicating smallpox in Bihar and in India and in the world. And so you had a feedback loop to keep you working harder and harder and harder or at least continue to be putting in tremendous amounts of effort because you were working toward an extraordinary goal of taking this killer disease and getting rid of it, 100% gone. It wasn't a - you didn't have to work - you didn't have to suffer for small gains. You could... Interviewer: Like you could see your - the results of what you were doing? Interviewee: You could see the results and you also knew that if you and everybody else worked hard that you were going to definitively get rid of smallpox. It wasn't something that was done by half or where you settled for a partial victory. We were headed to a 100% eradication which is an extraordinary achievement and in part why smallpox for me was the most - was the peak of my personal - my life and my professional experience. I mean it was an extraordinary one for that part of it and for a number of other things. Interviewer: Right. So you had mentioned that you saw this drastic decline in the smallpox cases in India and I think earlier you mentioned you also spent time then in Bangladesh. Is that about the time then - were you transferred or did you ask to go to Bangladesh or how did that happen? Interviewee: I actually - David Sensor was in India and I'm afraid I can't give the - this was I believe January of nineteen seventy five. And I remember riding on a train with him and I believe with Bill Foege and there was a discussion about - at that point it was clear that India was headed for success and the program in Bangladesh was in deep trouble in terms of having many outbreaks of smallpox. And I was one of the first people to go from the India program to the Bangladesh program as part of the beginning process of helping the Bangladesh program transform itself into what was the sort of India model I guess you would say. Interviewer: Were there differences in the composition of the teams or what were the differences? Interviewee: Well they - I believe this is the case and I'm - this is my impression. India, the India program was a transformed approach, a new approach because earlier in Asia in Pakistan and Afghanistan and other parts of and I think also in the Africa programs although I'm less clear about that, the model was a relatively small number of expatriates who were WHO employee, full time WHO employees, perhaps a dozen or so. And in India what had happened is that there was - it was such a large scale problem that the program model that evolved was the one that I sort of described where first you bring in some significant number of expatriates for short time work and then you amass resources and you have lots more money and government commitment and you provide lots and lots of vehicles. You provide - you pay for more local staff, you recruit the young Indian medical officers so that you have a huge, in the end you have a huge operation that was a sort of - I mean it was a parallel organization to the government and the local government, the government in India and the local government in the states and districts where you worked with a specific purpose. In the Bangladesh program was one where they were working with the old model and they were I think hoping that they would be able to show that the program in India was sort of overkill and that they could achieve smallpox eradication with a relatively small intimate group if you will of expatriates and WHO employees. And I believe that they had been offered resources but felt that they didn't need them. Interviewer: Did you have local counterparts in Bangladesh as well? Interviewee: Oh yeah. Interviewer: And was it - I'm sure a car and a driver and a translator. Interviewee: Yup. Interviewer: Others in addition? Interviewee: That was the pattern everywhere and the - in Bangladesh we had a - there was a different sort of type of expatriate. There were more people with young volunteers who were not medical officers and who came from a wider array of countries. There was more Americans in the India program and we had a lot of - substantial number of people from the U.K. and elsewhere. One of the aspects or the fascinating things of smallpox eradication work in India and Bangladesh was the fact that there was these many nations, people coming together from around the world whether it was the Soviet Union or France or the United Kingdom or the United States or Czechoslovakia or Poland or whatever working together in a team. So that was one of the extraordinary parts of working on smallpox eradication. Interviewer: Steve as we come to a close about this and you had mentioned a little bit about this before about how working in the smallpox eradication program really had a huge impact on your life and how you think about public health. Could you talk just a little bit about that before we close? Interviewee: Sure. I mentioned this aspect of smallpox eradication as this extraordinary in the sense of there was really nothing like the experience you could have of working on a killer that had existed for centuries and centuries and centuries and by your hard labor contributing to getting rid of a plague in the generic sense of it. And that - that's a life experience and I also in that process of work spent or got to know a lot more people from the CDC. And when I finished in Bangladesh in the summer of seventy six it was quite a challenging thing to think about coming back to the United States and changing from this sort of single focused monomania working on smallpox eradication to coming back to a quote unquote real world. And part of what I did was to gain time to get perspective by getting a masters in public health but I was just committed to work on public health. I was intoxicated by the experience and it was clearly something where you could have a huge impact. And my connections - the first work that I did after school of public health was to work on - with the immunization program in the Pan American Health Organization. And then I came back to CDC while working with that program and I was totally committed to public health and had no interest in clinical medicine whatsoever anymore. Interviewer: Thank you. It sounds like - I appreciate you being part of this oral history project and... Interviewee: It's a pleasure. Interviewer: ...just sharing your experience working with the smallpox program in both of those countries, around India and Bangladesh. It just sounds like it's had a tremendous impact and I know that you went on to have a very long and productive career in public health before retiring from CDC. So thank you again. Interviewee: Thank you. </pre> Player html for embedded player to stream video content <iframe src="https://www.youtube.com/embed/LJpf8xW7E_w" frameborder="0" width="560" height="315"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource JONES, T. STEPHEN Description An account of the resource Dr. Stephen Jones describes his experiences in the smallpox eradication program in India and Bangladesh Creator An entity primarily responsible for making the resource Jones, T. Stephen (Interviewee); CDC; Epidemiologist Date A point or period of time associated with an event in the lifecycle of the resource July 7, 2008 Format The file format, physical medium, or dimensions of the resource 8705880000 bytes video/x-dv Language A language of the resource English Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16s0t emory:16s0t https://www.globalhealthchronicles.org/files/original/9e73adb0276dae8e3e81b079dded3264.jpg a6b7596f97213fa0478af4a827dbca76 https://www.globalhealthchronicles.org/files/original/593067580a4e333a354d709d49ccd453.pdf c49df0c586f37185344bfce41561d04a Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> INTERVIEW Audio File: Stan Music Audio File Transcribed: January 29, 2009 Interviewer: This is an interview with Stan Music on July 11th, 2008 at the Centers for Disease Control and Prevention in Atlanta, Georgia about his role in the smallpox eradication campaign. The interviewer is Melissa McSwegan. With this interview we are hoping to capture for future generations the memories of participants and their families involved in eradicating smallpox. This is an incredibly important and historic achievement and we want to hear about your experience. I have some questions to guide you but please feel free to recount any special stories or anecdotes that you remember about events or people. The legal agreement you signed says that you are donating the oral history to the U.S. Federal government and it will be in the public domain. So for the record could you please state your full name and that you know you are being recorded. Interviewee: My name is Stanley Music and I know that I'm being recorded. Interviewer: Thank you. To start out with can you talk a bit about how your education and upbringing led you to work in the health field? Interviewee: Yeah. My father was an immigrant although he came to this country at a very early age. He was the oldest of five or six children and when his father died he was still a teenager and he had to quickly abandon any of his hopes at a higher education and start earning a living for his family. As a result of that he always encouraged both his sons -- me and my brother -- to become a professional man whatever that meant to him but he wanted me to be a doctor or a lawyer or something professional and not have the financial worries that he had pretty much all of his life. Interviewer: And so then once you did - begun working in health how did you get involved with the smallpox campaign? Interviewee: Well I went to - I got accepted to two medical schools one of which was in the same city in which I lived and the other was an hour away and would require that I be in residence away from home which opportunity I jumped at because I had been to college in the same city in which I lived. So I went to University of Maryland, medical school and fell under the influence of professor of medicine Ted Woodward who was quite well known in international infectious disease circles. Because I fit his profile of whatever he was looking for, during my junior year summer between third year and fourth year of medical school he sent me as a research assistant to Pakistan. And I saw an incredible variety of infectious diseases, human rabies, smallpox, cholera and a few others that made a deep and lasting impression on me and probably set my values for somebody who wanted to help make a difference in diseases of poverty in tropical areas and generally trying to bring the benefits of twentieth century medicine to a population that was living in hundreds of earlier times in effect. Interviewer: So, when you first began working with the smallpox campaign what was your role? Interviewee: Oh. We have skipped an awful lot of history then. So I was very much interested in infectious disease, internal medicine and actually specialized in infectious disease but couldn't quite see myself as an academic fighting for grants etcetera. So I followed a friend of mine, Mike Greg down to CDC and paid him a visit where he was part of the EIS program and editing the MMWR and got very interested in a career in the public health service in epidemiology. And the following year I applied to the EIS - excuse me - and was accepted and because of my Pakistan experience when I was an EIS officer and Pakistan and - West Pakistan and East Pakistan had a falling out and East Pakistan wanted to become an independent country called Bangladesh. I was part of the team that was sent by CDC to work in Bangladesh on a nutrition survey designed to make sure that the food that was in the country was given on a priority basis to the areas that needed it the most. That experience in turn led me to learn Bengali and that's why Stan Foster was very interested in recruiting me to the Bangladesh program because I had been to the country before and I spoke enough of the language to get around on my own. So that kind of set the stage for my smallpox involvement. I protested mightily when he asked me to join because I had just acquired admission and a full federal scholarship to University of London to get an MPH equivalent degree. But he agreed that if I gave him two years of smallpox eradication that he would see to it that I continued on in my academic studies before joining CDC permanently as a staff member and he was good to his word as was I. Interviewer: So tell me a little bit about the working relationships you had with your counterparts on the ground and what were the successes and failures you had with that. Interviewee: Well, counterpart was I think in many ways an exaggeration because they really had no clue as to what was expected and what was going to be done. We ended up actually setting up a whole parallel system of employment. We used Ministry of Health personnel to be sure but by giving them - by basically doubling their salaries and giving them access to motorbikes and Land Rovers and other transportation we elevated their status and they became very loyal to us. They became reliable surveillance partners who could go out on a schedule and be in a village market on a given day at a given time and advertise about the smallpox program and get information about whether there was any smallpox showing pictures of kids with smallpox and asking if they knew of anyone. But we set up a whole parallel system. The government of Bangladesh was very good at acquiescing to our stated and carefully thought out -- most of the times -- needs but they really weren't partners in the delivery of the services. They just stood aside and let us do our things mostly. Interviewer: What were some of the biggest challenges you faced on the work on the ground? Interviewee: Well, one of the biggest challenges was getting people to do what they were supposed to do. They weren't used to being inspected. They weren't used to being challenged, they weren't used to having somebody count the number of vaccines vials and then three weeks later come back and ask how many people had been vaccinated and then go back and count the vaccine vials again and see if things actually jived. I learnt very early that the Bengali intellect is quite well formed and they know for example that there are exceptions to every rule. So when I said you know if you find a smallpox case the whole village is quarantined and you vaccinate everyone, but if I then did an inspection when they said everyone had been vaccinated, they would - I would discover a guy dying of TB or congestive heart failure or something lying off in a corner of a hut, and he had been exempted from vaccination. But I said there are no exemptions and they said every rule has exemptions and I said okay, thought about for a while and then I said, "Okay. We are now going to vaccinate everybody with one exception. We will vaccinate no dead persons." And they laughed but they understood and then I had no problems. So it was a matter of understanding the culture, understanding their attitudes and the challenge then of translating my desires into something that they could follow and give me results that I was looking for. Another big challenge was these seasonal fairs that pulled people in from many, many miles away. They were a source of revenue to the district commissioners who got a piece of the commercial action but when I found that a particular fair was actually a disseminating source of smallpox because people who were infectious were coming, mingling with people who were still susceptible who then spread out and returned to their villages, I had a big problem. And I had to - people who were earning the money threatened me because I was going to report this. In the end I went to Dhaka and informed my superiors about it but basically got no support until D.A. arrived from Geneva, listened to my tale of woe and did his little magic with the political heads of the health department and WHO and then we managed to put vaccinators into the fair areas and stop the transmission. So there were challenges all the time. Another challenge we had was a lack of petrol in the area that I was designed to cover. So we had Land Rovers and we had jeeps and we had motorbikes but we couldn't run them because we didn't have any fuel and there was no way to get any fuel. But we ended up doing something quite inspired, quite illegal and quite dangerous. We found a train siding run by the army with cars full of petrol. We ended up one night unpinning the connection to the last car, rolling it a couple of miles down the track and siphoning out all the gasoline and finding ways to store it and returning the car under the cover of darkness back to the train as if nothing had happened only it was now largely empty instead of being full. But we needed the petrol to make our surveillance rounds and to keep pressure on this disease to stop it from spreading. So, yes there were challenges every day of many, many kinds. Interviewer: Tell me a little bit more about life in Bangladesh from a cultural perspective. Not so much just about the work but what was it like living in Bangladesh? Interviewee: Ha. It meant when the sun went down the lights went out. It meant learning to be patient, it meant learning to enjoy the simple things like a home cooked meal. There were a mixture of Muslims and Hindus and a few Christians and a few non believers of every variety. There were some people of the old ruling class under the days of the Maharaja who still lived in crumbling palaces but it was a wonderful education and at night there was nothing to do but talk. There was no radio or television or anything although I did have a little portable shortwave but the culture was rich, the people were wonderfully talkative. The oral traditions were great and I learnt a lot about the people and their culture, their habits, their food, their clothing, their rituals and the way that they accepted life. And although they had by my standards a very primitive existence, they actually enjoyed their lives I thought to a much greater extent even with all the poverty and the disease and the premature mortality and the excess morbidity to a greater extent and with more relish than I could recall from the United States. Interviewer: As you were working with the smallpox campaign, was there a particular point where you knew that smallpox could be eradicated and would be eradicated? Interviewee: Well, actually no. I had the belief that it could be because I understood the epidemiology and nothing in my experience had given any reason to believe that my understanding was different than reality but every day in Bangladesh ten thousand - that was the birth rate - ten thousand new susceptible would be born. So even if as in my dreams we could fly B-52 bombers wing tip to wing tip over the country spraying vaccine so that everybody who took a breath would be vaccinated, the very next day we would have ten thousand new susceptible. And I knew that just vaccinating, trying to vaccinate and keep a population fully vaccinated wasn't going to work. What we needed was an epidemiologically oriented program that Bill Fergie designed and clearly when we were working efficiently with good surveillance and good follow up, good containment, good ring vaccination, good quarantine, we stopped the spread cold and it worked every time. So I knew that once we had it all together it was going to happen very quickly and it did. Interviewer: Now that you have thirty some years of perspective on this campaign is there anything you would have done differently? Interviewee: No, I don't think there was actually. I think it was a treasure of an experience, it shaped my life and my career and my attitudes, my values. I thought that smallpox was just the beginning, that we would then march on to measles and all the other vaccine preventable diseases. After all we had the surveillance organized, we had the trained staff, we had people in place, all we had to do was implement it but that was not going to be. But my generation of CDC epidemiologists were always somehow more empowered and more aggressively