6 12 306 https://www.globalhealthchronicles.org/files/original/94064a975c98ca6ae1c40009d23fb30d.jpg a047267faf865fb0fadd45b781b195a0 https://www.globalhealthchronicles.org/files/original/b63c8295d352a11afbcfd628b03fb674.pdf c5abfeb38e9ae02ed968dcabe789e833 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> This is an interview with James W. Hicks about his activities in the West Africa Smallpox Eradication Project. The interview is being conducted at the Centers for Disease Control and Prevention in Atlanta, Georgia, on July 14, 2006. It is a part of the 40th anniversary reunion of the launching of the program. The interviewer is Victoria Harden. Harden: Mr. Hicks, you were born in Jacksonville, Florida, on January 17, 1930. Would you describe for me briefly your childhood and pre-college education in north Florida, and what it was like in the 1930s? Hicks: As a child, I grew up in the Depression years, and that had some differences when compared to a later period or today. We were poor, but we didn't know we were poor because everybody around us was no better off. It was a happy time in my life; however, at the age of 4, my mother died and that was a very sad time. I suppose, during that period when my mother died, the one person who was most influential in my life from that time on, and into my adult life, was my maternal grandmother. I liked my paternal grandmother very much, but I only saw her once for a 2- week visit because she lived in Vancouver, Canada, and British Columbia was a good ways from Florida in the '30s, so I really didn't know her. But my maternal grandmother was as close to a saint as you're going to find in this world. Harden: What was her name? Hicks: Her name was Elmira Fisher Brown, but we called her Big Dolly. That was developed out of an affectionate term: my mother had called her mother Dolly. It was just a nickname, but when my sister was born, the nickname became a name for my sister, and she was named Dolly. So now we had Little Dolly and Big Dolly. Well, I never looked on Big Dolly as any kind of a size associated with the name. It was just said in one swoop- Bigdolly. But I'm grateful for the chance to mention her name because she is the most influential person in my entire life, up until the time I got married. Harden: In 1947, you were 17, and you went into the US Navy and served in the Pacific until 1952. Would you tell me about your time in the navy, and how it might have helped prepare you for your later work in the smallpox program and elsewhere? Hicks: Well, I enlisted in the navy, and so as a recruit, I had to go through one of the naval training camps. My boot camp was in Bainbridge, Maryland. I came out of Bainbridge after 12 weeks and was selected to go to the Naval Air Technical Training Center in Jacksonville, Florida. It was like going back home again. It didn't seem like I was going to see the world, you know? I went back there, and I completed training in aviation fundamentals. Then I was selected to go to Control Tower Operators School. The rating was a specialty at that time and designated Specialist Y. The work was similar to that of flight controllers and control tower operators that control aircraft today. I finished that school, and then I went on my first assignment, which was in Kodiak, Alaska. I stayed there for about a year and a half, came back, and then my next assignment was an aiarways flight controller at Moffett Field, California. I was there a very short time because I wanted to go abroad and see something. I made the choice to accept an assignment to Agana, Guam, which is in the Marianas Islands in the Pacific. While on Guam, I also went at times to Saipan and Rota Islands, as part of my work, but for the most part I remained on Guam as the lead Control Tower Operator for the time I was there. When the Korean War broke out, I took a contingent of men from Guam, went to Sangley Point, Philippines, and opened up the small airport as a supply shipping point for the troops in Korea. We used metal mats, which had proven to be quite useful in World War II, for the single runway. We would later install a concrete runway to better serve the support mission.. I remained in the Philippines until it was time to return to the United States for discharge. During my last months of assignment, President Truman extended everybody involuntarily because of the war, and so I stayed there another year. When I left the Philippines, I went back to North Island, California. Again, I was in flight control there until I was discharged in January of 1952. I entered the University of Florida that spring semester. Harden: So, here you are coming back after long military service, and having definitely become an adult at this point, and then you start back to college. I expect that your approach to studying might have been different at this point from the 17- and 18-year- olds who were going to the University of Florida. You ended up with both a BA and a BS degree and were chosen for the Hall of Fame and elected to the Florida Blue Key Honor Society. You must have seen this period as an opportunity. Hicks: Well, I did realize that I lacked education, and the World War IIO and Korean Bill of Rights both offered an opportunity to help correct that. I didn't even have a high school diploma. I realized this early on, when I entered training in Jacksonville and I was selected to go to flight training at Pensacola. When I was about to leave for Pensacola, I was told by the personnel office, "We were pulling together everything for your file, and we don't have your high school diploma here." And I said, "Well, I can't produce it because I don't have one. But I passed all of your entrance tests with high scores." And they said, "Well, there's a right way, a wrong way, and a Navy way, and this is the Navy way. And we're sorry, but we can't accept you." Well, that bothered me immensely because I wanted very much to be a navy pilot. When I got into my next assignment, I took some Armed Forces Institute extension courses to get enough credits to at least get an equivalency certificate. Duvall High School, which was no longer a high school but more of an adult vocational school with correspondence courses, literally gave me a degree, but I never had a legitimate diploma. When I applied to the University of Florida, I was accepted because of what I had, but I was on probation, right from the first day I entered classes. Well, that woke me up a little bit, too. I've got to do something, or I'm going to lose this opportunity. So I took advantage of this opportunity, made dean's list the first semester, and after that, the university took me off of probation and left me alone. Harden: What did you major in? Hicks: I was fascinated with the whole liberal arts concept, and so my work was 2-pronged. For the Bachelor of Arts degree; my major was English, with minor courses in history and economics. For the Bachelor of Science portion, I majored in a typical pre- med course, with biology, chemistry, and psychology, and I took physics and philosophy as electives. So courses on one diploma, I could use on the other as electives and vice versa. I had to take, I think it was, 30 semester hours over and above the requirement for one degree because I was studying for both degrees at the same time. It was simply my attempt to catch up on a broad education because I had lacked academic achievement when I went into the navy. Harden: Then, when you graduated, you began to work with the Florida State Board of Health. Tell me about being a VD [venereal diseases] Representative of the Florida State Board of Health. You were in this co-op program with the Public Health Service, and I'd like to know more about that too. Hicks: The Public Health Service, and specifically CDC as a lead point, had an arrangement with some states, not all of them at that time, whereby you were an employee of the state but at the same time your paychecks came from the federal government. Someone in this program was called a Co-op. The understanding was that at some point in time, usually about 1 year, you would be tested and switched over to what then was called a Program Representative or VD Rep. Harden: So when you were switched over, then you were an employee of the federal government, working for the state, or you were still an employee of the state government? Hicks: I was a federal employee assigned to the state, with some supervision coming from state employees. As soon as we took the federal test administered by CDC, we were then promoted to GS-7 and became an employee of CDC. It was simply a co-op arrangement between CDC and state health departments. That relationship of being partners in public health programs has existed down through the years. There's always been that tie with state health departments and CDC. So that's what happened there. Harden: What did you do as a VD Officer? Hicks: First, I was assigned to a VD clinic. They spent a day or 2 teaching me how to take bloods from the arm to do serologic tests for syphilis and also how to trace contacts who had been named during interviews with patients to determine their sexual contacts. So that's basically what I did for about 3 or 4 weeks. Then I was transferred to a mobile team to take blood tests. We used a type of vacuum tube