public health oriented than our colleagues who didn't have this experience. Interviewer: What are the most important lessons that you learned from smallpox that you then applied to other areas of your career after the campaign finished? Interviewee: Well, to a certain degree smallpox was about breaking the rules or interpreting the rules with flexibility bordering on breaking the rules because nobody sitting back at a desk could figure out what was really going on in the field. If you went to the field you learned about the fairs that were spreading smallpox, you learned about the people not being vaccinated because they had some other illness and etcetera. So smallpox taught me to break the rules if I was going to be successful, if I was going to be carrying out the disease reduction, following through on the results of an investigation. But you can't operate that way in the civilized world and in modern European or in America. So I had to change the way that Bangladesh had taught me and learn how to be patient, learn how to educate, learn how to involve the public and not be the kind of imperialistic dictator that solved the smallpox problem but was not going to cut the mustard in the real world after that. Interviewer: And how did the overall experience impact your life? Interviewee: Well it made me a public health believer because I had a monster success under my belt. They gave me a quarter of Bangladesh, twenty five million people then, five districts, a suitcase full of money and some vaccine and some bifurcated needles and said go do it. And I had a driver and we did it. It was amazing and it filled me with a desire to have a full public health career and to carry out those initial dreams that I had when I was but a medical student wanting to bring those people up to the twentieth century in terms of their morbidity, mortality and infant child mortality experience. Interviewer: Did you continue working in infectious diseases? Interviewee: Well I continued working in epidemiology but I came back to CDC and worked with Lyle Conrad in supervising EIS officers that were assigned to state and local health departments. I kept my hand in international consultation and did a few WHO and USAID consultancies. I used the time to understand a lot about other countries and eventually was recruited to the global EIS by Phil Brockman and then when he retired I was named his successor and I put programs in Thailand, Indonesia, Mexico, Saudi Arabia, Taiwan, Philippines, Peru, Italy and Australia. And said no to a couple of very big countries to the disappointment of my boss because those countries weren't ready and they weren't going to participate but that was India and Egypt which have since changed and there are now cooperative programs with those countries. But I used that, that was - that helped define me. Interviewer: Can you tell us one - one of the most memorable moments you have of your time in Bangladesh? Something that happened, an event that happened, something that you remember and think back on. Interviewee: Yeah, I think I can. I don't think that there are very many people who know this story. There was a famine in Bangladesh at that time, at least in my area. There was a - they had two or three rice crops a year depending on how much water there was and the physical geography of individual areas. And a rice crop had failed so there was quite a bit of [inaudible 24.14] starvation and it was getting hard to hire people because the wages that we were authorized to pay wouldn't give them enough money to buy the food that they needed so we weren't really competitive. And then the new rice crop which was not failing was about to come in and here they got a living wage plus they could put handfuls of rice in their pants pockets and they could earn a lot more, in essence take home take a lot more than they could working for me. And working for me meant being guards, vaccinating around infected villages. Well I couldn't live with the idea that we could identify villages and then not protect them and not vaccinating those villages and not break the chain of transmission. And I sat down with one of my subordinates an Egyptian physician, Ali Salim [inaudible 25.32], wonderful man, and we sat up at night and thought about our dilemma and how we were going to resolve it. We had radioed back to Dhaka and they told us the price that we pay for each guard was fixed. I don't remember how much it was, fifteen taka a day or something like that but we couldn't pay anymore and we needed to pay more. And I said, "Look you're leaving me in an awkward position. I've got infected villages. I can't quarantine them, I can't vaccinate any of them. I don't have enough people." "Those are the rules." Okay. So Ali and I sat down and decided we were going to invent villages and were going to invent outbreaks, and we were going to invent workers and we did and we paid them the right wage on paper. And we encumbered then a lot of need for money which we then divided up among the real workers and paid them enough to keep them working for us and not harvesting the rice. So yes, I can tell you that and probably other stories as well about what we had to do to stop smallpox. Interviewer: Wow. Interviewee: Yes. Interviewer: Well, is there anything else that you would like to add or any other stories that you think? Interviewee: I think I've probably gotten myself in enough hot water you know. Interviewer: Like do you really want that story [inaudible 27.18]? No. Well, thank you very much. I appreciate your time in sharing your experience with us. It all looks very interesting so thank you. Interviewee: Okay. </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/-tJBUIy58qc" frameborder="0" allowfullscreen="allowfullscreen"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource interviews motion pictures moving image Date A point or period of time associated with an event in the lifecycle of the resource 2008-07-11 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16rzk emory:16rzk Subject The topic of the resource Bangladesh Smallpox Eradication Smallpox Eradication Smallpox Eradication Format The file format, physical medium, or dimensions of the resource 5947080000 bytes video/x-dv Creator An entity primarily responsible for making the resource McSwegin, Melissa (Interviewer) Music, Stanley (Interviewee) Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of Southeast Asia and East Africa Smallpox Workers (2008 : Atlanta, Georgia) Title A name given to the resource MUSIC, STANLEY Description An account of the resource Dr. Stanley Music describes his experiences as an epidemiologist in Bangladesh with the Smallpox Eradication Program from 1973-1975. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/35c8696b4dd6f0f097dcaf1c630112ff.jpg f8baece4f8f23a894202c3887c5a2a74 https://www.globalhealthchronicles.org/files/original/d04627830a2d6e8669f59fda68ccc468.pdf b992c68df44827472101ef704d64308f Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> INTERVIEW WITH RON WALDMAN Elisa: This is an interview with Ron Waldman on July 11th 2008 at the Centers for Disease Control and Prevention in Atlanta, Georgia about his role in the smallpox eradication project. The interviewer is Elisa Coskey. With this interview we're hoping to capture for future generations the memories of participants and their families involved in eradicating smallpox. This is an incredibly important and historic achievement and we want to hear about your experience. I have some questions to guide you but please feel free to recount any special stories or anecdotes that you remember about events or people. The legal agreement you just signed says that you're 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? Ron: Ron Waldman. Yes, I know I'm being recorded. Elisa: Okay, thank you very much and thanks again for being here today. I just want to start with a few chronological questions and if you can describe for me briefly your childhood, your college education and what influenced you to become interested in public health in general. Ron: Well, my childhood was spent in New York City and then in Long Beach, New York where I graduated from high school. I went to college at the University of Rochester in upstate New York and then to Law School at the University of Chicago in nineteen sixty seven where I studied for one year until I left the U.S. during a period when many people my age then were leaving out of objections for the Vietnam war and I ended up in medical school at the University of Geneva in Switzerland. I can't honestly say that while there I had any exposure to public health at all and I really didn't know what I wanted to do in medicine with my medical degree when it was awarded to me somewhat surprisingly in nineteen seventy - in May of nineteen seventy five. Being a foreigner in Switzerland that time meant that without having the benefit any more of a student permit to live there I had to leave the country and I really didn't have much knowledge of what I was going to do. While there I had been coaching a high school baseball team and I was talking one day to my star pitcher from the team who was graduating from the international school in Geneva at the time. And we were talking about what we were going to do. I asked him what he was going to do and he said he was going to go out to Colorado to ski. And he asked me what I was going to do and I said I didn't have any idea, that I had just finished medical school at the university and I would probably end up doing something related to medicine. And he said, "Oh that's pretty interesting. You ought to meet my girlfriend." And I said, "Why?" "Well her dad works with the World Health Organization," and I said, "Okay well bring her to the next game." So, he came to the next game accompanied by his girlfriend and she said, "Well you ought to go up and see my dad," and her dad turned out to be D.A. Henderson. So I went up to meet with him and was long hair and all at the time ushered up to the smallpox offices where I don't remember exactly what happened but the upside of it was that they asked me if could leave for Bangladesh within the next few days and I said sure. And that's how I got my introduction to public health and to smallpox, which has been basically the beginning of career that's still going on. Elisa: So, quite an unanticipated chain of events. Ron: Very serendipitous event as had other previous events been so yeah, not the usual pathway into the program. I don't think so. I left as a basically - no basically I left for Bangladesh a few days after that meeting as a WHO volunteer so smallpox eradication was really my first job of a serious nature but I didn't get paid really any more than just the subsistence that WHO volunteers had at the time. I didn't know anyone who was working in public health. I didn't know what public health was. I'm sorry to say and maybe it doesn't reflect well on the very strong academic program at the University of Geneva medical school, but I hadn't really heard of smallpox and I am not entirely sure that I had heard of Bangladesh either but there I went. Elisa: Quite the adventure you were beginning. Can you tell me a little bit about your arrival there in Bangladesh and? Ron: Yeah. We went - I remember leaving Geneva and we were heading off for training in Delhi. I remember distinctly flying into Delhi and when they opened the door of the plane there was this rush of heat that I had never experienced before in my life and I knew I was somewhere different. We had a small orientation group there in India. I remember some of the people who were in that group with whom I'm still good friends. I think that orientation took about five days. Some people stayed in India, others were sent on to Bangladesh that's where the action was and I remember that first plane trip t o Bangladesh. I never thought I was going to land at all. It was May, the beginning of the monsoon season and the plane flew over Dhaka, tried to land, storms came in, the plane was rocking, it was just awful. For about an hour they kept circling around and trying to land. They couldn't and eventually the plane went back to Calcutta where we spent the night. This is all like in the fog of all of this newness happening to me. We were forced to spend the night in Calcutta, got out the next day. They took us to the airport, put us on a plane again and flew us off to Dhaka where this time we landed and we were greeted by Daniel Tarantola who was - I don't know exactly what but high up in the smallpox bureaucracy in Bangladesh - and taken into another orientation session that lasted about a week. And that's where I met all these acquaintances and many of which were with people that I'm still in regular contact with as I am with Danielle just now. At the end of that orientation where they were talking about things like imprest accounts and administrative matters and stuff that I really didn't understand and which I had frankly little interest, they shipped me off. I was young and there were few of us, a number of volunteers like myself. They shipped me off to the northeastern corner of the country, Syhlet district and there I went. I went from Syhlet - the smallpox base in Syhlet they shipped me off even further towards the Indian border to a upazila I think they're called now, a thana called Chhatak - a town called Chhatak where there were no roads. They had given me an outboard motor. I had no experience with motorboats but they gave an outdoor motor. I carried it up there on my back, found a boat, found a driver and started doing what they had instructed me to do which was to conduct surveillance activity. Elisa: You mentioned that you traveled further outside of your central village and had an outboard motor. Can you tell a little bit about what travel was like, did you have a team with you? Ron: I had one person with me basically, a driver who I had hired. I located up there. This was a place it was really far out in many ways but it was a place that had a big paper pulp factory that was run by an Eastern European country and when I got up there I didn't speak the language or anything. But I went over there and with a translator -- I had a translator -- just to find somebody who could drive me around in this motorboat. And we located a guy who just turned out to be fantastic and who literally saved my life a number of times. He'd been a freedom fighter during the Bangladeshi war of independence and those guys, Rakkhi Bahini they were called, were very highly respected by everyone. This was a guy of indeterminate age I would say. He had long flowing white beard but I don't think he was very old. He was probably in his forties or early fifties. And he attached himself to me and when we explained what I was there to do and what the program was about and became a very, very loyal, faithful, dedicated and incredibly competent colleague. We went around with fliers and posters and obviously had supplies of vaccine, bifurcated needles, everything else that we needed to control outbreaks of smallpox should we find them. We went around to - there were no roads literally. We only had the rivers to follow and then when enough rain had fallen and as I mentioned we were on the Indian border and when they created Bangladesh they just - the surveyors establishing the boundaries would walk and walk and walk and as soon as they took a step up, that's where they drew the border. So, Bangladesh was completely flat and there was no rock to build with. So, all of the stones for construction came from the Indian side of the border and they would carry them along the rivers in these long - I don't know - canoe like boats that they would load with rock until there was no free board whatsoever on the side of the boat. They were going with the top of their boats flushed with the waterline. Why not? There wasn't really any motorized traffic in these areas until I came along with my motorboat. So, I basically held their lives in - my driver did cause if we had created wake going past them with their boats filled with rock they were going down. So, the upshot of it was that basically I was king of the river or my driver was. So, it was really kind of we went everywhere. Like we went to market places, mosques, other gathering places, every little village we could find. After it had rained enough we could go straight as the crow flies. We didn't have to stay to the course of the rivers. Little rice paddies filled with water and the whole place was under water. I remember that we would just go straight from one point to another. Sometimes they had these little dykes between the rice paddies and sometimes we would hit our motor up against those dykes and we would break off what's called a shearing pin that keeps the propeller in place. So, we always had to have a hefty stock of shearing pins whenever we traveled. I remember that and I remember having to change them quite a number of times. As time went by I learned how to deal with the boat and I learnt enough of the language to get by so that on the weekends when we would go down to Syhlet to get a little R&amp;R; for a day or so with the other smallpox workers from the region, I used to take the boat down myself. I'd leave the driver up at home with his family and I used to go down probably about a three-hour ride with this little maybe thirty horsepower Yamaha engine that we had. So, I got to be pretty good with the motorboat in addition to smallpox. And you know by now many people must have explained what the deal was. We would ask if people - we had these recognition cards that the WHO had given us and we'd show them around and we would invite people to tell us if they had seen anybody with a rash that led them to suspect that this person might have smallpox. And then we would go out to that place, to the person's house. We'd try to get enough information to know where it was. And if indeed we identified the patient as a person who had smallpox we would institute containment activities which meant that we would isolate the patient in the home, hire guards from the village to make sure that no one could come in or out of the person's hut and we began vaccination routine. That's when we started hiring people and we would round up as many people as we could. They were usually younger kids who were interested; at least interested in earning the pittance that we were paying them. Six taka a day I remember really. It wasn't very much money and they would begin to - we would instruct them on how to vaccinate and they would begin vaccinating everybody. I don't remember exactly what the protocol was but it was maybe within the first day to vaccinate everybody within a one hundred meter radius of the index case and then within five days maybe three hundred meter radius or five hundred meter radius and eventually up to a kilometer around the case. For us it wasn't difficult at all because this was a pretty sparsely populated rural area and as I mentioned everything was water. So, the little villages if you could call them that, the clusters of homes were all on little islands basically that just were slightly elevated above the water. Maybe there'd be ten or twenty homes or something like that so we do 00:15:25 and vaccinate everybody and then just get back in the boat and go to the next line and get out and explain what we were doing there and vaccinate everybody. So it really wasn't for me all that many people. On the other hand we had a lot of smallpox. So, out of all the people that you will be talking to, I've seen as many cases of smallpox as anyone. This happened I think it was in March or April or maybe early May in Bangladesh the government knocked down the slums in the capital city of Dhaka and when they did that people fled back to their home villages and they transported diseases all over the country. During that - I know it's a big event that the WHO people really tried and CDC people really tried to get the government not to do this but the government was intent on knocking down these slums and they did and because then when smallpox was carried throughout the country that's when they had this huge resurgence. They had been doing quite well in bringing it under control but in that spring of nineteen seventy five there was a huge resurgence in the number of cases which is why coming full circle, they were so interested in taking anybody who would go basically and sending them out there. So, when I turned up on the basis of D A's daughter's recommendation at the offices in WHO they were really happy to see a warm body who was willing to go out there. They were throwing everything into trying to bring the epidemiological situation back under control. Elisa: Very interesting. Can you tell a little bit about your reception in some of these villages or as you called them like clusters of homes in combination with the social circumstances at the time? Were there ever any challenges that arose for you? Ron: Yeah, that's a terrific question and one that my answer will maybe be a little bit controversial and has been at other meetings of smallpox people. One of the reasons why the smallpox eradication effort in countries like Bangladesh was so successful was that those of us working in the program were fanatically committed to its success. I think that the tone was set by those people who were leaders and Bangladesh for us it was Stan Foster, Daniel Tarantola, a number of others, people from the CDC but we were going to get this job done. And I can't even tell you with tremendous accuracy what the reception was. Sometimes it was quite warm, we were always invited. I remember before we did anything when we arrived there and remember I was traveling with a guy who was incredibly respected in society there and who everyone knew. But we were always asked to take a seat; we were always offered green coconuts and the coconut water. We were offered tea always with - whatever little bit they had to offer guests we were always offered right off the bat. The hospitality was incredible. When it came to doing the job of if it meant isolating somebody in a home, if it meant vaccinating people who might not want to be vaccinated for one reason or another, the reception could become at times a little cooler. But it never really dissuaded us from getting the job done. So there were times when things were done even forcibly. If people tried to flee when it was their turn to be vaccinated because they were afraid of what it might be and it was never I don't think all together adequately explained to people or maybe it was and they didn't understand. They could be at times physically restrained and forcibly vaccinated. I have a very deep and abiding interest in human rights and in the relationship between communicable disease control and human rights. But I have to say that at least in my - from my personal experiences in Bangladesh there were times when one could be questioned about one's respect for other people's rights to have a particular intervention explained to them. And I know that this was the case in India as well and there was some papers and the literature to talk about this. There were times - I was very friendly because I had this big motorboat, not big but I had a motorboat, which was unusual for the area so the military forces would come by at times and you know just to see what I was up to because I had something that could be of value to them under certain circumstances. So, I was kind of friends with the military and people knew that and it was interesting. But we always got the job done and I really, really hope that we did it with the maximum amount of explaining to people what we were after and to the largest degree possible with their assent and their accord. Elisa: Okay. I'm really interested in hearing a little bit more about your relationship with your guide. It sounds like he was an incredible asset to your whole experience there and you mentioned really early in our conversation that there were a couple of times when he may have even saved your life. Could you discuss that a little bit more? Ron: Well sure. So, you know he was a Rakkhi Bahini. He was with the Bangladeshi Liberation Fighters during the war of separation from - of independence, Bangladesh independence from Pakistan, which was in 1971 and 1972. These are the guys who - they're the - that war was terrible as wars are in that part of the world, in any part of the world and the Pakistani forces would pillage villages, rape women and so on and so forth. And the major resistance was in the peripheral areas where these, I guess you could call them to a certain extent guerilla fighters who would do what they could to resist. Hit and run activities. Just you know, sabotage and whatever. These are guys who would when they were being chased they would stay underwater. The apocryphal stories were that they would stay underwater for 12 or 24 hours at a time breathing through a reed they would have plucked from the brush on the side of a river. So they were legendary and he happened to be a part of that and in the post independence days they could pretty much do what they wanted. And he was just a really upstanding guy who wanted to continue to provide service to the people and the country that he loved. And he was very, very happy to hook up with the smallpox eradication program. I don't remember if he had had relatives who had died of smallpox but everybody knew people who had smallpox. It was a fairly common disease in that part of the world. So yeah, I was really lucky that I had him because I'm sure I could have made some serious diplomatic faux pas and probably did and I'm sure I don't know of all the many times that he protected me actually. But I did say that there were times when he did save my life and that's true because as I said I didn't really know what I was doing with the motorboat at all and I would go and get in trouble with it a lot of the time. And I remember one time leaving - I lived in a guesthouse on one part of this town of Chhatak and he lived on the other side of the town along the river still. I remember I took the boat out one evening just to go for a little spin and it stalled. There was a big river we were on, the Surma River and I took the boat out and I didn't know what I was doing. And the motor stalled out and I got caught in a current and I was going down, down the river to places I didn't know. I didn't speak the language; I didn't know where I was going to end up or how I was going to get out of it. I just remember that as I was going down past where he lived I was waving my arms and everything and somehow he was there and he saw me. I don't know how. And he hopped into a canoe like thing and paddled out to the motorboat and got it started and took me home. It was dark by then I remember. I was a little scared but I remember him coming to the rescue. Elisa: Great story. Can you tell me anything about your relationships with other country counterparts and your relationship with other WHO team members, CDC team members? Ron: Yeah. In terms of the country counterparts I didn't have - in that iteration I later was transferred - actually maybe I was transferred because of this incident that I might recount now. So I did - I was up there for about five or six months in that part and then I was transferred down. We took - smallpox was over and I was assigned to an area that was on the Bay of Bengal so in the southern part of the country, Noakhali it was called. My relations with the Bangladeshi Ministry of Health officials who were up there in Chhatak my first posting were not so great. I remember - you know we worked a lot - a lot of people who have been working in the malaria program came over and were assigned to smallpox. And for the most part the ones I had to deal with were not - maybe they were malaria people but I remember there were some district medical officers. Remember this is my first job ever and I was - you know we were focused is what we wanted to do and that my impression is that as I remember it now is that I wasn't impressed with their dedication to their job. I thought that they were not working hard enough to get the job done. I thought that they could have been doing a lot more and basically I didn't have so much respect for their competence. Now I've been working in global health ever since then so for the past thirty or some odd years or more and I know a lot of things now that I should have known then about how much they were being paid, how they had to do other things to earn a living to support their families. I didn't have any of these things. I had never had a paying job and still didn't have a paying job. I didn't have a family. I had nothing but smallpox eradication. And I went in and I suspect I was probably an imperious, self-centered, uncaring foreigner who didn't know anything about the place where I was working. I didn't even have an appreciation for learning the culture or having an understanding of the history of the place. I was a young kid, brash, brazen and interested in only one thing which was getting the job done that I was there to do as quickly and as effectively as possible and I was probably pretty obnoxious. On the other hand there were things that in the way that I was treated there also they were pretty annoying and people will tell you Bangladeshis have this strange habit that I've really never seen any place else of staring and gathering around foreigners and staring at them and sometimes just poking. And just you know they don't have the same at least then or at least my perception then was that they didn't have same respect for individual space that we have. On top that I'm left handed and they eat with their hands and I ate with my left hand which wasn't a really cool thing to do in a society like that. I remember I had to go out to a restaurant in town. I always went to the same place every night to eat the small amount that there was to eat but people commented. I'd be trying to eat and people would be - you'd have a crowd around you cause they didn't see 00:29:04 standing there looking, staring at you or what you were doing. And I'd be eating and I'd be eating with the wrong hand and eventually the restaurant owner took pity on me and built a small little - put a curtain up in a corner of the restaurant and that would by my area where I could go and eat in peace. So it was tough. It was a lot of pressure on me. It was a strange environment, it was my first job and so on and so forth and it got at times a little lonely up there. I was on my own in terms of WHO team and it was tremendous. It was just a phenomenal learning experience that I tried to handle as well as possible. I'm very happy that we got the job done. I'm very happy to have had that experience and to have grown so much from it, to have learned from it and to have launched my career there and I've had a great career since then. So, that was good. In terms of other people from WHO there was another guy like me a young - I think he's going to be here this weekend, in the thana next door, much bigger thana. I had - most of us had a - I forget what the words that the administrative areas were called; you know the equivalent of a province or region or something. And most of the people were assigned to a region of a country that contained a number of districts. I had one district under my - in my area of supervision. It was a large district and it was so difficult to get around. But there was a guy in the one next-door called Sunamganj who had the same job as I did and we would get together occasionally. Not all that often cause it was probably an hour down the big river between us. An hour one way and an hour back the other way against the current. It's a lot. We did get together as I mentioned on weekends probably about eight or ten people. Steve Jones was the sort of overall supervisor of all of us working in that area and we would go down to his place in the center of Syhlet and meet up for a weekend. Elisa: Did you find it helpful to have a group of people that you could sort of commune with to share your experiences with who were also foreigners doing the same type of job and what sort of things did you do when you got together? Ron: Yeah. Yeah, I found it great. It was a good break from the field. I think we went every two weeks. It was a good break from the field. It was only a couple of days which was fine because after a day you wanted to get back to the field and back to work anyway. But it was a nice house and it had a roof. I remember we used to sit up on the roof and you know if somebody got their hands on a couple of cans of beer or a bottle of whisky or some marijuana or whatever it was we would have a nice little time and it was a good break. And then we'd go back and back to work. But we really only went down for the Dhaka very, very rarely maybe. Maybe I went in the whole time I was up there twice at the most except that in the middle of all this I had mentioned my relationship with the military. In the middle of all this the President of the country Sheikh Mujibur Rahman was assassinated by a military coup and it was basically a lock down every place. And they came because they knew where I was and took my boat because they needed it to get around. So that was a little scary too cause you know we communicated with the center by radio, walkie-talkie and communications were down, they took my boat. It was a little scary for a little while but I don't remember how eventually I got down to Dhaka but I know that during that period we were called back in and I know that I got there somehow so that was okay. Elisa: I'd like to talk a little bit about how your experiences in Bangladesh impacted the rest of your life and as you said it started you on a long career in public health. Ron: Yeah, it sure did. I mean I - while I was there obviously I met a lot of the people from here from the CDC who had gone out there. Some people were there for a long time like Stan and Steve Jones. They were doing - they stayed in smallpox for a while. Other people, a lot of people came through on a regular basis from the CDC. We used to call them 90-day wonders. Those of us who were the hippie volunteers in the field after a month or so you were a veteran and you knew what you were doing and you were totally experienced. And here came these new coming guys from the EIS or whatever and they were going to come out for three months where we had all made two year commitments or more. And we just, 'big hot shot docs from the U.S.' and we used to look down on them a lot. Try to make fun of them whenever we could so we called them ninety day wonders but I met a lot of them and asked them questions like you're asking me, "Why did you get into public health, what are you doing, do you like it?" and I liked a lot of them and they liked me. And before I left they asked if I would consider joining the EIS program and I said, "Yeah let me in. It sounds good." I'd finally found my calling. This is really wanted to do was the kind of stuff I was doing, the field work that I was doing in Bangladesh. Elisa: Sure. I was just asking about how your experiences in Bangladesh influenced your subsequent career in public health? Ron: So, I met a lot of people from the CDC and I liked them, they liked me and before I left they asked if I would consider joining the EIS. I said sure but I had remembered I didn't have any internship. I had just graduated from medical school and had my degree. So, it was a requirement that you had to do an internship so eventually when I left smallpox, I guess it was in seventy seven, I went back to the States where I hadn't been in some time, almost ten years and I did an internship. And then I liked that so I stayed another year and I started doing a residency in internal medicine. But then I started not liking it so much but what I did was I had called D.A. Henderson. I went Johns Hopkins after having contacted D.A. again and I got my Masters in Public Health degree. They had then a preventive medicine program and the second year of their preventive medicine program that I was in they would place the students with state and county health departments and things like that. So, I remember that the chief resident, the head of that residency program asked me, "Well Ron for your practicum how would you like to go work with the EIS officer in Maryland?" And that sort of triggered my memories of EIS. I was a student. I was paying them for the privilege and here they wanted me to go and work alongside of whoever the EIS officer was who was making what was a not bad salary. So, I basically said, "Listen that reminds me. I don't want to work with EIS officer I can be the EIS officer." And I applied to the EIS that year and got in and there you have it. I was assigned to the state of Michigan to do my EIS and that time I was one of the few people in the EIS class that had substantial overseas - international experience, my Bangladesh experience but I don't know if they counted my Switzerland experience or not I don't know. But early on they asked me if I wanted to go and work in the Cambodian crisis. The genocide from Cambodia had resulted in large numbers of people fleeing to Thailand and they asked if I would head a team from CDC to - no they asked if I would work as a epidemiologist on a team of people going out there and for a number of reasons I didn't want to do that so I didn't go. I was involved in other stuff in Michigan actually but a few months there was a crisis, a refugee crisis in Somalia and they asked me again. The CDC had very good ties with Somalia because it was the last country that had smallpox and there was a guy there in particular named Abullahi Deria who had been instrumental in the Somalia effort to control smallpox and he had friends -- Bill Fagee notably -- at the CDC. And they asked me if I would head a team going out to Somalia. And by that time I had things in Michigan under better control and I was happy to do that. So, I went out to Somalia for about three months we organized things with the ministry of health. Now I really had the benefit of much more experience than I did the first time I had done this and we did a pretty darn good job. Some people came over who I met who were excellent. We had a number of EIS officers and we did a really good job there organizing what was called the refugee health unit at the ministry of health in Somalia. And was actually the first time that we were able to undertake a series of fairly decent epidemiological studies that enabled us to define and describe the kinds of problems that refugees face when they are settled in refugee camps as at that time was so often the case. With other colleagues here and people that we brought in here afterwards we really kind of developed the epidemiology of refugee health and that's - did that for a long time. After EIS I'd gone to Somalia two or three times 00:40:14 EIS. Then there was - I applied for a position here in what was called the international health program office and I was accepted into that and I came down to Atlanta to work. But there was a reduction in force in the public health service so they shipped me out to Somalia again and I was there for another six months and we developed primary health care programs and so on and so forth. But the point is that I basically stayed connected to the CDC here for about five years in the international health program office. Eventually I became a division director in that office. Stan Foster was - there were three divisions. Stan Foster was the other division director on the country support side and I was the head of the technical support division. We were implementing a program called Combating Childhood Communicable Diseases in fourteen African countries, a programs funded by USAID so I was traveling all over the place doing a variety of stuff. Before taking the division director job I had been posted as an epidemiologist in Africa so I was in Abidjan, Ivory Coast for three years for the CDC as a regional epidemiologist in the context of this combating childhood communicable diseases or Triple C D Program as it was called. Interestingly there were three of us in Africa, three regional