to obtain a blood sample once you got into the vein. I remember calling them Kydell or Shepherd tubes. And we would get a great big bullhorn and put 78-rpm records on a record player in the front seat of a panel truck. We would go park somewhere out under a chinaberry tree, and people would come and dance in all that dust and all. And while that was going on, we, wearing white coats, would put Shepherd tubes in one pocket, the samples in the other pocket, and we would just walk through the crowd of people. They'd put out their arm, and we'd take their blood. I'm sure it wouldn't be allowed today. I got pretty proficient at taking bloods. In fact, I sometimes help out now in the hospital when they try for a while to take my blood. I say, "You want me to do that?" Because we did so many of them. I mean, so many of them. The music, which we played loud, would attract the people, and while they were there, in a big carnival-like atmosphere, we would get all these blood samples from this mass testing. And then we would send them off that night to the State Board of Health in Jacksonville, and then they would send the reports back and we would do follow-up on those bloods. We were trying to find syphilis. We found a lot of latent syphilis, but we didn't find as many cases of primary and secondary syphilis as we hoped we would because it was through serologic testing and not a physical exam. So I did that on that mobile team for 2-4 months, something like that, mainly in the Daytona Beach area and in the small communities near DeLand, Florida. Then a VD Rep was needed in Tampa, covering Pinellas County with St. Petersburg, and Tampa, including Hillsborough County. So I was sent to Tampa, and I worked there for, well, from '57 for about 3 years. And then, besides those 2 counties, I worked on a regular basis for 3 clinics-one in Pinellas County and St. Petersburg, one in Tampa, and one in Plant City, the strawberry capital of the world, about 30 miles east of Tampa. So we managed those clinics, interviewing for both gonorrhea and syphilis, but our primary concern was syphilis. And then if there was an outbreak in Naples, or somewhere along the west coast, the so-called Gold Coast there, I would go down to Naples or Fort Myers or wherever, and do interviews, and then trace people and get them into local clinics for treatment. Harden: Then after you did this, you moved to Philadelphia. You were doing the same sort of thing, I believe, in Philadelphia? Hicks: Yes, but it was altered a little bit. When I got there, we had city employees as well as federal employees, assignees, in the same group in the VD part of it. There was a senior federal assignee, fellow by the name of Bill Hamlin, and I went in as sort of his assistant. The reason they brought me up there, I think, was because I was having pretty good success with the interviewing technique. I thought it was kind of fun, you know. I went through school in Atlanta to do it, and they test you there and I got a perfect score. So I guess based on that and my work later (I don't mean to be saying anything other than what happened) I think I was selected there to try to rescue some of the interviewing failures in Philadelphia. So I spent an awful, awful lot of time on reinterviews, to get contacts who weren't obtained before. And then, gradually I evolved into other activities there. Harden: The other important thing about Philadelphia is that you met your wife. Hicks: I did. Harden: And married, and then moved in '63 to Raleigh, North Carolina. And by that time you were Chief of the VD Program and coordinator of the co-op program, which you had come up through. Hicks: Well, North Carolina had always been a heavy co-op training state-probably the largest in the country. And there were times when we probably had 30, 40-odd people in training there. So the assignee in the position in Raleigh, by arrangement, primarily on the part of the state, inherited the title of Chief of the VD Control Program, or VD Program, whatever it was named. And so the state looked at me as head of the VD Program. I was an assignee at the GS-13 level, according to CDC. So I was one of those federal assignees doing work for the state and carrying a state title. And I stayed in that for about 3 years, until I got the call from Billy Griggs, offering me the job in smallpox. Harden: I want to come back to that, but I want to divert for 1 moment and say you also adopted 2 children during this time. And you're going to tell us a little bit later about the problems you had in Africa. Hicks: Well, yes, I had a serious problem with one of my sons. But now they are both beautiful young men, who have reached that age when they have families of their own, and I can't even think about them without filling up, I have so much love for my boys. And they're both doing extremely well, with families of their own. But my concern was, when we had those 2 children, I think it was Bill Griggs who said, "You have to let those arranging the assignment know they're adopted, that they're not natural birth, because you've got to have a birth certificate, all that, to get visas, and passports, and this kind of thing" We didn't have the final papers for my youngest son, Stewart, and they weren't due for another year. So that meant I had to get a waiver, and I made it clear to the folks in Atlanta that, if I can't get clearance on Stewart, we're back to ground zero. The deal is off, you know? But by that time, I was wrapped up in the program and the excitement of it, and so fortunately we got a waiver that allowed the follow-up to be done in Lagos, Nigeria, where we were to live. Harden: All right. Now I want to drop back and say, here you are in Raleigh. You're the Chief of the VD Program. You've risen through the ranks and obviously done very well. So when they were looking for someone to be the head of the operations part of the smallpox program in the regional office, you were a natural choice, I think. Would you tell me who recruited you, and what they said? Hicks: Well, Billy Griggs was the one who made the call to me. I think it was June of '66. And he and D.A. Henderson [Donald A. Henderson] apparently had discussed me and my track record up to that time. You'll have to get more from them as specifically why they chose me. But I was glad they did. Being in North Carolina, I had obviously heard about the smallpox/measles control program, but most of what was going on I didn't know about. Billy called and asked me about the job, and then when I told him about Jimmy and Sewart and that I did need to get a waiver, he said he was sure that they would be willing to do all they could to help me in that regard. I was grateful for that. The leadership in CDC has always been that way-for my family, and I've witnessed it for so many other families. I came down to Atlanta in '66, July the 1st, I think, may have been the official date. It may have been a few days off from that. This was during that period of time, 3 or 4 months, when people were being trained to go to West Africa. I spent part of my time in French language training because I would be covering not only an anglophone country but also French-speaking countries. So to get that francophone requirement, I took French again. I had studied it earlier in school. I was also preparing job descriptions for those who would go to Africa. I particularly remember working up Gordon Robbins, our Health Educator for the project. He was a very bright, capable guy, and helpful in my attempts to get him nailed down for the program. It was things like that, and cable traffic overseas, and different projects that would have to be done to keep things moving. The EIS (Epidemic Intelligence Service) folks were putting on training in virology and assessment and things of that nature. Harden: Were you taking training and also trying to get organized with the people you had to help? Hicks: I was, but there were a lot of sessions in the training I didn't get in on because these other things were felt to be more important. We were all very busy. At that time, there were maybe 40 families holed up around Atlanta in different motels, including the Emory Inn, but they were all over the Atlanta area. Well, I had this young child who I had just adopted, and so my wife, Dorothy, and I decided that we would leave her and the 2 children in Raleigh and I would commute home on weekends. Eastern Airlines was on a strike in 1966, so you had to resort to rail travel, which wasn't bad; there were 2 terminals in Atlanta, and if you missed a train going into one station, you could usually pick up another in the other terminal. Seaboard, Coastline, or whatever. There was one train leaving from downtown Raleigh at about 10:00 on a Sunday night. I would usually take that train and plan to get off at the Emory station near CDC in the morning. Emory was a small train station, down at the foot of the hill on Clifton Road. It later closed and became a restaurant for awhile. I'd ride the train all night, have breakfast on the train, and then get off at the Emory station, walk up the hill, and go to work. I would arrive in the station about 7:33 or something, so by 8:00 I was up the hill, ready to go. That worked fine for the summer, when I couldn't use the airlines. Dot stayed in Raleigh, where