epidemiologists. Myself, there were two people during that time in then Zaire and then in Malawi David Hamen was posted who had also been in smallpox in India in west Bengal at the same time that I had been in Bangladesh. So we were pretty close friends and we still are to this day. After that I stayed here until about - I don't know - eighty eight, eighty nine, something like that and then I moved to Geneva to WHO and became eventually the head of cholera program there but continued doing refugee work. So, I served in a - I was asked to coordinate humanitarian assistance for CDC. I was still at CDC. During the Gulf War I was in northern Iraq and Turkey and then continued to work in these humanitarian crises. I was seconded by CDC to the UN to coordinate infectious disease control policy in Zaire after the Rwanda genocide in Goma and just continued on. And I had - eventually I built up a reputation here of getting very creative assignments and in nineteen ninety four still on a CDC billet, I was actually assigned to the private sector to a company called John Snow Incorporated that is a contractor to USAID. And they had a very large child health program, a hundred and twenty five million dollar program called BASICS and I was the technical director of that for a while. And then still on a CDC billet I did that for about five years and then I was asked to start this program at the Mailman School of Public Health of Columbia. It was called the - it is called still the program on forced migration and health. And then I eventually retired from CDC although I'm still - well now I'm working for USAID on pandemic preparedness. So yeah that initial experience not only exposed me to public health but also exposed me to the CDC where I've spent the better part of my career doing different things all directly involved in global health. And so I'm really grateful to have had that experience because while I was in medical school what I was entertaining most was becoming a thoracic surgeon which sort of would have taken me in a different direction all together. Elisa: A very different direction. Ron: Yeah. Elisa: Well, thank you so much for sharing your experience. It sounds like experience with smallpox in Bangladesh certainly started off a very long and rewarding career in public health. And in closing I just want to ask if there is anything else you would like to share, anything I didn't touch on that you would like to add to our discussion? Ron: I guess the only thing that I would say in regards to smallpox eradication, it's really taught me a lot about programming and I think that different people have different thoughts about not so much smallpox eradication which everyone accepts has having been an inordinately successful program. But you know it spawned a number of other programs I think we need to learn from the smallpox experience both the things that were good about it but also the potential pitfalls that a program like this created because it really was a big employment industry if you will, smallpox. It went in and it really took control of a lot of ministries of health in a lot of poor and developing countries. And all of the other programs that were going on in a country like Bangladesh or like India, I won't say all I don't want to exaggerate, but this really cut the legs out from a lot of other programs because we took the personnel, we had the resources, we had the action and we really set the agenda in a lot of these countries. And I think we have to learn from that because from smallpox you've had a lot of other things happening. One thing led to obviously the guinea worm eradication program, the polio eradication programs, soon there will be a measles eradication program. And I think we have to learn that the most important thing that's come out of my experiences and my career for me is that people have a right to access health care for whatever their needs might be. And we have to make sure when we're undertaking these very singularly focused programs that we're doing it in a way that strengthens rather than weakens health systems in poorer countries where people can still go to a public health facility near where they live and make claims on that facility to meet their current health needs. Not everybody is going to require smallpox services. We should make sure that when these other programs are being implemented and they're all good programs, that they're not cutting the legs out from under malaria control programs or diarrhea control programs or pneumonia programs or whatever else it might be. Those things that are so important to people's health and their ability to survive and towards meeting the overarching millennium development goals that have been set for all of us working in public health. Elisa: Okay. Thank you again for sharing with us and we appreciate it. Ron: Thanks. </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/bi_KyDH9Qks" frameborder="0" allowfullscreen></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource interviews motion pictures moving image Date A point or period of time associated with an event in the lifecycle of the resource 2008-07-11 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16rv5 emory:16rv5 Format The file format, physical medium, or dimensions of the resource 10340160000 bytes video/x-dv Creator An entity primarily responsible for making the resource McNatt, Kellie (Interviewer); Emory; Student Waldman, Ronald (Interviewee); WHO; Epidemiologist Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of Southeast Asia and East Africa Smallpox Workers (2008 : Atlanta, Georgia) Title A name given to the resource WALDMAN, RONALD J. Description An account of the resource Dr. Ron Waldman describes experiences in the Peace Corps working with the Smallpox Eradication Program in Bangladesh during 1974-1975 Subject The topic of the resource Language A language of the resource English https://www.globalhealthchronicles.org/files/original/363d193ed536cb7836b61897f0a6c8ca.jpg 30104dee25ce624dad29f9c8a5729104 https://www.globalhealthchronicles.org/files/original/df674b895b797ba76665c753c25d89f0.pdf 7ed6a30202a54ab0c63e89057679dbc7 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> Interview 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] </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/iChsdh1PVag" frameborder="0" allowfullscreen></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource interviews motion pictures moving image Date A point or period of time associated with an event in the lifecycle of the resource 2008-04-02 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16rsw emory:16rsw Subject The topic of the resource WHO CDC CDC Smallpox Eradication USAID Smallpox Eradication Format The file format, physical medium, or dimensions of the resource 4897200000 bytes video/x-dv Creator An entity primarily responsible for making the resource Crippen, Peter (Interviewee) Unknown Interviewer, (Interviewer 1) Dr. David Sencer, (Interviewer 2) Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of Southeast Asia and East Africa Smallpox Workers (2008 : Atlanta, Georgia) Title A name given to the resource CRIPPEN, PETER Description An account of the resource 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. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/189c6990eb95656e8ffa65d0f8bb8ee1.jpg fc484870df069fb62562aa7cae6e7ba4 https://www.globalhealthchronicles.org/files/original/03c080dab62178c653cac747f195f221.pdf 8b86e28aa2301d6f1ecb3e5fcd68ad68 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> Interview Dr. Mary Guinan | with Interviewer Melissa McSwigan Transcribed: January 28 2009 | Duration 0:54:36 Melissa McSwigan: This is an interview with Mary Guinan on July10, 2008 at the Centers for Disease Control and Prevention in Atlanta, Georgia, about her involvement with the Smallpox Eradication Program. The interview is being conducted as part of our reunion, marking the 40th anniversary of the program in Asia and East Africa. The interviewer is Melissa McSwigan. Now, with this interview, we are hoping to capture for future generations the memories of participants and their families involved in eradicating smallpox from Asia and East Africa. 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. So you sign the legal agreement which says that you were donating the oral history to the U.S. Federal Government and it will be in the public domain. You will have a chance to edit the transcribed interview and add or delete information as you see fit before it is made public. So at this point, I'm going to ask you to state your full name and that you know the interview is being recorded. Mary Guinan: I'm Mary Guinan and I know this interview is being recorded. Melissa McSwigan: Okay perfect. Could you maybe start out by talking about how your education and upbringing led you into working in Public Health? Mary Guinan: Well-I'm not sure how my education and upbringing brought me into Public Health, but I'll tell you how I decided that I wanted to be part of the Smallpox Eradication Program. I was born in New York City, a child of immigrants. My parents were immigrants from Ireland. They were farmers. They had maybe three years of education, 3rd Grade education level and they came to follow the American dream. There were lots of political persecutions in Ireland and they were - and it wasn't a good time. So they met on a ship coming here. Neither of them knew anyone here in America and they established a presence in New York. My dad worked with the Subway, the New York City Subway System. My mom had a job as a dressmaker I think first, and then she was working in a house as an Assistant to the Chef, in a house in New York. Many Irish women came to America worked as servants or assistants with large wealthy families and that's what my mother did; and they eventually got married years later - five years later. The Irish were very slow at this. I grew up in New York City and they believed in education. They believed that that was the way to move ahead and they loved this country because of its freedom and lack of persecution for your political views and they were very, very - they were very loyal Americans and felt that this was really an important place to be and that we should be grateful-I was the middle of five children- we should be grateful for being born in this country and for exactly what we had available to us. So when I was a young teenager my dad died very suddenly and my mother had no means of support and we all got jobs to work our way through school; and I worked my way through school and graduated from high school. I worked my way through college. I wanted to be a physician, but women weren't being admitted to medical school then; and also, one of the criteria for medical school was that you had to have money to pay for it; and there weren't scholarships available or other things available to students like me who really didn't have the means to do that. So I decided then that I would pursue other things. I majored in Chemistry in college and when I graduated, I couldn't get a job because they didn't hire woman Chemists. So I was interested in - I got a job in a Chewing Gum Factory... Melissa McSwigan: Really! Mary Guinan: ...making chewing gum. It was the American Chicle Company and they made Chiclets and all sorts of chewing gum. Black Jack chewing gum was one of them and I was the Flavor Chemist. I was hired as a Flavor Chemist so part of my job was making new flavors, developing new flavors of chewing gum. It was not terribly rewarding kind of existence, but there wasn't really much available for women then and I try to look for fellowships and I applied to many schools, to graduate school, and I was rejected mostly because I was a woman; and if I was accepted, I couldn't get a fellowship program because they didn't give them to women at that time. But at the time the Space Program was in full bloom and with Sputnik, President Kennedy had said we wanted to be on the moon; that we were going to the moon; and there were lots of became-available fellowships for scientists. They wanted scientists to be in the Space Program and I've decided that I wanted to be an astronaut. So I found out that the University of Texas was where the Space Program was, near NASA in Texas, Clear Lake City, but the University of Texas Medical Branch in Texas had a program for scientist in Aerospace Medicine and that the Director of the Medical Program, Chuck Berry - Dr. Chuck Berry, had an appointment at the University of Texas there. So I applied there to get my PhD in Physiology and Space Medicine and I wanted to be an astronaut. Of course I didn't tell anybody then that I wanted to be an astronaut because women didn't do those sorts of things. So I went to Texas and people in New York said: You won't last there-about six months. You know you're a New York person born and brought up in New York. But I did, I lasted four years and I went to NASA. I applied - all of my class in physiology and space medicine there at the University took a test for the Astronaut Program and I was the only woman who took it and I was the only one who passed the test. The reason I passed the test was I had 20/20 vision; and all the other people wore glasses. I mean that - and you also had to fit into the capsule. It was like the old days of being a flight attendant, you had to be a certain height and weight and not wear glasses. But I knew that it was unlikely that I was going to be an astronaut, that there was a great deal of competition for it. So I finished my - but I got to see all the astronauts, I took classes at NASA. The astronauts, you know like John Glenn and Neil Armstrong gave classes and talked about their experiences in space. It was really exciting; I was really excited as a Scientist; and I did a post doctoral fellowship; I got a Post Doctoral Fellowship at the National Institutes of Health in Bethesda, Maryland; and it was during the Vietnam War and I actually had gotten a place that was for a man who had been drafted. So I filled in and I knew that I wouldn't really be there very long because they saved the places for men who had been drafted and had gone to war; and it was very difficult for me to get a job at NIH because I didn't have an MD degree, and my mentor there at NIH said to me, "It would be so easy to get you a job if you had an MD." You know, this is always the case, you know, if you just did this, you know, we could get you a job. So I applied to two medical schools. Since I was living in Maryland, I applied to the University of Maryland to Johns Hopkins; and I got rejected from the University of Maryland and accepted at Johns Hopkins which tells you something about the crazy system we have about being accepted into medical school. I was very grateful because I was sort of an alternative student. I didn't go from college to medical school. I had done this detour and had been in Texas which most people think: What in God's name did you go to Texas for? In Texas, people said, "What is this New York girl doing in Texas?" So I think one of the presumption was I try and find a rich husband, you know, a Texas oil man or something and that was the assumption-there weren't very many women doing graduate work. So I went to medical school and I graduated from Johns Hopkins in 1972 and during that time period, I was continuing my career, I had done my PhD, my doctorate in physiology in the area of blood coagulation and I was wanting to continue my career and be a hematologist, oncologist, and go in academic medicine. That's what I thought I would want to do. Never thought about public health, didn't really know about public health. I went to medical school at Johns Hopkins where one of the premiere Public Health Schools in the nation is, and took courses but really had no interest in public health at that time. But I was interested in tropical medicine and I did a tropical medicine fellowship in Mexico during my senior year at Hopkins and was interested in tropical medicine. Then, as I was graduating, this was the end of the 60's and beginning of the 70's and what happened during my last year of medical school really changed my life, in that what happened was Kent State happened. People were killed for demonstrating. This is a free country, our Government. The United States Government, which I was very proud of being an American and was very, very upset about what happened in the anti-war demonstrations that went on; and then these students in Kent State were killed, unarmed students, by the National Guards that had been even called out. People killed and I thought: What has happed to this country that I live in? How can this be-that we're living in this country where they're killing unarmed demonstrators? Our whole history of our country was revolution and fighting for freedom and doing what we thought was right. So what happened was I decided I wasn't sure what I was going to do and so in my senior year I read in this magazine, sort of like a magazine at Hopkins about the Smallpox Eradication Program. That there was this idea to eradicate smallpox in the world and I thought, "Isn't that wonderful? What a great idea that we could eliminate a scourge. It would be the first time in history that by the design of man or woman, there would be a human disease eliminated from the world and smallpox, a very frightening disease." But you know, I just thought that, "Isn't that a wonderful idea?" I didn't really think about it much. Then after that Kent State and I started doing my internship in Internal Medicine with the idea that I would go on to be a hematologist and do a fellowship in hematology, oncology; and as I was going, during my senior of medical school, I was on the clinical service with someone who was going to be an EIS Officer at the CDC. I had no idea what an EIS Officer was and he told me that it was the Epidemic Intelligence Service at CDC. I said, "What's that?" He said it was a two-year program and you go there and you learn how to be an epidemiologist, which I really didn't have any interest in. Then I saw this other article in the Hopkins Journal Magazine. You know, they have an internal magazine, about this Smallpox Eradication Program worldwide, and how our Government was participating in it, our Government. So I thought, "Wouldn't that be wonderful to be part of a Government Program that was really doing something wonderful?" Then I found out that the people who were going were being assigned from CDC, so you had to come to CDC and somehow get a job at CDC and then you could be assigned to the Smallpox Eradication Program. So I talked to my friend at Hopkins about this program and he said, "Yes, it's EIS Officers who were going over there on the Smallpox Eradication Program." So I applied to the EIS Program and in 1973 I guess, I was accepted; and I came to interview and I was the only woman physician in my class that was accepted, and during that time, when you are hired at CDC you are hired in the commission core of the public health service which was an alternative to military service and the draft was still ongoing. So people would say, "We're not accepting women here because if we do, another guy has to go to Vietnam. So we're not accepting women." During the interview I was told this when I came to CDC for the interview. So I wasn't sure that I would be accepted, but I was. I don't know why, but I was. I was accepted into the program and so I came as an EIS Officer. I was assigned to hospital infections that's in bacterial diseases then and I would go - we used to have a Tuesday morning seminar in Auditorium-B every week for all the EIS Officers and we'd attend this meeting and there'd be announcements at the beginning and every time somebody from the smallpox program would go up and say, "We are looking for volunteers for the Smallpox Eradication Program." You know it was a three or four-month assignment in India now was the part; and I applied to go and they told me, they were not taking women. Now, Indira Gandhi was the Prime Minister of India so it's like to say, "Well, how is it possible?" That was the first round and then each week, you know, they'd have somebody and finally, Phil Brachman was head of the EIS Program and I said, "You know, I keep volunteering and I keep getting turned down, but I don't know why. Can you tell me what the criteria are?" So I think they thought I might make a fuss because I actually had made a little bit of a fuss although I didn't think it was a big deal, but everybody else thought it was a big deal. When I applied to the EIS, I was accepted, but we had to get three references from physicians who knew us, and they sent me the reference sheets that had to be completed and it was: "Will you please rate this candidate on his background on his - whatever he does and is he a leader? Is he going to..." You know, there wasn't a parenthesis with "she" and so I sent back the forms, I said, "I'm sorry. I'm a woman. Do you have forms for women?" and apparently that caused some issues here at CDC before I arrived, so they figured, "Oh, oh-this is trouble coming." They wrote back and said, "We do not discriminate, but we don't have any female forms." So, they crossed out the "he" and put "her" and "she" in the appropriate spots. So when I came, I think that there was an idea that maybe - feminism was just sort of coming into existence. It really didn't exist until later; it was funny. So there was this worry I think so finally, they said, "You're going. You're going to India." So I went in December of '74 through early May of '75. Melissa McSwigan: Okay. So that was about six months that you were in India? Mary Guinan: Probably less-somewhere in there. Melissa McSwigan: And what was your exact role while you were in India? Mary Guinan: What our roles were was that we would be assigned to a district, some district area that - and you did surveillance for smallpox, looked for smallpox cases and then if you found one, you quarantine the case and then surrounded it with a ring of immunity in a five or 10-mile radius around because smallpox spread locally; and this have been demonstrated in India, actually Bill Foege who really was a person who worked this out and really is probably one of the people responsible for the eradication of smallpox. Because he was in Africa and he probably told the story and you've heard it, but they would have a shortage of vaccine and they tried to figure out how to use it appropriately and they theorized that smallpox spread locally. So what you need to do is to surround the populate of the infected person with a ring of immunity and then it won't spread because it only spreads from person to person. There's no environmental reservoir for smallpox. Humans were the only source of smallpox; so you would find that - that was funny. Anyway that's what we had to do and we would be assigned. When I arrived at my destination, we first went to Geneva. On our first assignment, we'd go to Geneva and we met all the people who were being assigned; and I went with Walter Einstein from CDC who you probably will be interviewing too. He and I were both from New York City and we were assigned together to Uttar Pradesh; and then we were assigned to go to Uttar Pradesh. So we were in Geneva and then we were sent to Uttar Pradesh and there were still smallpox in Uttar Pradesh. There were two provinces in India, Uttar Pradesh and Bihar that still had smallpox. So it was like a competition between Bihar and Uttar Pradesh; who would come first down to smallpox zero? What we'd do is, we would go out into the field; we would go and do surveillance. You were assigned a driver and a paramedical assistant and then you were given all these traveler's checks like in Rupees because you had to hire people, and you had to pay them. Then I would go to the bank and cash these checks so I'd have lots of money to pay people to immunize. You had to get vaccinators. You had to get people to work for you. I didn't realize what the whole system was in India, but since my driver and paramedical assistant had been working, and my paramedical assistant was Shaffy[0:22:56] Mohamed, he was a Muslim, and my driver was a Hindu, and they spoke different languages actually. Shaffy spoke English perfectly, but his native language is Urdu not Hindi, so that we had this three way thing going on trying to communicate with Urdu, Hindi and English. I didn't speak any of either, but I learned to read the Hindi symbols so I could read the road signs and they were very small - rarely was there a road sign, but if there were, the driver couldn't read, so I would phonetically sound the symbols so I could tell which way the direction was pointing. I would say, "Kahnpour[inaudible 23:44]; that way, okay this is where we want to go." The paramedical assistant acted as your interpreter, your cook. To find a place to stay, we were issued Tenson[0:24:10] sleeping bags and these mattresses. You know, thinking about India, I thought it would be very hot and didn't bring any warm clothes, but Uttar Pradesh is up North near Nepal and it got very cold. It was three degrees (3º) centigrade when I arrived at the Delhi airport and it was cold. So I had made a quilt, so I would wrap it around me because I didn't have any warm clothes. We would go out and we would offer a reward; we'd go like to a village and the paramedical assistant would get up and say to the villagers, they had never seen a foreigner before so I was a great source of interest to people like: look at me, this is incredible.. This is an area of Uttar Pradesh which was 99% illiterate. They had never seen a foreigner before nor heard of America; and very often if we went to a Muslim village the women wanted me to come into their house because they didn't come out; they lived in - it was a part of their practice. So they always wanted me to come in to their house, their little mud hut, but they wouldn't allow my paramedical assistant in because he was a man, so I would go in there and we would do sign language. They couldn't understand; you know: Where were my babies? What was I doing there? I soon found out everybody - most of the women were pregnant, they had babies every year and while I was there, there were several babies that were named America because they heard this word America. They had no idea, they didn't have a concept of another language or another place; and if they asked my paramedical assistant where I was from, he'd say, "Oh, she's from the capital, Lucknow" Because they had no concept of another country and languages but they couldn't understand why I couldn't understand them. So it was that interesting. We would go to the village and we had these picture postcards that showed cases of smallpox and we would say, "Ten Rupees to anyone who can show me a case of smallpox" and it was increasingly - 10 Rupees was a lot of money then for the average person. So if there was smallpox in the village they would bring you to the person. Very often it was chickenpox, not smallpox; or something else. It wasn't smallpox; and you were supposed to be the expert, not having ever seen a case of smallpox, it was like strange to think that you were going to be the expert and tell whether this was smallpox or chickenpox. Of course we were taught at all of these training sessions how to do it. So we heard about a report of smallpox in a village that was supposed to be free of smallpox. So I was sent there out of my district, my district was Kanpur, but this was outside of my district, a place called Rampur Madras. So I went there and I looked at the case and it sure looked like smallpox to me; and at that time we took a culture of the lesions and put them in a little vial and a mailing case. Then I mailed it off to Delhi and they would either confirm, because they wanted to culture every case to see if it was really a case; but it would take weeks and weeks before the results came back. I declared it as smallpox and so we started our immunization. There were vaccinators who actually worked in all the villages. There's this infrastructure in India where they have these people who are vaccinators; and they could be hired. So my paramedical assistant would just let out the word and people would come and want to work for you because we paid very well. So what we would do, we would pay the people's family to be guards at the door. This is a mud hut in these villages and then we would pay a family member to be the guard at the door and the only people - they'd have to vaccinate them. Anybody who went in or out of the house had to be vaccinated. Melissa McSwigan: So this is the door of the house where the smallpox patient was? Mary Guinan: Yes, the smallpox case. So here's the case: this was a young man and nobody knew where he'd gotten smallpox from and he was a Brahman. The Caste System was a part of what was happening in India at the time although it was banned, it was outlawed, it was pretty much the practice. Everybody recognized - when you went into a village the first thing people asked was what Caste you were; and since I was an outsider, they weren't quite sure how to treat me, and so the Brahman didn't want me to touch him. You see this young man, they are Brahmans; but I interviewed him to try to find out where he got smallpox because he had to have gotten it from another person, and where he had traveled; and it turned out that he had travelled to a village somewhere, I'm not sure where; where he had received the services of a prostitute for his inauguration into his, you know, Right of Passage, but of course, this was not something that anybody could know about. Melissa McSwigan: Right. Mary Guinan: And it was not something that I would be able to track. You know, to find out that case. In fact, they were very vague about where the village was and how it was. So we just decided then to employ a member of the family, it was a father, to be at the door and then we paid a vaccinator to stay there to vaccinate. We paid the parents money to keep the person in the house-keep the young boy in the house and to get food so he wouldn't come out until we declared him to be non-infectious. So we went about, and I found out that when we go to the villages surrounding it, we didn't have maps, it wasn't like you'd say, "Okay let's draw a five-mile radius around this and try and find some maps to figure out what the radius was or how you could do this." So, we got these rather rudimentary maps and we started going to the villages to try to vaccinate. We found out when people would come - we had a jeep, they were Mahindra &amp; Mahindra jeeps I think is the name of them, and they were provided by the Indian Government, the jeeps; and when the jeeps came and the only time the villagers ever saw a jeep come in was when the Family Planning person came and there was a big initiative in India at that time to reduce the population and to introduce birth control, and they used to pay the men to have a vasectomy, gave them a portable radio was one of the gifts that the men would get. Melissa McSwigan: Mmh! Mary Guinan: And then were these - the Family Planning people had told us that they had to meet every month. They had to have so many vasectomies and so many tubal ligations and they were not terribly receptive people so they saw this jeep coming and they thought it was the Family Planning people and they all ran away. So nobody would be there. So we said, "We couldn't find anybody to vaccinate, everybody disappeared." In India, you know, people would disappear and then reappear; it was so incredible the number of people; when you go to India, all you see is people everywhere. There's never any privacy. You go out, you're on this road and you're there in this wheat growing and things, this farm area and you go, and if something happened, if you broke down, my driver would just shout out, and all of a sudden people would appear and they'd come out of the fields, there were people everywhere. They'd sleep in the fields, they were there, but you know, with the heat they'd be hiding in the shade. So the whole idea of us being Family Planning people caused problems for us to be able to do the immunization. So what we decided to do was to do a survey of the town, to get all the names, and this was something that we understood what the people used to do that gave - what the politicians used to do to give resources to a town or village. They would take a census of the village, and the village then - and then take the census of everybody who lived in each house in the village and maybe there were 50 or 60 or 70 houses in the village or less, and there usually would be sometimes 10 or 15 people living in that one room mud hut. So we would just go in and say we're doing a census; and we'd go to the village Elder and talk to him and tell him first that we were going to do the census; and then we would tell him after we did the census when we had all of the - then we would ask the Elder if we could vaccinate the village and why. If the elder agreed then, we could go and start the vaccination. So we would go, but we knew how many people were there. They would all sort of list all these children and you always knew that there was a child every year, so if you had a one-year-old that look like one, you would look for the baby somewhere underneath, hidden in blanket somewhere there was always a baby. So we would find a baby. It was just amazing, we would ask how old people were and they didn't know how old they were. That wasn't a concept to them, the children how old they were. So we would just guess at their ages, and then we would vaccinate them and vaccinate each village until we completed the circuit. Then I'd come back every once in a while to make sure that the guard was at the door. We had these surprise inspections because people didn't really understand what we were doing. They thought, you know: Okay, they're going to give me money for this, I'll do it, but then when I was out of sight, well maybe not understanding why they needed to keep this person inside, they might not, you know - So we would come back regularly to check every two or three days. Sometimes there wouldn't be the guard at the door and we say, "Okay, where is the guard?" and we had the guard and the vaccinator had a book in which he listed all the people he vaccinated so we'd know who were vaccinated. So that was my first start, and it was smallpox and then I kept finding more smallpox cases. Melissa McSwigan: So that was your first case, but there were more? Mary Guinan: That was my first case, and then as we went from village to village, I'd find another one and declare it then, I would culture the lesion and send it off to the post office and this is a big thing to do, to find a post office that would take this and send it off to Delhi. You'd never know if it would arrive there or not, because sometimes they didn't have stamps at the post office so you couldn't buy stamps and it was a complicated system that you had to try and figure out how to ensure that your specimen got sent. So I kept sending them off and then we kept moving around from village to village; and the person who was in-charge of Uttar Pradesh at the time of the Smallpox Eradication Program was Don Francis and he would come to visit. He came down to visit me about a month and two into it. I lived in a mud hut outside and my paramedical assistant would try and find some place for me to live, that would have a shelter; and sometimes we did and sometimes we didn't. It was very cold at night. But there were all sorts of things; there were rats around that really used to scare me. They'd come in and run around at night and the Indians always respected life. So they never killed anything. The Hindus didn't kill anything and so there would be rats. One morning, there was a rat in my purse and I told my driver there was a rat in my purse and he just opened the purse and let the rat out. Okay! So Don Francis came down to visit to see what we were doing because they wanted to make sure, you know I was new, of what you were really doing and actually, I was a woman and they weren't sure women could do those things at that time. So Don came down and he said, "Listen, this place was declared free of smallpox and you are sending off all these sample saying there's smallpox. Are you sure these are smallpox?" I said, "As sure as I can be. I certainly - all I can say is, to the best of my ability I call them smallpox." "Sure they weren't chickenpox?" "I think they were smallpox, it's a possibility that they were." He said, "Are you sure because you're causing a big sensation here. The leader, the Indian Public Health leader in the area was very upset because he had declared his districts free of smallpox and I was saying it wasn't. So that caused a little political problem. Anyway, it was miles and it would take them several hours to come to where I was, and they went back. Then as I moved toward the other villages that were infected in this area, we had difficulty crossing the rivers. There were three rivers - parts of a river that intersected the villages and each time I would have to cross the river; and it was too deep for the jeep to cross it, so I decided the first day we came to this I said, "I'm going to wigan[inaudible0:41:35] and wade across" because the water was the water is about up to here maybe at my waist, and we're going to wade across with the supplies and everybody would wade across. So I always wore pants because showing your legs is not something that the Hindu women or Muslim women do, so I had made a series of Muslim outfits like pants and a long shirt, a Kurta, I think it was called and that's what Muslim women wore. The Hindu women wore Saris, but the pants were much easier for me to work in and I always kept my head covered. I had very long hair then, it was a braid and I decided before I went to India that I would dye my hair black so I wouldn't look so conspicuous. Melissa McSwigan: Did that work? Mary Guinan: No. Well, you know, when the white roots started coming out, they thought I was going grey; and it got streaked as it went, and I'm pretty tall; so I was taller than what most people saw, so I stuck out in the crowd no matter what. So I decided to roll up my pants-now I tell you that showing legs isn't a good thing in India, and there was nobody around, but after I rolled up my pants and started going across the river, a big crowd came out and there was a huge crowd, and I had rolled up my pants and I'd walked and crossed to the other side to get the supplies over, the vaccine, needles and things. Then we went and did the thing and on return I realized that I'd caused some sensation so I just didn't roll my pants up, I just waded across and word travelled fast, who knows how, but it went to Delhi; and people were saying, "Oh, I heard you went to..." Once a month we would have this meeting and Bill Foege would - Bill Foege was the head of the Indian Smallpox Eradication at the time when I arrived, and he would come up from Delhi. He would go to each of the districts once a month, and he would come to Uttar Pradesh one day a week and then we would all come in from the field, there were number of us; and he was the first person that we would talk with, and we'd take showers, I mean I might not have showered in weeks and weeks. So you would stay at the hotel and meet friends, and they would tell you what was happening, and they'd show you how many cases of smallpox there were and how they were decreasing and how close we were to zero- coming to zero in India; and that UP was winning from Bihar. We were ahead of Bihar. So that was a monthly meeting and when I was coming into town, we would stop at the railroad station and I would know whether Bill Foege was there or not because Bill was very tall, he's 6'6", and they would always know when he came from the railroad station. He was here. So they'd tell me, "He's here." So I would know he was at the hotel. People would know you were with the smallpox program and they'd let to know, I mean, word would travel fast and anything I did was reported. People knew what I was doing and all. That was interesting, I didn't do that again. Melissa McSwigan: How would you - let me interrupt you for