she was more comfortable, and there were so many requirements on the part of the new adoption procedure that she had to be close by or else she'd be doing a lot of traveling. So basically, that's how that worked out for us. Harden: So, were you the person, then, who was getting the complaints from the people who would be in your region, in terms of, get us over there, find us housing, help us get settled? Hicks: Depending on who initiated them, those primarily went to Don Millar [J. Donald Millar] (on technical aspects of the vaccine, virology), or they went to Billy Griggs (on equipment and program operations). But it didn't matter who got it; everybody was together on it. The organization was not nailed into place at that time. I had made a quick trip over in the early fall to Lagos because we were having some housing problems there. Billy Griggs had gone over before me. I don't know how he accomplished things so quickly, but he's a gifted guy, when it comes to management. I would say, he's a very gifted guy. And so a lot of that was done. I was going to manage what was then determined to be a line position out to the field, for equipment, supplies, money, bodies-this kind of administrative operation. Harden: So, when did you move to the Lagos office and stay there? Hicks: I think it was some time in the early part of November of 1966. We wanted to get operational by January 1 of '67, and so much had to be done. When I first went over there, we were operating the regional office out of Muriel Roy's apartment. She was the secretary for the regional office and lived nearby. Well, that didn't work for very long. My chief concern was getting into the building across from her and having a legitimate headquarters, not working out of one's back pocket. Harden: Were you there ahead of the other folks who were going to come and implement the country programs? Hicks: Some got there ahead of me and were making do with contact with Atlanta and with the USAID [US Agency for International Development] representatives because this program was under their funding. Harden: Did you have to deal with them directly? Hicks: Oh, a lot. An awful lot. Harden: What kinds of interactions did you have? Hicks: All cable traffic concerning any issue came to the embassy, so any communications we received came in through the embassy and were directed through the USAID people to the regional office. Harden: And I understand that if you were in an anglophone country and wanted to cable a francophone country, or talk to one, you had to go through London and back to Paris? Hicks: We did it through the embassy, but they had selective ways of handling communications. Even though I had a top priority clearance, it didn't make any difference when it got to talking about how the embassies communicated. I got to be good friends with one of the embassy people, and I asked some simple questions. He said, "Jim, I can't share anything with you on this. That's just privileged information on a need-to-know basis." It was difficult, oftentimes, to communicate from one country to another. It was easier with the embassy, it seemed, to get a cable to Atlanta. Not always, because you'd go through the same procedures. And don't forget, for much of the time there, a civil war was going on, and there were priorities that a lot of people felt were higher than what smallpox was doing. But the beautiful part of it, in spite of all that, was the job got done. Harden: The job got done. My understanding is that the regional office was originally conceived to do one thing, but there were some difficulties with Atlanta and USAID. Would you talk about those problems? Hicks: Okay. If you were to look at it in one way, professionally, the greatest problem that I, Jim Hicks, saw there was communications, followed by transportation. Those were the 2 main problems that we faced. Harden: Would you explain a little more? Hicks: Okay. Communications would lag. Sometimes they wouldn't go through. It was very difficult. You had to make reservations for long-distance calls if you wanted to reach somebody with the normal telephone service, and that was very poor. You'd get cut off, and they did a lot of rerouting through Europe and whatnot. All of that, I never paid much mind to. I just knew that there was some serious lag time in getting through to Atlanta. The regional office, in the beginning, was looked on as the headquarters here, as having the overall responsibility. So here in Africa is the regional office, with almost lateral positions with various disciplines in Atlanta. The regional office in the beginning, I think, was primarily designed to serve as an in-line focal point. But the communication was so bad that people gradually would simply tie in to who got them back the quickest answer. And if a guy is sitting in-I'll just use this for example-Dakar, Senegal, on the furthest western part of West Africa, he could communicate to the States a lot easier usually than somebody buried up in Dahomey (the country that later became Benin). Communication was a big problem. That was the most serious problem to me. And when you have that kind of communication, things get misunderstood, and then they get worse. So some out in the field, based in Guinea or somewhere, might feel, well, you know, who is supposed to give me the information? Regional office? I don't get a response. Atlanta? Maybe I'll get a better response. So I'll just deal direct with Atlanta. Well, then that caused more problems, see? It caused bruised feelings. You know what saved all of that? Harden: What? Hicks: Relationships established in that summer program in Atlanta, and among people who came out of Public Health Advisor programs, who knew the players. It's hard to stay mad for long at somebody you care about. And obviously, the people in Atlanta cared about us in Lagos and West and Central Africa, and we liked the people who cared about us in Atlanta. So even though these things came up, understandably, it wasn't disruptive in a serious kind of way. It was just one of the problems you dealt with. Harden: And this was your most difficult professional problem? Hicks: For me, it was communications. Operations Officers in the actual countries might come up with something else. But for me, the most difficult thing was the communication-and transportation. Harden: Tell me some more about the transportation problems. Hicks: Well, you had a Pan-American flight from the States out, a couple of times a week, maybe 3 times a week. The transportation throughout Africa was mostly by Mali Airlines, Ghana Airlines, Nigerian Airways, Air Niger, and others; and these different local country airlines often had other priorities. Their concern, when they started flying, was, hey, we've got to get tied in with Paris if we're francophone. We've got to get tied in with London if we're anglophone; we're going to get tied in with Europe, you know? And a lot of the traffic was back and forth with expatriate help into these countries. So there was more concern to develop the airline system between Africa and Europe. At least that's the way it seemed to me. Sometimes you wondered whether they really cared whether they got some goats, or tombstones, or something else, from Dahomey to Lagos, or from the Cameroons to Gabon. That inter- country travel didn't seem to have the attention on developing countries as getting tied in with Europe. I remember once George Lythcott had to get back for a very important meeting. I don't remember whether he was in Ouagadougou, or Bamako, but somewhere in the central part of West Africa. And he'd figured out that the only way he could get back was to fly to Madrid, and then from Madrid to Lagos. He could have come across in the normal manner, but it was much, much quicker to fly him to Europe and back down again. So, there was occasionally travel like that. Harden: And did you have trouble moving supplies for the people in the field because of that, too? Hicks: I'm sure we did, but so many of these supplies were offloaded at the respective country and did not come to Lagos for further shipment. There were some that went out from WACS, the West Africa Consolidated Service, which was operated with US and country agreement. But primarily, things were delivered by ship or air direct from the States and offloaded in the country of concern. Harden: You had a serious personal problem, too, that you had to deal with, with your son. Would you tell me about that? Hicks: Well, my oldest boy at the time was about 3 years old. He had severe asthma. He had been treated in Atlanta, and at Duke University, and different places before going to West Africa. I had to get a medical waiver on Jimmy, and a legal waiver on Stewart. All this did add to my personal problems. Jimmy had bad times of it there. In fact, in 1968, on a trip that Dave Sencer [David J. Sencer] made over there, I guess because of my feelings, he didn't want to really tell me personally. He could do it better writing. So he wrote a beautiful letter that just frankly told me, "Jim, I think you're too close to the problem. You should think seriously about coming back to Atlanta." To illustrate with one related incident, one time I was in The Gambia, which is like a dagger in the heart, some say, of the surrounding French