a second. How would you say that this experience that you had, the six months that you had in India, how would you say that affected your career after that? Mary Guinan: Well, I became a believer. I believed that this was the way to go. I decided that I was going to have a career in public health because it was so successful. I mean, I couldn't believe it, what you were doing and all the things you were doing and all the problems you were having, and you would come, and it's working. It's actually working, so you were reinvigorated to go out in the field and keep doing what you were doing because you can't really see the results and you often see the errors that are made and sometimes things slipped through the cracks, somebody didn't guard the patient, and did they possibly infect someone else and you had a whole trail of smallpox moving about. You're always worried about that, but it worked. So I decided to work in public health-that changed my life. Melissa McSwigan: Did you keep travelling after that? Did you go to other countries as well? Mary Guinan: Yes, I've been probably all over the world. I've been to Asia: Thailand and China, Japan; and Central and South America. I guess the only place I really haven't been is to Eastern Europe. So it was the - during that time it was the Cold War so there were lots of difficulties getting in and out of countries. But I came back and then I left CDC after my EIS program and then was recruited back to CDC, and then I worked at CDC for 20 years then retired. I was part of the First Aid Task Force so I was a trained Virologist and that's how my career evolved. Melissa McSwigan: It sounds like you faced a lot of challenges before you went for the Smallpox Eradication Campaign. Particularly, you've talked a lot about being a woman and how that presented some obstacles as far as getting into school and so on. Did you find that in this particular campaign that being a woman affected the work that you were doing? You talked a little bit about when Don Francis, I think you said, came to visit you, how they kind of doubted maybe your effectiveness? Mary Guinan: Well, they were worried. You know, as I would've been in Don's place. It turned out they were all smallpox. But I think it did affect the people - I think it helped me a lot. People were much more trusting of a woman than a man in that situation when I'd go into a village. Melissa McSwigan: That was as far as the Indians were concerned? Mary Guinan: Yeah, as far as the Indians were concerned. Because I was such a curiosity to them; and also, people helped me a lot. I told you about these rivers. We had problems traversing the rivers and the only way to get across was a boat, a camel or an elephant. So there were always camel drivers and we would just wait until a camel came along then I would rent the camel and then we'd get across; and how I got back from over the other side; we'd hope another camel would come or somebody would show up with a rowboat and would row us across. We'd pay them to take us across. So one day, while we're working in the village, this local Raja Saab they call him came, and he said, "What are you doing?" And I told him what we were doing and he said, "That's wonderful." He said, "Well, since you're having this difficulty, I have an elephant and I'm going to give you an elephant so you can have this elephant to go across the river." So I got this elephant. I mean elephants swim and their wonderful. Camels are nasty and they want to bite you. It's really difficult getting on a camel. They'd turn around and bite you; and the elephant, very sweet and there was a Mahout, an elephant driver, and he said to me, "When the elephant swims over this river, he will take you up in his trunk, so you won't get wet" I said, "No. No. I'm not doing that. I'll get wet-it's okay if I get wet." So when we would go across, he would take the Mahout. The elephant would take - it was a female, she would take the Mahout in her trunk and carry him over, and swim to the other side and then I'd go; and then we'd come back and then somehow somebody would call an elephant. The elephant would come and then take me back to the other side. Of courts Don Francis heard about this naturally, and he came saying he wants an elephant ride. He came down, he says, "I want my first ride." So he got an elephant ride. So I'm not sure, I think this man, because I was a woman, he thought I needed help in getting across and so, he gave me an elephant. I gave it back to him. I didn't take it home. Melissa McSwigan: That would be kind of hard to fit and you're carry- on luggage I'm sure. What would you say is the most memorable moment that you have from your time in India with the smallpox program, the memory that sticks out the most? Mary Guinan: Well the memory is - and the first is the cultural shock of going to a country where you don't know the morays and learning them it's a bit of a - it was one of those culture shocks that it would take years to adapt to, you take these small steps. But I think that the most exciting thing was that it worked and that these monthly meetings that we would go to, we would learn that it was working. It was just - and that whole idea that this is actually going to work. I mean, it's actually going to work was intoxicating. So that was the most wonderful thing about - and the thing I remember, it was effective. Melissa McSwigan: Well, is there anything else that you would like to add, to tell future public health professionals like myself about the time and the program and so on that you would like to share? Mary Guinan: I don't think so. I don't know what I'd say except, an opportunity like this where your Government was doing something and you have an opportunity for public service, it's just - I don't know that I got any better satisfaction of anything I've done in my lifetime, than feeling like I participated with so many other people from other nations to do something that improved people's lives and you had an opportunity, I mean it was a privilege to have that opportunity, so I feel that our government who was doing what I thought, such terrible things, but somewhere there was someone doing this wonderful thing. It was in these rickety old buildings at CDC that nobody ever heard of then, CDC wasn't in the spotlight, and all these Quonset[0:53:41] huts out in [inaudible 0:53:43], that's what people were living in. I mean this is CDC and it was these old Government buildings, but these people planned; imagine, they planned as well. They were part of the planning of this momentous event, and I feel very privileged to have been a part of it. So it was that sense of, I guess, if you have that opportunity to do something that's outside of anything you could possibly do as an individual, do as a team, then that will surely be one of the greatest satisfactions in your life. Melissa McSwigan: Well, thank you very much for your time and thank you for sharing your stories. Mary Guinan: Okay. [End of audio - 0:54:36] </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/nxg5wfuUAtE" frameborder="0" allowfullscreen></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource interviews motion pictures moving image Date A point or period of time associated with an event in the lifecycle of the resource 2008-07-10 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16rrr emory:16rrr Subject The topic of the resource WHO Smallpox Eradication CDC India Format The file format, physical medium, or dimensions of the resource 11782080000 bytes video/x-dv Creator An entity primarily responsible for making the resource McSwegin, Melissa (Interviewer) Guinan, Mary (Interviewee); Epidemiologist Contributor An entity responsible for making contributions to the resource Centers for Disease Control Title A name given to the resource GUINAN, MARY Description An account of the resource Dr. Mary Guinan describes her experiences as an epidemiologist in India in 1973. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/5886931fc3a8d668deb94810253b6946.jpg b003e03025e4df2a0b83f48b49651638 https://www.globalhealthchronicles.org/files/original/220e2a27fe5ca76edb23c2260a5fef66.pdf f241df0c4eed163ea5776e099e069586 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/sANYn6J6hh4" frameborder="0"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource interviews motion pictures Date A point or period of time associated with an event in the lifecycle of the resource July 12, 2008 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16rqm emory:16rqm Format The file format, physical medium, or dimensions of the resource 8188200000 bytes video/x-dv Creator An entity primarily responsible for making the resource Altman, Lawrence K. (Narrator)5th, Kenline, Carolyn (Interviewer); Emory SPH; Grad Student Contributor An entity responsible for making contributions to the resource Centers for Disease Control Title A name given to the resource ALTMAN, LAWRENCE K. Description An account of the resource As an EIS officer, Dr. Larry Altman was initially assigned to Upper Volta (now Burkina Faso) to follow the field trials for the measles immunization program, which eventually became the smallpox eradication effort in West Africa. After completing his training in internal medicine, he joined The New York Times as a medical correspondent. He wrote about the end of smallpox after the eradication program had progressed to the last cases in India and Bangladesh. Subject The topic of the resource Smallpox Eradication Program India MOH Language A language of the resource English https://www.globalhealthchronicles.org/files/original/a14efb4876e19798ed4188337823e916.JPG 135e6ef2baee7c0adf478b944437aaf3 https://www.globalhealthchronicles.org/files/original/2004fffab008be1051279b90bc2a4356.pdf 99ab9a0ed4c6bcf117145ae31a0fad4c Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> Conversation Dr. William Foege &amp; Dr. William Foege Transcribed: January 30, 2009 | Duration 0:41:22 A Conversation between Dr Mahendra Dutta &amp; Dr William Foege Introduction Today is the 9th of July, 2008. This is a taping as part of the Continuing Series of all Histories of Smallpox Eradication Program. Today Dr. William Foege and Dr. Mahendra Dutta are going to have a conversation. Both of them know that this is being taped and they've signed permission for us to tape and to use it in appropriate manners. Dr. William Foege: Okay. Mahendra, 30-plus years ago, we spent so much time together working on smallpox, but I never asked you, how did you happen to get into the program? Did you volunteer? Was this dictated? Dr.Mahendra Dutta: Yes, I did volunteer. I had returned from my training in Epidemiology for nearly 9 months back to the office where I worked with the Director General of Health Services and the campaign was being mounted and they needed more people to help in the campaign, and that's how I volunteered. Dr. William Foege: Ah, ah. So you did volunteer. Now, we've often talked about the top group of people. You, M.I.D Sharma, C.K Rao, Pidish, and so forth, an extraordinary team, but how did it happen that they came together, because I don't think you could have found a better group of people if you'd searched the world. How did that happen? Dr Mahendra Dutta: There was a continuous process of selection. People at the helm of affairs in the Ministry of Health, technocrats, were getting involved and those who could not perform they were quitting also. So ultimately the fittest survived. So that's how you saw them all together. Dr. William Foege: Ah! So this was evolution. Okay-Survival of the fittest. Now there was a person I was very fond of early on in the program who was running the program in Bihar. I totally missed the fact that he was extracting funds from us at an alarming rate. How did you pick that up and how did you handle it? Dr Mahendra Dutta: I got involved with the program in February when Dr. Dish[inaudible name0:02:49] asked me to visit and see how things are moving there because he was not comfortable. Dr. William Foege: This was February 1974? Dr Mahendra Dutta: February 1974, and in this visit, when I reached, I went to a district, Munger, there is a district by that name, where I spent a week seeing how things are happening. The reports we were receiving were that people do not accept vaccination; and when I went there I was surprised. Every morning we went to villages, we had a team of 20 people to vaccinate with us, and one after another village where we went, people were pleading to get vaccinated; and the stories that we got were: so many died in this village, people were really alarmed. They wanted vaccination, then the civil surgeon, the head of the health administration of the district was hostile to Dr. Sinha and he narrated me all those stories, how he is employing over and above the normal staff, some extra workers, and virtually paying them 1/5th or 1/6th of the money that they are supposed to get and the remaining is being pocketed. So this was corroborated by another colleague who had worked with me earlier who was my other class fellow in the public health training, and he corroborated that this is actually happening. I finally met the Health Commissioner at a very personal level in a club and told him. He said that this is no news to him. So then everybody knew-so I said then, "What to do." The gentleman said, "Well! I am not heading the health services. It is a technocrat there. He has to come. I am a bureaucrat. Then only, I will step in." It went on like this, till fortunately, let me say, may be you are aware, in 1974 May, there was a nuclear explosion in India. Dr. William Foege: I remember that! Dr Mahendra Dutta: Pokharan, and after Pokhran, the Newsweek in its front page carried a report, "Another Explosion in India" and this was the smallpox explosion in Bihar, when you will recollect that in our May search, we discovered over 8,500 new outbreaks with 11,000 cases. So - Dr. William Foege: In one week, 11,000 cases - if I can just interject here - The previous Fall, D.A Henderson had asked me, "What's the largest number of cases you will find in any State in a week in India?" And we actually took this quite seriously, and we concluded that it would be less than1,000 cases. So we suggested that they use 3 digits for their computer programming. D.A- always suspicious of us; added 4 digits, and then we had to call and say, we've had 11,000-plus cases in one week, in one State, and so even the computers were not cooperating anymore. Okay, so go ahead - then May of 1974... Dr MahendraDutta: Yeah, then the stage came that the government of India and the State Government, they all got really startled because a lot of journalists who had come to Rajasthan to cover the nuclear explosion, they moved into Bihar and started reporting. Now at that point of time, we were asked by the Health Commissioner there who was the chief bureaucrat in the Health Service. Earlier he took the stand that the Technical Head should come to me but now he himself went to the political head and told him that this is the problem that they want the Program Manager Dr. Sinha to be moved out; and then he was - a substitute was selected by consensus. He was a very good person. Everybody felt that he was going to deliver, and he moved in and then things moved. So after that, we had very fast track movements on the program. Dr. William Foege: I want to come back to this, but this has always been an example to me of an outsider not able to see what was actually happening and an insider understanding immediately what was happening. What else did I miss? Dr Mahendra Dutta: Well, you didn't miss much because even in this case, I recall you were believing that smallpox will definitely go sooner or later. I wanted it to be sooner. Dr. William Foege: Yes, Dr Mahendra Dutta: That's about the only difference of you. Dr. William Foege: So the reporters came to India, they did their reporting on the nuclear test and now looking for other stories, suddenly this becomes a very good story. Smallpox is out of control and they have no background to know that this is partly due to the improvement of the program and surveillance was improving and there were a lot of people now on the problem, but it caused Parliament to make life miserable for you because everyday they were asking for explanations; and how important was that in diverting people from smallpox eradication to answering Parliament? Dr Mahendra Dutta: Well, the group of workers who were handling at the National level for the Parliament was only being fed by the peripheral workers. We were not disturbed much in the field. In fact, we were helped by this lot of reporters coming in and giving the stories. It was a helpful thing because the Government at that time asked us to request whatever we needed more and we increased our efforts far more then. Dr. William Foege: What was Karan Singh's, the Minister of Health, what was his approach to all of that bad news? Dr Mahendra Dutta: Oh! He was the real support. He recognized that the disease is being tackled in other States and it was only the problem of inactivity in Bihar, that's why they were lagging behind. So he himself visited later in Bihar and emphasized that we put in more efforts and things were already showing up, and very soon things will be completed. In fact, we recollect that he all along was a big moral support. Dr. William Foege: So, at the very top, you had all the support you needed. If you go down a layer, to the Director General of Health Services, to Dr. J.B Srivastav, what was his role at this time? Dr Mahendra Dutta: Unfortunately he belonged to the group of unbelievers. There were people, I believe in every country, who did not believe that Smallpox can be eradicated vis-à-vis the others. He belonged to the other group and he was always pessimistic about our claims of eradicating it very soon. So all I recollect is that I had a very good liaison with him and he, several times, enquired of me, "Is it real what you are reporting-so good a progress in so short a time?" So that was the main thing he would always accept when I say so and I recollect when later we were so close to the endpoint and we were going in for announcing a reward for a case. The minister was to make that announcement on July 1, 1974. He was asking, "Isn't it too early to make such an announcement?" And I said, "Well the amount of money and effort we are putting in each day, I shall be so happy that if I can have all the remaining few hundred cases discovered by this reward and it will save a lot of money and time." It was a matter of chance that not a single case was found and we didn't have to pay a single reward but Dr. Srivastav had apparently not been at the most peripheral level, in the field level; that is why he couldn't appreciate how thoroughly the things were happening. Dr. William Foege: How powerful was his pessimism in influencing the Minister of Health of Bihar when they wanted to change back to mass vaccination. Dr Mahendra Dutta: He came to Patna on the asking of the Minister of Health and addressed the civil surgeons and at this meeting he pleaded that the ultimate solution of the problem would be covering backlog of mass primary vaccinations; children who have never been vaccinated. Unfortunately, the minister took it very seriously and wrote to Dr. Karan Singh, the Indian Minister for Health that your Director General has requested that we should cover the backlog of primary vaccinations, children who have never been vaccinated. He asked for money; vaccine and bifurcated needles for vaccination to harness a new organization, the block level health staff to complete it. Because Dr. Srivastav said he is not against the firefighting efforts that are being carried out. So Dr. Srivastav's comments were sought about the statement that he made and I recollect that Dr. Srivastav was uncomfortable how to respond to it and he asked me, I had to go back from Patna and I said there is an anomaly. They too are saying the same thing; that first we bring the disease to zero level and thereafter we can concentrate on the backlog of primary vaccinations