area of Senegal. I was in The Gambia, which is an English-speaking country, just a little narrow country, which followed along the Gambia River, extending a few miles on either side of the river. Well, that's where I was, and I got this cable that said, "Come home immediately. Your son is in very serious condition." Well, I didn't know what it was, you know. It could have been illness; an automobile accident; or it could have been the war. And which son? There was no cell phone to pick up; there was no computer or Internet. There was none of that. So you just tried to get back as soon as you could, which might be a day and a half. I was fortunate to be able to do that. But anyway, I got back, and it was Jimmy. I had tried on the way home to put 2 and 2 together and I did think it was probably asthma because Jimmy had had many of these attacks. He was very, very seriously ill then and a number of other times. So, the greatest problem of the West Africa program, are you talking about program-wise? Communications. Are you talking about personal problems? My son Jimmy's illness. The communications problem got solved, to some extent, just with time. You find ways to get around things. Everything was working, and progress was being made. So there was a lot of forgetting; there was a lot of overlooking. There are people who in excitement may say one thing, and you've got to say, "Well, wait a minute. I know good-and-well he didn't mean that." So it was relationships established that took care of a lot of misunderstanding. Ultimately though, the difficulty with communications, I think, was a major cause of the demise of the regional office. It changed from what it was intended to be and became more of a storehouse of knowledge and help in certain areas. Because we had a virologist there, a health educator, equipment specialists, and so on. As a Medical Officer, Rafe [Ralph H. Henderson] was heavy into epidemiology and virology and the management of those disciplines. And George Lythcott, bless his heart, had to spend so much time, with his enormous gift of diplomacy, dealing with people, whether they were foreign nationals, expatriates, or our own people. He had a great deal of charisma, a great deal of ability to deal with people. So that was a great help. You add all those things together, and though in the beginning, in 1967, things were troublesome, they worked themselves out to a certain degree, but not totally. Because the way you got rid of the problem, essentially, was to move a lot of the problem-or a lot of the intent of the regional office-back to Atlanta. Harden: I see. Were there any unique occurrences that you would like to talk about? Hicks: Oh, there were so many. The whole program was unique. You could just pick out almost any of them, but the best illustrations of those unique problems would have to come from the Operations Officers in the respective countries. Well, we did have one unique occurrence in Lagos, during the war, when a Fokker aircraft from Benin, in the midwest region, was taken over by some mercenaries and Biafran sympathizers. One night, it was about 1:00 AM, we heard this awful, awful explosion. The Fokker aircraft had been taken away from the Nigerian Airlines, flown to Biafra, and 5 white mercenaries and 4 Africans came on a bombing run. And they came over Lagos. We pretty much figured out they were on the way to Dogon Barracks, where General Yakubu Gowan was, who was the head of the federal Nigerian government. The Ibos over in the eastern section of the country were the ones who were doing the bombing. Their bombs, however, were 55- gallon drums, or something in that neighborhood, and they were constructing Molotov cocktails of that size, and just pushing the barrels out the door of the plane. I think they got 2 off. There was some damage done. The drum would break, causing primarily explosion and fire. But the plane blew up in midair, very, very close to the regional office. It gradually got pieced together during the investigation that they had simply tried to use a different door, apparently, in the back of the plane, to push one of these barrels out, and it was already lit, and it wouldn't go through, so the plane blew up in midair. They recovered 9 bodies, or the remains of 9, 5 of them white mercenaries sympathetic to the Biafran cause, or paid by them. Muriel Roy, our secretary, got hit with flying glass, and if she hadn't been wearing a kind of heavy bathrobe, I guess it was, she'd have got hurt bad. It blew out most of the windows in the regional office across the street and caused some other minor damage. Another unusual thing I remember. . .Lagos at that time was getting black-and-white television. They had a little television station that was not very good for anything, but it was there, and it was better than nothing. You saw antennas on many rooftops. Well, the explosion twisted Muriel's antenna, which had never worked very well, such that she started getting pretty darn good reception. I remember an incident that was unique to me. It's not of any real importance, but it's something those of us who were there when it happened have chuckled over. We were on our way back from a regional conference in Yaounde, Cameroon, in early '67 for the OCEAC [Organization de Coordination pur la Lutte contre Endemies d'Afrique Central] countries. We had had a successful time up there and were all heading home. Some of us were on our way back to Lagos, and we hit some turbulence just outside of Lagos, as we were making a long approach into Ikeja Airport. The service personnel had taken all of the meal trays and put them on an open rack normally used for luggage, like you find in buses and trains. All these trays were stacked up there, but what we didn't know at the time was that they weren't tied down. Well, I'm in the seat underneath them. So when we approached for the landing, the plane made a violent wobble as it sometimes does in turbulence, and the trays all came down. Well, they didn't come down on the floor; they came down on Jim's head. So they hit the top of my head, and out I went. They told me later that a French physician from Senegal who was on that aircraft got up to see if he could do something to help me. So I later found out he undid my collar (I had a suit on with a tie), and he undid the belt on my trousers. Well, he went and sat back down because we were coming in for the landing. So I didn't know from anything. So when I came to and got up, everybody's still seated in the plane because they're going to unload us from the front to the back. It was a small aircraft. But anyway, I stood up. My pants dropped straight down around my ankles, and I stood there in my underwear on that plane. Everybody on the plane had a good laugh. Anyway, that was unique for me, but it doesn't have any value to the West African program. Harden: In 1968, you came back to Atlanta, and were named Chief of Operations of Area A, which was a 12-country area of West Africa. Now, tell me what that job was, and how it was different from the regional office. Hicks: When we first went into Africa, Medical Officers and Operations Officers were assigned to one or more countries. Nigeria was divided into 4 regions. A Medical Officer was assigned to head up Nigeria and, because of the size and population of Nigeria, other Medical Officers were assigned to the 4 regions. Operations Officers were assigned to work with the onerous chores of keeping trucks going, Ped-O-Jets and refrigerators operational, and other logistical support. The Medical Officers had a tremendous schedule of dealing with virology, assessment, surveillance, and other things, and a lot of the things that the Operations Officer could have helped with, he couldn't because he had to train people to help with equipment repair and Ped-O-Jet repair. One of the early-on problems was axles. They broke all the time in those Dodge trucks. Particularly the W-200. A lot of broken axles, and that was a real problem. So in the beginning, in early '67, with all the problems in communication and that enormous challenge that faced us, I remember George Lythcott asking me, "Jim, do you think we're going to eradicate smallpox?" And I said "No, but I am grateful as grateful can be that you and I both, George, are going to have a shot at it. Because," I said, "I think we can reduce the morbidity such that we will save many, many lives." You know, when we started the program in '66, there were 40-something countries endemic with smallpox. Seven of them were in that West African program, and at that time, there must have been 3-1/2 to 4 million people dying every year from smallpox. Well, if you've got that kind of problem, and you can reduce the morbidity so that 25%, maybe, of the morbidity doesn't become mortality, then you've made a big jump. And I was trying to get that point across to George, but he already knew what I was talking about. Harden: Let me follow up on that. When did you finally feel that smallpox would be eradicated? Hicks: For me, it was in April, May of '68. And why do I say that? Because in January of 1968-just 13 months after we started in January of '68 in Accra, Ghana,-we had a celebration of 25 million vaccinations. Well, now we're pumping out a lot of vaccinations. There's something like 105, 110 million people, maybe, in the overall area. The statistics are hard to come by with accuracy. But out of all that, 25 million in 13 months, something like that, I figured that, yeah, we're getting people vaccinated. But that wasn't really it. You see, to me this whole program was a Gordian Knot from the beginning. You had smallpox around for 10,000 or 15,000 years. And people dealt with it, and it would be clean for a little while. Then there'd be another outbreak, and it went on and on. It was a Gordian Knot. It was unsolvable. You couldn't get it answered because you couldn't untie the knot. All right. Here's where the big change happened. Alexander the Great may have cut with one fell swoop the Gordian Knot that couldn't be untied. I think we had 2 fell swoops, backed up by a lot of support. I think the first one came from Bill Foege [William H. Foege]. Bill Foege was a principal architect of what we called "eradication escalation." E-square, we called it. And that was presented, as I remember it, about May. It was based on his early work in the Ogoja Province, over in eastern Nigeria, before he had to leave when the war broke out. And it had to do more with identifying cases and then containing those cases, rather than just willy-nilly going across the country from one side to the other, vaccinating people. When I saw what eradication escalation could mean to the total program, that was the first cut through the Gordian Knot. The second one, Don Millar. Don Millar bought and understood it clearly from the very early conversation about it. But Bill's original ideas wouldn't have gotten anywhere if Don Millar had not said, "Hey, we need to do this as an adjunct of mass vaccination; we need to implement this." Well, it all came out in April, May, something like that, in '68. Now it was about that time, after I knew about E-square and I saw vaccinations going on in the area, that I made up my mind. Exactly right then, I did a flip-flop. And George Lythcott asked me, "Jim, you know when I asked you this probably a year ago, how about if I asked you now? What do you really feel, now that we're in the program, been in it a little over a year: are we going to be able to eradicate smallpox?" And I said, "I've done a complete flip-flop"-those were my words-"I've done a complete flip-flop. This disease can be eradicated." And I believed it. Now, a year before, I thought we'd bitten off more than we could chew, but that it was still very, very important to reduce that morbidity. So that's where I was coming from on that. Harden: Beautifully said. When the West African program ended, you continued to work with smallpox eradication in the rest of the world. What special expertise did you see coming? Hicks: We need to back up a little bit to the summer of '68, following the letter from Dave Sencer about Jimmy and his asthma, which he wrote to me in Lagos while he was actually there. Then I knew I wasn't fooling anybody, and I then began to realize seriously, "I may be putting my child at risk" because medical care there was not super. I had mentioned to Don Millar that I had to come back, and I would much prefer to continue on in the smallpox program. Well, up until that time, Henry Gelfand had 12 countries in West Africa (Area A) that he was responsible for from Atlanta. Bill Foege had primarily Nigeria and, I forget, maybe something else; that was Area B. And then Area C was Mike Lane [J. Michael Lane], the OCEAC area, over at Cameroon, Gabon, Chad, that area. So the long and short of it, I came back to play a role in Atlanta with the Area A countries when Henry Gelfand left. That pleased me immensely because now I still had direct operational opportunity to help these people in so many ways. And don't forget that these people now meant something to me. They meant a lot to the eradication of smallpox. But one of the greatest joys in this thing was working with people who were gifted, and who cared about each other. And they cared about millions of people they didn't even know. Now, that was important to me. So I wanted very much to stay put. And Don Millar saw that I could do that job, and so he brought me into that, for which I'm very, very grateful. This was one of those early examples of an Operations Officer, a Public Health Advisor type, being able to step into a role formerly held by a Medical Officer. Because it was management, and we could get things done through other people in management as effectively in one discipline as the other. So that's how I got into that. Then, Bob Hogan [Robert C. Hogan], another Operations Officer, came back soon after that. And now, Lane and Foege could go on to other important things, to directing the program itself. We still had a tremendous amount of money being dumped into protecting the country from smallpox. Now we've got no deaths from smallpox, but we've got deaths from smallpox vaccination complications. So when you add all this together, we had to do something from a humane standpoint, from an economic standpoint. What were we going to do as our domestic policy? So I got involved in some of that. Then the case manual was written. We had to go out and talk with State Epidemiologists about control activities in a smallpox emergency, something like that. So that's how I stayed on with smallpox. And then from that I gradually became Deputy Director of Nutrition, and from there Assistant Director of Management for the Center for Infectious Diseases, under Walter Dowdle. Harden: Coming back then, if you were going to do this program over, the smallpox program, what would you change? Hicks: Well, this is unfair because if I were in the shoes of any of the principal players in 1966, I daresay I would have done it the same way. So in hindsight, I'm really doing Monday morning quarterbacking, and that's awful easy to do. But you have to consider that I lugged around something to compute that probably weighed 20 pounds, which was an iron cranking calculator. The Dutch made it. If you pushed this lever down, it would multiply and divide. But lugging that thing around, and you can buy something that'll do a lot more than that for 3 bucks at Walgreens, or someplace, and it weighs ounces. But in any event, the difficulties we had then, no computers, no cell phones, no emails, none of that stuff. So I'd have done it the same way, probably. But to do it over again, if I were stepping in now and facing the same problem, I would not have put the regional office in the plans. I would have had the senior Operations Officers and MDs in Atlanta with responsibilities of specified countries. They would travel frequently to determine problems and help assess the program operations. In this way, they could share problems with others in headquarters and do business with cable traffic and regular scheduled phone calls-whatever was needed. George Lythcott had several years' experience in recent work in African when he came to CDC. He would have been extremely effective with his diplomatic skills, medical knowledge, and high-level contacts in West Africa to service as a sort of roving ambassador and personal representative of Don Millar. George had demonstrated his exceptional skills at the very highest level to settle major problems in Africa with the Liberian program before he left fo the regional office. That's what I'd do differently. I would not have the regional office. Harden: Once smallpox was eradicated in the world, in 1977, you were awarded the Order of the Bifurcated Needle. Would you explain this for the record? Hicks: I wish I could, totally. All I know, it came to me one day, but not to me alone. I have seen at this reunion some of the guys still wearing the little twisted bifurcated needle. WHO [the World Health Organization] was looking for something to let those who participated actively in the eradication of smallpox receive as an award. I participated, but look at the hundreds and hundreds of others. It was not anything unique to me. I'd have been way down the line. There are so many others who received it with more input than I ever put into the program. Harden: No, but I just think this is the neatest thing because people give awards for military accomplishment, for various and sundry other things, and they may not understand the impact that people made with this little bifurcated needle, in terms of contributions to humanity. Hicks: Well, the bifurcated needle was a turning point in the total vaccinating procedure in the countries. You could go train somebody in a hurry, with no doubts that you had the right amount of vaccine between those forks. And when you put it into the arm, it took. That was a great turning point. So it was a thrilling time. I am thankful I had a part in it. Time will tell, but I certainly think enough time has passed by now to show the world that there's much learned in the smallpox program that can be applied to other things. I know with me, personally, it helped a great deal. I went on to do other things at CDC that required a lot more managerial skills than I had before I went into the program. But when you're thrown into the fire, so to speak, you learn rapidly. And the school I worked in, the people were just so dear to me, even to this day. Harden: Before we stop, is there anything else you'd like to add? Hicks: Well, I've talked way too much. There are lots of people who can give you the other things that may be missing, but I appreciate the opportunity to share what I have shared, and I hope I've done it in a way that might be helpful. Harden: I want to thank you very much. It has been just a super interview. Thank you for speaking. Hicks: Thank you, Victoria. </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/yCqN9sJH8F0" 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 2006-07-14 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/15p40 emory:15p40 Subject The topic of the resource WHO Administration Smallpox Eradication USAID CDC Role of regional office Format The file format, physical medium, or dimensions of the resource 13872720000 bytes video/x-dv Creator An entity primarily responsible for making the resource Harden, Victoria (Interviewer) Hicks, James (Interviewee); CDC; RegionalOperations Officer Contributor An entity responsible for making contributions to the resource Centers for Disease Control Title A name given to the resource HICKS, JIM Description An account of the resource Jim Hicks relates his experiences in the Venereal Disease Program and as Regional Operations Officer in Lagos with the Smallpox Eradication Program, and then duty in Atlanta. This interview is a comprehensive covering of the administrative problems facing the program and steps taken to solve those problems. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/15cff6897b42722de6d85ec8ddd53485.jpg 96f9857b18795fa6e75ffee8451b5e43 https://www.globalhealthchronicles.org/files/original/3f591a9f59cfa5f845cac4a292f46849.pdf cbe8473a9db438866875ed8550f218c2 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: Dawn Eidelman Audio File Transcribed: January 23, 2008 Interviewer: This is just formality. Now I'm David Sensor. I'm interviewing Dawn Eidelman on the third of April, two thousand and eight at CDC. Dawn knows that she is being taped and has signed permission. How old were you when you went to Africa? Interviewee: When we went to Africa I was five years old so I started my formal schooling in Lome, Togo at L'ecole de la Marina, not speaking a word of French on day one and it was a rather traumatic first day of school. I about half way through the day had to use the facilities but didn't know how to ask. They figured out what I needed but then when they showed me the facilities I had no idea how to use the drain in the ground. So luckily we had a long school day and a long lunch and I went home for lunch and my ingenious mother noticed that I had an outfit that was almost identical, persuaded me that nobody would know the difference. I went back for the afternoon and she clued me in how to use the little drain in the ground and astonishingly within a month I was starting to understand the French. They only white kid in the class, pigtails, we had the little inkwells in the desk and by the end kindergarten my father was I think a little bit jealous that my French was pretty solid and quite effortlessly. So, in my line of work now I'm a huge advocate of total immersion for English acquisition. I don't believe in segregating students for a lingual education because I know that children are really like sponges. Interviewer: How long were you in school in Togo? Interviewee: In Togo I was there through middle of the third grade. So kindergarten first and second, at L'ecole de la Marina, French system but African private school. Third grade was an interesting experience. The first half of the year we were still in Lome and the first house that we had lived in, the bottom floor - excuse me - the bottom floor had become Boutique Togo Agogo and the top floor our school house for the American kids. And we used Calvert which is still in existence now for distance learning and one or two of the moms who had teaching experience facilitated. And we had assembly in the living room and the two bedrooms were I think the odd grades and the even grades. So we did distance learning in an American program and that's when I first started formal studies of English. Interviewer: In addition to learning about how to use the toilette what are some of your other interesting experiences in your formative years? Interviewee: So many. As I shared on the way over here I really did not like the Sunday ritual of having to take Aralen. It was really nasty and bitter and ugh I just couldn't abide it. So, I didn't take it on a couple of occasions and I became quite ill with malaria and I remember that fever and sitting in the tub taking baths, trying to get that fever to break. That one is definitely a distinct memory. It was actually an idyllic childhood. We didn't have TV. I had a record player and a few records and I know those lyrics to this day backward, forward, inside out. Just a couple of toys and what that really did was promote a comfort level with time in solitude, time for recollection, time to develop an expansive imagination and I regret that more children don't have that experience in childhood now because I think it's very important for really becoming who you're capable of becoming. Having some quiet time and not being programmed all the time with activities. And we had a lot of really cool pets. A family of bush babies, we had a parrot, feisty Senegalese parrot Bud who came back to the States with my mum and lived another twenty years or so in captivity and remained feisty all the way. We also had a podo and that was quite the dramatic story and a small python. We kept mice in a cage. Every Sunday after waffles and Aralen we would in the afternoon watch the python devour a mouse. That's what we did for kicks. Some men came to paint our ceiling fans, let the mice out of the cage. One of the mice bit the podo and the podo was probably our closest family pet. She would pluck out my dad's chest hairs when he was taking a nap. She got into my mum's birth control pills. Very, very intimate family member and so it was really tragic when she got rabies and she also bit my mother. So the whole family went through the rabies series and I remember Dr. Henn would clean up the syringes and obviously get rid of the needles and everything and make them suitable for water fights so my brother Dave and I would have water fights. But Christmas that year we had a rabies shot because we were going through the series at that point. So memories of pets and lazy days, a lot of reading, listening to music, very few toys but the ones we had we really cherished. Halloween was fun. We would -they thought that we were absolutely nuts. My mum was a really fun hostess and I remember one year we put sheets over the clothes line to make a tunnel of terror and we dressed up in all kind of different costumes that our tailor made for us and wondered what the crazy Americans were up to. I remember some rollicking fun. There was some great adult parties and they never seemed to mind that we were kind of milling around. Interviewer: I remember visiting your house. It was probably in seventy, no sixty eight, and George (Lithket) and Don Millar and I we were making our big tour of Africa. It was a very pleasant evening I remember. What was your feeling about life in - of other people in Africa? Interviewee: Of the Africans or the other Americans? Interviewer: Africans. Interviewee: Interesting again from a child's perspective. I did have an awareness of being very privileged and I remember one day standing out on the balcony with my doll and looking across the street at an African girl who was about the same age who was also holding up her doll. And just noting the disparity in the quality of the houses that we were living in and feeling that somehow that wasn't fair but I loved the experience of going to L'ecole de la Marina and I think that too has had a profound impact on my world view as an adult. A lot of what I do professionally is - most of our charter schools that we start up and manage are in the inner city and Inc. magazine has something called Inner City 100 the fastest growing companies that serve, that revitalize, generate jobs for, really enhance inner city populations in the U.S. and our company for three years in a row was in the top five. So the need is really great in neighborhoods where children live poverty. And so much of what I feel really deeply about is not prejudging what children are capable of accomplishing and really holding a high standard and a high expectation for everyone and rising to the occasion as adults to serve that need. And a lot of it I think goes back to how I felt on that first day of school looking around me at the all these kids, African kids who understood everything that was going on in French. I didn't understand a word. It was a hugely humbling experience and I think that that childhood experience and being a minority having - really I recall that it was just a very happy culture. It was a wonderful time in life and I think that that had an impact on the way I see these children in the U.S. living in poverty and not all of them. We serve children in affluent neighborhoods too but I think that even as a child I was keenly aware coming back to the States in seventy two how marginalized African Americans were in this country and just being astonished by that because I'd really idealized the States living