which we never needed there, probably; and it was completed without the backlog. Nobody needed it. Dr. William Foege: Now you talked about the believers and the unbelievers. Do you recall the day you became a believer? Dr Mahendra Dutta: I recall the day when the non-believers were shunted out. I was responsible myself. Several of my Indian colleagues who came to work in Bihar with me in the initial discussions, they belonged to that thinking, though they were working and I pleaded with them, if you don't believe, probably, morally, you should not agree to do it. Couple of them did go back instantly, because unless you have a conviction that you can achieve, then you are not doing it. Dr. William Foege: The National Institute of Communicable Diseases put a lot of effort into this program. Did they take great pride at it when it succeeded; and did it make a difference in the way the Government of India supported NICD. Dr Mahendra Dutta: Oh! Tremendously; I believe they are surviving on the laurels of achievement of smallpox even today. That's the biggest thing they did. Of course, they did a couple of other good things after that but smallpox is a feather in their cap. Dr. William Foege: There were very many foreign workers and often times coming for three months and then leaving, and that's the most difficult, to get people acclimated in 3 months to get some productive work out of them and then have them leave. What were, from your point of view, the biggest problems of having these foreign workers in India? Dr Mahendra Dutta: Well, I recollect when they landed in Patna, they volunteered, many of them came through CDC, and when they arrived in Patna, they were very enthusiastic in performing. At the same time, probably, they have never worked in a developing country before. So they were also apprehensive. What we did was that upon their arrival, besides the technical briefing, a sociologist was made to speak with them; and this session attracted them the most. They had so many things to ask the sociologist. Probably, this was the longest session in the briefing in Patna, three to four hours, and they were told about the communities in India, how they operate and how they live together. So that helped them to know quickly, in the filed, how to perform. I recollect that the work to be done was so much that many of them did long extended hours of the day in the field. From morning till late evening, and we were always telling them that in the summer months, you should not be out in the peak hours in the noon but they were defying it also in the enthusiasm that they must complete the work before they leave. Fortunately, some of them, and they were good, those some of them; they asked for extending their period of stay so that before they leave they could see things happening and I recollect at least, a couple of them, Steve Jones and David Hyman; they were later on moved to Bangladesh but they stayed for about five months in India. So that was their enthusiasm to show the results. The small mistake that happened in the beginning, a couple of them arrived with their better-halves and they couldn't perform because field conditions in India were not so conducive for their wives to stay alone; and they did not perform well in the field, and subsequently we had to advice that anybody coming here must come without their spouse. Dr. William Foege: So you worked them so hard maybe 90 days was as long as they could actually take. We wore them out. Have you ever thought pf what were the biggest mistakes that were made in the program. If you were doing it all over again, what would you avoid doing? Dr Mahendra Dutta: I don't see back, anything wrong, the only thing that for this short program, as I said, it lasted hardly an year or so, and there were other programs that suffered because everybody was occupied with this program, but we had to pursue with those programs. I recollect that Family Planning was our biggest competitor as a program, and time and again, the people in the family planning were disturbed but we had to tell them that ours was going to last a few more months, and later on we can join with you in the program. Dr. William Foege: That brings up the question; if the National Institute of Communicable Diseases took great pride in this, did Family Planning take pride in the contribution they made-because it was an enormous contribution? Dr Mahendra Dutta: Well, maybe that was only after April or sometime in 1975 that the Family Planning was given a top priority during the emergency era in India. Before that, they had certain target approach and that's why they were more eager to perform and let not their workers be diverted to help in smallpox. Because in the smallpox, we involved every month, for a week all health workers for the search and that's what was disturbing them but seeing the results, they also agreed that we are doing some job and let it be finished. Dr. William Foege: You mention that it was in truth a very short program, at the time it seemed to go on forever. But it only took us three months to sort of come up with the system, another four months to perfect the system and then, India went from the highest rates in May of 1974 to zero twelve months later. No place else in the world was the change so fast, so dramatic, it's amazing in retrospect to even look at that. But then you went on from India to work in Ethiopia. Compare the two programs. Dr Mahendra Dutta: Things were very different in Indian program. We did not have the difficult terrain working conditions in the field. In Ethiopia, the communications in the field was so difficult, and here I recollect when at the end phases, every case occurring in Bihar, I personally went to that village, I could reach in less than 24 hours. But this could not happen over there. They needed a much prolonged sustained effort, and I was part of it that was done from moving from one district to another so that you make one area free. There, the people also do not move so much as they do in India; because here in the Indian program, fortunately, when our efforts were at the peak that was the lean season for transmission. The disease was expected to come down with the onset of monsoons but our efforts were peaking up further. So that's how we could come over so soon. Because around October-November, when the rains cease and people started moving about again, we were left with very few cases; 150 odd villages where the disease was present, and I recollect later in July, we had some junior teams, mobile teams, we stationed a team in every outbreak and these young doctors who were coming as medical interns, they performed so well because they were all trained, they were all relied upon, they were amazed at what kind of faith we were placing upon them. I recollect those who were bearded Sikh gentlemen, when I met them in the field, they removed their beard; I have no time to wash every day; and those who didn't have the beard, they were having beard, I have no time to shave everyday. So those young people changed the whole complex. Then we introduced the strategy of guarding the case which was paying dividend that the case would not be allowed to spread the disease to another place, around the clock, 8 hour shifts, watch guards were placed, watch guard supervisor was placed. The family was compensated that they can't go out for work. So therefore we will pay rent for the house where our guards will stay; so all these strategies helped in achieving a very fast disappearance of the disease. Dr. William Foege: Its nice, 33 years after the last case, to hear you talk about it and still have the enthusiasm that you had 33 years ago. What is it though that you would like to tell to young public health workers that you've learned from this experience that you hope you can pass on. Dr Mahendra Dutta: All I could say in brief was that in public health, community approach, your conviction, your devotion and team effort, that's what matters the most. The entire team of workers national, international, higher, lower level functionaries, they all worked like a very close team; and that's what I can believe public health team-effort approach-is pride. Dr. William Foege: I agree with you. I think that's the lesson of smallpox in India; that the team worked as a unit. It was a coalition in truth, and people lost their national identities... Dr Mahendra Dutta: Absolutely, absolutely. Dr. William Foege: ...their personal identities and it seems as though we made decisions based on everyone agreeing, I can't remember that we ever took a vote or had really strong disagreements. So it seems to me that it was a coalition that was quite unique. Now, I worry that we have lost the words now of people like M.I.D Sharma. You talked to him a great deal after smallpox eradication and I don't know if you have any message that you would like to pass on from MID Sharma or Dr. Pidish, or some of the other people who we don't have a chance to question. Dr Mahendra Dutta: I was meeting them till/[while] they were alive, and my only understanding was that they felt that the success story of smallpox eradication was also an achievement which gave them satisfaction in their life, and the only thing which I felt they wanted the young generation to follow or emulate what they saw was, the same thing as I said earlier, that devoted efforts, team efforts always mattered in community health work. Dr. William Foege: Years later, I had lunch with Dr. Pidish and he said something similar, that it was quite different to be on an Indian team than to be on an international team working on an Indian problem, and he said to me at that time that, "If you come back to India, I will come out of retirement," we will do this again. Dr Mahendra Dutta: I would say the same. Working with you was a real pleasure. Dr. William Foege: Thank you. How did you get into public health though? Dr Mahendra Dutta: That was a very different story. My father was a Public Health Physician. Dr. William Foege: I know, the Rockefeller Foundation sponsored him. Dr Mahendra Dutta: Yes, he was a Rockefeller Fellow and right from when I graduated from the medical school, I made the choice that I am going to study in the School of Public Health. I didn't waste any time. Very next year, I joined the School of Public Health. Dr. William Foege: Where? Dr Mahendra Dutta: In Calcutta in India, and then pursued the career through married[inaudible0:28:34] life, and I have no regrets. Dr. William Foege: And what did you do after smallpox eradication? Dr Mahendra Dutta: Oh! After smallpox I worked with the Municipal Corporation of the City of Delhi. I was their Chief Health Officer for a few years. Dr. William Foege: Your father had done the same thing? Dr Mahendra Dutta: Oh, he'd done the same thing too, and then I was the Chief Epidemiologist of the NICD for a three-year period, and finally I was the Deputy Director General for the public health work in the Ministry of Health, and looking back I feel very happy that I worked in these positions and got a satisfaction. Dr. William Foege: But there is something genetic here also. Talk about your son. Dr Mahendra Dutta: Oh, he chose it himself, that he wants to also be a Public Health Physician. He came to the U.S. He was a bit disgusted about the policies of reservation for certain backward classes, and he said that he may not get the opportunity in India to work in the specific field where he wishes to work, and he will choose to go to public health work and go to U.S. for training. So I said, "If you wish to go, its up to you." So he is working here. Dr. William Foege: Three weeks ago, I was at my final meeting at the Rockefeller Foundation and I was asked to speak to the staff, and I said: when people ask me what the Rockefeller Foundation has done, I resist talking about the Green Revolution, or the Yellow Fever Vaccine, or the Hookworm Program; I said-I talk about the scholarships that they gave to people around the world, and I talked about your father getting one of those to study public health and that for three generations, this investment by the Rockefeller Foundation has continued to pay off. I mean, it's just a wonderful story. Dr Mahendra Dutta: Very nice of you to say that. My father has left behind his writings of life and he feels the same, that I received the training in public through the Rockefeller Program and I owed a lot to repay it, and I have repaid it because my son followed the same, my grandson followed the same. So that's the same way he thought. Dr. William Foege: In India, how do we improve the number of people going into public health? You've done it. You've found it to be a very enjoyable satisfying profession. How do we increase the number of people doing this? Dr Mahendra Dutta: It has been a dilemma for all the years but I don't know how, but things appear to be going haywire now. More and more people are interested in public health. It's a big change happening in recent years, and I recollect that four years ago, a Foundation with the collaboration from the Harvard University was established to raise Public Health Schools in India - establish new Schools of Public. Medical Research Council also following the same example, they are also supporting establishment of new schools of public health; and the young doctors are also getting more interested in pursuing Public Health as careers. Unfortunately, so far the Governmental System doesn't create more opportunities or caters for public health people. But I am sure there are two ways of doing it. One is that you train the people and there will be careers coming up, the other way is you create careers and then you find shortage and then people will be trained. So apparently we are going the other way round. People will get trained and opportunities will be created to meet those demands. Already several programs, National [inaudible0:33:06] Programs have started creating posts for public health physicians at district levels and lower. So that approach probably is going to be there. Dr. William Foege: I think we are seeing a renaissance of global health interest in recent years and I am just pleased that we both lived long enough to see what's going to be a great change in the future. Dr Mahendra Dutta: I wish too. Dr. William Foege: Are there stories or things that you want to say about the Smallpox Eradication Program because, you know, we may never get an opportunity like this again to talk about it. Are there things that you want to make sure that people hear? Dr Mahendra Dutta: We have said a lot but the only thing I'll add will be that in achieving success, besides technical things, there is also an element of administrative tact, I would call it; whether you say diplomacy in the modified terms but we, people in public health, should use this more often and after all you have to work with your own team, and also this is the team in our system: there is a bureaucracy, there is a political leadership. So you have to work along with them and carry them with you. Dr. William Foege: I hope to make that point at our reunion that behind every public health decision, there is a political decision... Dr Mahendra Dutta: True. Dr. William Foege: ...and that we end up trying to educate politicians but it's a very labor-intensive sort of thing to do because the politicians keep turning over; that they have a limited time in office and that I now miss no opportunity to try to get public health people to go into politics. It seems to be a shortcut, more efficient, if we can get more public health people to actually become politicians. Dr Mahendra Dutta: I wish it happens in my country too. At the moment, we are facing a dilemma because more and more politicians are coming from another group, the group which is rather not desirable but they are the people who flout laws and more and more of them are entering into politics. A separate stream has come. Formerly, most politicians were coming over from categories like rich people, business people, like accepted heads of the communities. Now some bad elements have started infiltrating into politics. Dr. William Foege: We are years ahead of you. Dr Mahendra Dutta: It is worrying, not me, but it is worrying the Indian Government itself; how to get rid of these elements in the politics. Anyway, it's not for me to too much comment on that. Dr. William Foege: But that seems to be a chronic problem in many countries. Let me ask you one final question and that is, the remarkable contribution made by TATA for the Smallpox Eradication Program where you had a private corporation agree to work under Government rules and to use the same approaches and so forth. It now has happened with other corporations, MURK with what they have done with River Blindness and Glaxo Smith-Kline with lymphatic psoriasis and so forth, but that was a very early example of what TATA did. Has this continued? Do you have private, public collaboration in health programs from that TATA experience? Dr Mahendra Dutta: All I would say is that per force, we had to go for that collaboration because the Southern Bihar lacked adequate infrastructure of health from the Government side and TATA has had a very good infrastructure in that region. They have their [inaudible0:37:35] and coal fields and factories all over- spread. Therefore we approached them and they readily agreed because they were working with the people there where it was benefitting. I have seen that now it has become a Governmental Policy in recent years to accept that kind of - because the medical care itself is going to the private sector more and more; and government is only obliged to deliver public health service to the community; the preventive medical care, and in these efforts, they know that we cannot invest so much, so they are seeking collaborations from non-governmental agencies including the private sector. Dr. William Foege: Well, this has been great fun to get together again after - we have done it before, but till now at 33 years to talk a little bit about this, and I will say this on Saturday, but I want to be sure that it gets recorded now. How wonderful it was to work with you, what a hard field worker you are, that you never shied away from doing anything that needed to be done in the field, and you were just the epitome of deliberate approaches to solving problems, rather than getting excited when things went wrong, you would sit down and ask how do we solve this problem and so it was great to work with you then, and it's great to hear you reminiscence now. Dr Mahendra Dutta: I am also pleased that I'd worked with you, and in fact I learnt also a lot of things, but basically, as I said, our team-approach was the most successful approach. Dr. William Foege: Great-good. Thank you. Question from Audience: May I ask one question? Did he play jokes on you? Dr Mahendra Dutta: He played rings because whenever he had nothing - rather, he had something in his brain lurking to solve, he would have a set of rings how to unfold them. But I don't think Bill was that kind of person. He was a serious person. The best thing I recollect is he was a very good assessor. He could assess how people are performing and that's what we got from him; his personal assessment of people who were coordinating, who could survive. Dr. William Foege: But the ring story reminds me of an absolutely true story; where we were going to a meeting where another person had absolutely different ideas than I did, and I knew that because we discussed it quite often; and it was a 2-day meeting. It was early in the first meeting when I took off my puzzle ring and let it fall apart, and I just said, "Oh could you put this back together? He had had a puzzle ring as a child and he said sure. He spent the next six hours on this puzzle ring. He even missed the discussion of the issue that I was worried about where he would bring up the other side. We were passed on other things before he realized that the puzzle ring had kept him occupied. *** Thank both of you. [End of audio] </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/pc6RzIlxjKg" frameborder="0" allowfullscreen></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource DUTTA M. WITH FOEGE W. Description An account of the resource A Conversation between Dr. Mahendra Dutta and Dr. William Foege, two of the key people in the smallpox eradication program in India. Dr. Mahendra Dutta, former New Delhi, India Health Commissioner Dr. William Foege, former CDC Director Source A related resource from which the described resource is derived The David J. Sencer CDC Museum at the U. S. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333 www.cdc.gov/museum Date A point or period of time associated with an event in the lifecycle of the resource July 10, 2008 Format The file format, physical medium, or dimensions of the resource 8928960000 bytes video/x-dv Language A language of the resource English Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16rk2 emory:16rk2 https://www.globalhealthchronicles.org/files/original/d9d3344841f7ee1e31cbf1119e18815e.jpg b119c483da7ce5e9c4aff054054e1608 https://www.globalhealthchronicles.org/files/original/b9b13dc7be656fa4160662dd5f22a075.pdf 9d00fbcda7d3d95f10ace91b05468fde Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> INTERVIEW Audio File: Dennis Olsen Audio File Transcribed: January 24, 2009 Melissa McSwegan: This is an interview with Dennis Olsen on July 11th, two thousand eight at the Centers for Disease Control and Prevention in Atlanta, Georgia about his role in the smallpox eradication campaign. The Melissa McSwegan is Melissa McSwegan. With this interview we're hoping to capture for future generations the memories of participants and their families involved in eradicating small pox. This is an incredibly important and historic achievement and we want to hear about your experience. I have some questions to guide you but please feel free to recount any special stories or anecdotes that you remember about events or people. The legal agreement you signed says that you are donating the oral history to the U.S. Federal government and it will be in the public domain. Now, for the record could you please state your name and that you know you are being recorded. Dennis Olsen: My name is Dennis G. Olsen and I know that I'm being recorded. Melissa McSwegan: Okay, great. Thank you. So to start out with could briefly describe your childhood, your college education and how that led into you working in public health? Dennis Olsen: Well, I grew up in Bend Oregon and all of my pre-college schooling there. Went off to the University of Oregon then for my college work and I can honestly say that none of that prepared me for a role in public health. My first inclination to be involved in public health was through the University of Oregon placement service where I met a CDC colleague E. J. Spike and I was recruited at the CDC and spent thirty two years with the organization. Melissa McSwegan: Okay. Well great. Well how did you then become involved with the smallpox eradication [inaudible 01.53]? Dennis Olsen: I was first recruited to come back to Atlanta out of my assignment in Los Angeles California to actually be involved with the early malaria eradication effort and as the politics of that were working their way through Washington and it was determined that what the plans had been were not going to come fruition, I was contacted to ask if I wanted to go to West Africa for smallpox eradication. Agreed to do that, got married to my lovely wife and off we went to the country of Liberia and spent three years there. After returning from that we knew then eventually that the Indian program was going on and made overtures to be one of the people who went to India for a three month assignment. At the conclusion of that and the enjoyment of that work and the colleagues from around the world and the imminent success of the program I asked if I could go back for a longer term and was - we were accepted and returned for a two year stint and that time I was named the WHO World Health Organization coordinator of the smallpox eradication effort in the state of Uttar Pradesh, a population of about one hundred and ten to one hundred and twenty million people. My role was to assure that the program policies were being carried out, searches were being conducted, that the international staff and the Indian domestic staff that were working on the effort had the resources that they needed to carry out the function, to do spot assessments of the work at the primary health care centers and/or hospitals. Handle largely also to be the banker and make sure all the funds were flowing in the right direction. A very enjoyable experience and I met a lot of interesting people. Besides Uttar Pradesh my wife and I went to Bangladesh for a three to four week period of time to assist in one of the major searches and quite possibly look at an assignment in Bangladesh that they were - they need an administrator and I'm a public health advisor and not a physician. We decided that we're - we appreciated more the Indian aspects of that project and returned to Lucknow and carried out those functions for another, I'm guessing now - six to seven months and then we were reassigned into Delhi in the regional office in order to be the senior administrator for the program for its duration in India and participated with the international commission to declare India smallpox free. So, quite an interesting period of time for us and we really enjoyed the work. Melissa McSwegan: Describe a little bit your relationship with your - with the host country counterparts in India and Bangladesh? Dennis Olsen: On the first assignment, the three month assignment, we were working directly with the - I was assigned to a city in Bihar state or a town called Bhagalpur along the Ganges and our immediate relationship was with the health officer of that town. And the people who had gone before of which there were at least two others possibly three, had developed a strong working relationship so my fitting into that was just a simple as it possibly could be. There was absolutely not difficulty at all. We could work and do what it was that was required, got support to the extent that it was available from the locals and of course a lot of support from Cyro in Delhi. So it was a very easy experience that way. And all of the people, staff for the most part at the primary health care centers had been heavily involved with the effort to eradicate smallpox and participated to the extent that their abilities allowed. There were those times when we had to do a little extra encouragement in some areas and so forth but we still had very strong support of the local health officer and the Indian government from Delhi. Those people made periodic visits to assure that these relationships were maintained and overcame any of the infrequent difficulties that approached. When I became the WHO coordinator in Uttar Pradesh then I worked directly with the Minister of Health for that state and the staff at the other levels in order to carry out the functions. Again these things went very smoothly because of the overall direction of the Indian government from Delhi and the support that they provided to the program and those relationships never got in the way of carrying out the function. That is why I think the program was successful to a large degree. Melissa McSwegan: What would you say would have been the biggest challenge while you were there? Dennis Olsen: That's a hard question. There were - the challenges of first of all motivating the population to report rash like illness. So many other things were impacting on the population. Of course we instituted a reward system, a financial reward system to help with that. The difficulties of just getting around in the country. Not all areas had a road network been established. Quite often those that were established were interrupted for flow of water to farm. Quite often where we had to go roads had never been established so just getting to investigate an outbreak, getting to it was difficult. Getting supplies sometime the area were difficult. Heat, surviving in certain areas was difficult but all of those things could be overcome. It just took a little bit longer to do things than one might have hoped for. Melissa McSwegan: And what do you think - you've talked a little bit about the relationships that you've had and other things that helped it to be very successful but what do you think were the greatest successes that you had during that time? Dennis Olsen: Well the great success was that smallpox eradicated and I think that also a success to show that through a combined effort and the cooperation you could - excuse me - tackle a difficult situation and have some success from it and therefore the encouragement to continue with whatever effort you were in. Quite often we were approached out in the hinterland if you will about doing something for other sets of problems that existed in the country. Something to do with water, something to do with sanitation, to go beyond our scope of work in smallpox eradication to add some assistance or input into these levels. And of course we would report these sorts of requests back through the system but I think our experience and our being on site and the success of the program probably led, I think there is evidence that it did lead to attention being paid to these sorts of circumstances and problems as well and having them attacked when resources and political support were provided. Melissa McSwegan: How did your family adapt to living abroad both in Africa or in India? Dennis Olsen: Well, my wife were together. We don't have children. We're still married so. My wife Carolyn actually was quite involved in the Indian program. Some of the things that I would make recommendations to the central offices in Delhi with technical graphs and so forth that had to do with demonstrating how you could show your project was moving in a certain direction or had these successes or these failures, Carolyn being an engineer and having these kinds of talents put these together. So - and she went with me on the searches out into the field and through her own oral history she'll tell you some very interesting stories from her side but I probably would not have made the full two years if she hadn't have been there. Melissa McSwegan: So, what was it like living in India beyond the working environment, just living in India and participating in the culture? Dennis Olsen: Well, I can tell you from my - I had already been to Africa with that program and so when I thought, not thought but had been accepted to go to India the African situation would prepare me and it was largely true. But I do remember getting off the plane in New Delhi and the heat and the just large numbers of people and the immediate difference with - just an overwhelming humanity kind of thing, I thought what in the world have I gotten myself into. And we had a few days of training in Delhi then we were set out into the field to be with colleagues that had already been in the country two to three months to gain some experience. And I met a good friend Ras Charter in Bareilly who showed me how to get the jeep stuck as soon as you could but did demonstrate how work was done in the field. And then I went off to my assignment and met another CDC person waiting for me in Bhagalpur, Dr. David Hayman who had been there for a couple of months and he was kind of a light yellow. He had hepatitis so I thought well if he can put up with that I can put up with whatever is here. But I - Bhagalpur was a small place in comparison to the capital of Bihar, Patna. Patna was a small place compared to Delhi and I guess the point of this story is when I got back to Delhi after three months it looked like a large European city that I can definitely survive in. That's when - with that successful three months I asked Dr. Henderson - D. A. Henderson - and Dr. Bill Fergie if it would be possible to come back to India for a longer period. And after that longer period both my wife and I asked again if there was some way to stay with an active program be it immunization, diarrheal disease control, malaria, whatever it is that we might do to remain in India because we enjoyed the experience so much. We met a lot of interesting people. The Das family Lucknow. We lived above their residence. The people that we rented from in New Delhi, people in the field, it was just a pleasurable two years. Melissa McSwegan: Have you maintained any of your relationships with people you met in India probably? Dennis Olsen: You know thirty years have passed and I'm not sure how many people are - but the answer to that, short answer to that is not from the Indian side although I understand I will be seeing - we will be seeing a Dr. Dada who was a senior person in the Ministry of Health. He's in town and I look forward to renewing that relationship. We have shared with our CDC colleagues and others over the years when reliving these experiences, honing our lives and things like that. Melissa McSwegan: What would you say are your most memorable moments from working with the smallpox campaign? Dennis Olsen: Oh my goodness. One was going out to the very first smallpox investigation in Bhagalpur with Dr. Hayman. We had to walk through the rice paddies and wade through a river and my shoes were not appropriate. I lost the nails off both big toes, had full foot blisters underneath the - on my bottoms of my feet. Had to have tea and sugar and salts to get the electrolytes up and rode out on a donkey. It was - thanks to Dr. Hayman. Other experiences, I have to take some time to reflect. The international commission we happened to be there at the end of our assignment when they actually the commission came and announced that smallpox was eradicated from India. That was so satisfying to have spent the time and then to actually be there at a moment when history had been made. That will certainly be hard to - I will never forget it. And the others I think were just the individual relationships we made with people. The staff in Lucknow from the secretary to the very important and very good friend paramedical assistant Rujinder Singh. It's just things like that that stick with you and if it ever could happen again would not hesitate at all to do it again. Melissa McSwegan: And how would you say working with this campaign has affected your life and career since then? Dennis Olsen: Well I don't have a career anymore. I retired in nineteen ninety four. Affected our lives is that we're extremely proud that we had the opportunity to do it. I like to think that we did it well and enjoy the relationships that we still have with people that went over and did these sorts of things and days like today when we're back to remember what we all went through. It wasn't always easy. I don't ever want to let people think that it was just all good times and success. We lived in very harsh conditions a lot of the time and we put ourselves in jeopardy many times but just the pride of having done it, the pride of success and listening just this morning to what's happening with global programs. We like to think that maybe we were in a small way part of what allowed these things that now happening to move forward and hopefully enjoy some of the success that we had. We did the pioneer work they live to say. Melissa McSwegan: At what point during the program while you were working on it, at what point did you know that smallpox would be eradicated? Dennis Olsen: The day they announced it. Melissa McSwegan: So you weren't convinced until then? Dennis Olsen: Well you know you always wait for the next person to come forward and say we have a report of rash like illness. And you might have gone for six or seven months or a year and think you know this is pretty much it, we're sort of wrapping so it can happen. When I left Liberia in the African program we were sure for a whole year that we had not smallpox, quite successful and then someone came down from upcountry and said we have a woman and child in the hospital with rash like illness that looks like smallpox. So, when I - my wife and I were just ready to leave the country. Our assignment was over and my replacement had arrived so the same thing could have happened in India. As it turned out the African issue was monkey pox not smallpox but once they made the announcement in India we had assurances after many, many searches that there was no illness, no smallpox. Of course the search went on for anther couple of years to continue to assure that. It really didn't end at that point. It was the point where we said that we had reached that particular part of the goal but we had to confirm it again. Melissa McSwegan: What were the important lessons that you learned from smallpox eradication that you then applied to other parts of your career afterwards? Dennis Olsen: Well, the career after that was some domestic program work in childhood immunizations, then international work in HIV Aids and some work with international immunizations, diarrhea disease control and malaria control. For the international things what was learned was how to deal in an international setting. What things had to be attended to, to allow the program to have some success in the relationships that you needed to develop with the host country. How important it was to assure that you had the proper logistics before you tried, got the plan established and the logistics to carry it out and the resources to carry it out. And the important, very important tools of assessment. Continuing to look to see where you were along the road to trying to achieve your objective. Not just assuming you were doing okay but actively making sure from tools to asses your program activities and a personal relationship skills were honed I think. How to make sure that you were for example whatever credit might be accruing that you made sure it was the local that got the recognition. We knew we were doing okay, we didn't need to be told. So those kinds of things. I think those are always helpful. They are the more mundane things about improving your writing skills and these sorts of things but I think I touched on the more important. Melissa McSwegan: Now you have spoken a lot about the successes of the program. If you had been the one running the entire program worldwide is there anything that you would have done differently, that you would have changed about it? Dennis Olsen: No, I don't think so. How can you fight with success? You know I never ever thought of myself having those kind of capabilities. When you work for someone like D.A. Henderson, Bill Fergie, those are the people that have those visions and skills and at that level it's just a happy occasion that we got to be able to be a part of it. I can't think of anything I would change. Melissa McSwegan: Well do you have anything else that you would like to add about your experience? Dennis Olsen: No, I think we've pretty much covered the territory. Melissa McSwegan: All right. Well, thank you very you much for your time and I appreciate you sharing with us your experience in India. Dennis Olsen: Thank you very much for doing this. </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/vMgriQjaR74" frameborder="0" allowfullscreen></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource interviews moving image Date A point or period of time associated with an event in the lifecycle of the resource 2008-07-11 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16rjx emory:16rjx Format The file format, physical medium, or dimensions of the resource 4643160000 bytes video/x-dv Creator An entity primarily responsible for making the resource McSwegin, Melissa (Interviewer) Olsen, Dennis (Interviewee) Contributor An entity responsible for making contributions to the resource Centers for Disease Control Title A name given to the resource OLSEN, DENNIS Description An account of the resource Dennis Olsen describes his experiences as a CDC Operations Officer and Manager in the Smallpox Eradication Program in India 1972-1974. <br />Interviewed by Melissa McSwegin. Subject The topic of the resource Smallpox Eradication WHO Language A language of the resource English