overseas and it was - it was a surprise. Interviewer: Were you stationed in any of the other countries in Africa? Interviewee: We were in Nigeria for a year and we lived in Kaduna in the Hogan's house after they moved out. That was - it was a huge cavernous house great for telling ghost stories. There were parts of the house we never even went into and that was during the civil war so we stayed very close to home. There we ended up going to a Catholic school, Sacred Heart and that's when I had my encounter with British education and it really for years I had some issues with my spelling as a result. But it was - Nigeria was a positive experience for my brother and me as children but unfortunately that was the time that my parents' marriage was starting to come apart. So that was for them I don't think nearly as positive as Togo had been. Interviewer: You were in a Muslim culture in Kaduna. Interviewee: Hmm. Interviewer: Did that hinge upon you in any way? Interviewee: Not in a way that I can recall. I don't really - maybe it had to do with the fact that we were going to a Catholic school but I think I was a little bit oblivious to that because it was never much of an issue with my parents and I don't think that that really registered. Interviewer: I would think that the environment in Togo was a much happier environment then? Interviewee: It really was. It was just such as positive place and really all the other expats there that we met I loved the peace corps volunteers for years as a kid that I aspired to serving in the peace corps and it just - it was a great culture. Wonderful gatherings, great music. The music too that my parents had on the reel to reel tapes that we played over and over again. The top one hundred hits of nineteen sixty six Bob Dylan, Blood Sweat and Tears, Beach Boys, but they made for some really wonderful gatherings. Interviewer: You spent some time in Bangladesh with you father? Interviewee: We did. My brother and I spent about half of the summer. The year must have been seventy five and we went to Bangladesh first and stayed in (Aham) and he was wrapping up some work and then we went together to Nepal and stayed in Dave Newberry's house in Kathmandu and we went to India and we were in New Delhi almost the whole time we were there. We did a couple of side trips. I think my brother and I went to see the Taj Mahal one day and we spent a week on a houseboat in Kashmir as well and that was an interesting experience because the only meat that one could eat there was lamb. So we either ate lamb or things cooked in lamb's grease. The left an impression too. French toast in lamb's grease. Interviewer: Do you still like lamb? Interviewee: I really don't. Not so much, not if it's gamey. Interviewer: And I think that's - to me that's one of the problems with lamb today is not gamey enough. You hardly know you're eating it. Were you in Bangladesh long enough to have any feeling for the country? Interviewee: I remember the crushing poverty of the country and seeing a body on the street and I couldn't discern if the person was sleeping or dead. It was, I was just really aware of the poverty and it was also so incredibly muggy. That also left quite the impression. Almost hard to breathe there and in India and you know this was in the back half of the summer so it was incredibly hot and humid. No I just - I remember Bangladesh as being - and I was a little older too. I was fourteen when we visited Dad that summer so I was very aware of children living in poverty and begging and you know missing limbs. It was very hard especially coming from living in the States for a few years then, living a very comfortable middle class lifestyle and then experiencing the poverty was - it was a lot more shocking at that point. Interviewer: Is there anything else about your experiences that you would like to get on the record? Interviewee: Yeah. I think what's really most remarkable to me about those years besides the fact that it was truly an idyllic childhood and a time to be able to enjoy family, friends, gathering, time for reflection, time to really, to read, to sing, to get to know a few texts really, really well because there weren't a lot of other distractions. And I'm very proud of having been a part of smallpox eradication as a child experiencing that because it was such an amazing endeavor and I remember upstairs in the bar you know the house in Lome dad kept scabs in the freezer of the things of that - we just never went into that refrigerator. It was also a bar. We weren't supposed to be there but I remember even at the time - I remember even at the time being very proud of the work that my dad was doing and really liking the people he was working with and finding it really interesting to hear the stories of when he was breaking bread with the chief of the village and trying to negotiate access to the veiled women so that he could vaccinate them. I loved the time that I got to spend with both of my parents with that lifestyle. Dad and I used to play chess all the time and that was a lot of fun and we spoke French together and that was enjoyable. From my perspective today it's - I'm very proud to have been a part of something so historic and huge and I loved doing the reunion a couple of years ago. The reflections about how the young doctors and - what were they called? The operations... Interviewer: Operations officers. Interviewee: Officers, operations officers, really in many ways didn't know what they didn't know. That's something as an entrepreneur that I can really appreciate and it's something that I think it's what's truly remarkable about this global endeavor that was really impressive [inaudible 19.40] at the time. Sometimes not knowing what you don't know, not knowing the magnitude of the project that you're taking on is a blessing and thank goodness, thank goodness we had courageous, bold, ambitious, tenacious, brilliant, dedicated people who with all those qualities didn't know what they didn't know and they kept at it and they chased this disease from the face of the earth. Interviewer: And most of them were very kind people. Interviewee: Absolutely. Absolutely so. It was, it was a great community to be part of and I remember that vividly even as a child. These were - several of these folks I called uncle for years to come and even at the time I knew that it was special and we were part of something that we could be proud of. Interviewer: Thank you. </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/jdlLEyID2OI" 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 2008-04-03 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/15jnn emory:15jnn Subject The topic of the resource CDC Smallpox Eradication USAID WHO Life as expatriate child Format The file format, physical medium, or dimensions of the resource 4466760000 bytes video/x-dv Creator An entity primarily responsible for making the resource Sencer, David (Interviewer); CDC Eidelman, Dawn (Interviewee) Contributor An entity responsible for making contributions to the resource Centers for Disease Control Title A name given to the resource EIDELMAN, DAWN Description An account of the resource Dawn Eidelman, daughter of Andy Agle, who served as an Operations Officer in Togo and later in Southeast Asia. Dawn begins by recounting her first day at a French school in Lome, Togo at age 5, coming down with malaria, their unusual household pets, celebrating holidays while living abroad, as well as realizing disparities of wealth as a child. Later Dawn accompanied her father on smallpox eradication work trips in Bangladesh, India, and Nepal. Dawn expresses her pride in being a member of the of the Smallpox Eradication Program community. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/52e3a6012227df4737362c23378943c1.jpg f7d78b88df4e468df04a13d6b5b8f263 https://www.globalhealthchronicles.org/files/original/6fdf939dd6d1e87749f04827b6d25b6b.pdf 56ec1ccdb453f5b28d463fc0b50e594d 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> This is an interview with Ernestine Hopkins on July 14, 2006, at the Centers for Disease Control and Prevention in Atlanta, Georgia, about her involvement with the West African Smallpox Eradication Program. This interview is being conducted as part of a reunion marking the 40th anniversary of the launch of the program. The interviewer is Kata Chillag. Chillag: I'm going to ask you to broadly describe your relationship to the West African Smallpox Eradication Program. I know it was as a spouse. Hopkins: We came over to West Africa in October 1967. We were part of the second wave to come over. My husband was in charge of the Smallpox Eradication Program in Sierra Leone, and I believe it was the country with the highest rate of smallpox cases in West Africa. I guess my role was basically to support my husband. I had worked up until then, but I wasn't able to work there, so I ended up traveling with him out into the villages. Our weekly schedule was basically 3 or 4 days living in the villages and then coming back to a wonderful apartment on the weekends. Chillag: So you were in the capital? Hopkins: We lived in the capital, but we traveled out in the villages during the week. Chillag: And where did you stay when you were in the villages? Hopkins: We usually stayed in government rest houses. Some of them were OK, but many were mud huts. For me, one problem was the heat, and of course there was no air-conditioning out in the villages. A second problem was that often the houses had been closed up for long periods of time, which allowed bugs to accumulate. And a third problem was that very little electricity was available. So we had to put a coin in a meter, which produced light for about 10 minutes. So it was very difficult for me in the beginning. It was my first trip out of the United States. Chillag: Oh, yes. I was going to ask. Hopkins: So it was a very interesting experience and I'm very happy I had it. Chillag: Before you went, what were your expectations of what it was going to be like? Hopkins: Actually, it was pretty much like what I had expected. The only difference was that the capital cities were more developed than I had anticipated. They were very similar to those I'd visited in Caribbean countries, such as Puerto Rico and the Bahamas. So the capitals were fine, but as soon as we left the boundaries of the capitals, we were kind of in the bush. But overall, it was very much like what I had expected. Chillag: How long were you there? Hopkins: We spent 2 years in Sierra Leone. We were in India for about 3 months with the same program. And then we were in East Africa for a few weeks during Don's [Donald R. Hopkins] residency. Chillag: How did you feel when you found out you were going to Sierra Leone? Hopkins: Well, I had been hoping we would to be assigned to a French- speaking country so that I could learn to speak French. I have to say the first few months were really difficult for me because of the climate, but not for Don. Don's from Miami, so I think the climate was pretty similar, so it didn't bother him so much. The first 3 months were very difficult because we didn't have an apartment and we lived at a hotel. After we got our apartment, we began to travel to the villages more frequently. There, we met many Peace Corps volunteers, who helped the program by alerting the health offices of smallpox cases they had seen. So after the first 3 months, the experience was just wonderful. Chillag: What were some of the cultural challenges that you encountered? Hopkins: Well, actually, everything was a challenge. But for me, a major challenge was having people who did the cooking and cleaning for us and the lack of privacy. Another was that we had to be very careful with food (disinfecting all vegetables) and water (boiling and filtering). Most of the Sierra Leoneans we met socially had studied in the States, so I can't say that there was a big cultural difference there. Chillag: You mentioned that you had worked before, but you couldn't work there. How was that? Hopkins: For me, that was the most difficult part of the experience because I had worked my way through college. So I had always been very busy, and suddenly, there was no work. I was told that I couldn't work there because I would be taking a job from a Sierra Leonean. There was an institute for the blind in Freetown, where I'd hoped to volunteer, but I could not. So I decided to travel with Don, even though I had no particular interest in public health. Many of the wives had children. I believe Ilze [Ilze Henderson] and I were the only spouses who did not have children, so we were able to travel with our husbands. In retrospect, I think my experiences when traveling with Don proved to be invaluable. And I began to enjoy it very much, particularly during our second year there. Chillag: So, what was a typical day like when you were out in the field, in the bush? Hopkins: Well, on a typical day we would travel to different villages. The roads were terrible in Sierra Leone, so, for example, going from Freetown to Bo, the second largest city in Sierra Leone, took about 3 hours in a Land Rover-on a very rough road. So we were kind of bumping along until we got to a village after 3-4 hours. Eating while on the road was another problem. We ate mostly bananas. Basically our diet consisted of Coca-Cola, nuts and maybe a piece of cheese, and, of course, bananas. The villages were very interesting to me and I saw a lot of smallpox. Overall, my African experience was a fantastic educational experience for me and I would have been happy to have had another assignment there. But we had to return to the United States so that Don could complete his residency. After completing his residency and earning an MPH, the political and social climate in America had changed and there was not another opportunity for us to go back to Africa. Chillag: You mentioned about people with smallpox in the villages. What was that like? Hopkins: Well, I wasn't worried about getting smallpox because I had been vaccinated. I often saw people who had smallpox pustules, but they often didn't appear to be very ill. But, I distinctly remember a little boy who was covered with smallpox pustules and his eyes were swollen. He was about 4 or 5 years old, and he looked so miserable because he had to stand up in front of a doctor so that he could be examined. Every inch of his skin was covered with pustules; even his eyes were swollen and closed. He stood so still and silent. This was very painful for me to see. Chillag: What do you think were the biggest challenges for your husband in doing the work? Hopkins: I think the large number of cases was a major challenge because Sierra Leone had the highest incidence of smallpox of any country in the program. I also think the time frame was a concern because Don wanted to eradicate smallpox during his 2- year assignment in Sierra Leone. So I would say that the time frame and the number of cases were the 2 biggest challenges for him there. Chillag: And you said you followed him most of the time. Were you separated at other times, or you were with him the whole time? Hopkins: I was with him all the time. I don't think we were ever separated in West Africa, except when he went to the office. Chillag: You mentioned that, out in the village, you were in the rest houses, which were often mud huts. Did you have any experiences that are very striking to you? Hopkins: Oh yes. One of the government rest houses had apparently been closed up for some time. We had traveled from early morning, and it was quite dark outside, so I would assume it was about 9:00 PM when we arrived at the rest house. In order to have light inside, we had to insert a coin into the electricity meter, which would provide electricity for 10 or 12 minutes. So we put a coin in and opened the door, and all of a sudden I heard these bodies falling on the floor from the walls. There were huge cockroaches covering the walls, and they were dropping from the walls to the floor. Some of the locals sprayed inside the room and swept up the dead bugs; there were hundreds of them. On another occasion, after conscientiously attaching my bed netting around the bed, I fell asleep. During the night I felt something crawling on my hand. I saw the largest cockroach crawling on my hand inside the mosquito net. I screamed and woke Don up. I think the size of the bug even bothered him. All of the experiences which were difficult for me were related to bugs. For Don, I believe the most difficult were related to the few snakes we saw there. Chillag: Were there any difficult experiences with people? Hopkins: No, none at all. The people there were really wonderful, both those with the embassy and the locals that we met. I was very young then; I was 23. There were a lot of young people, under age 30, who had studied in the States and now worked in businesses in Freetown, so I had only positive experiences with the people there. Living there was a very good experience for me. Chillag: So, what were the most rewarding parts of it? Hopkins: The fact that Sierra Leone did get rid of the smallpox. And for me, I began to become a little bit more interested in languages. I've always had an interest in Spanish, but never French. After visiting some of the francophone countries, I became very interested in French language and culture, and later earned an MA [Master of Arts] degree in French. Chillag: So, clearly, this experience has affected your life in that way. Are there any other ways that participating in this program has affected your life? Hopkins: Oh, it's made me generally more interested in people from different cultures. I don't think I would have had that interest had I not been involved with Smallpox Eradication Program. Chillag: Well, thinking back to that time, if you had been in charge of the program, what practical or technical aspects would you have done differently to prepare people like you, couples like you, who went over to live? Hopkins: I think it's very important to protect your health, particularly regarding water and food. I don't think the medical facilities are ideal, even today. Additionally, in order to get a better idea of what it would be like to live in a village, I would recommend speaking with a Peace Corps volunteer about his or her experiences living in that area. But I think people learn as they live in an environment. Chillag: So, at what point did you think smallpox could actually be eradicated? Hopkins: From the start, because I believed my husband. I knew nothing about it, but I just knew that he was very good at what he was doing, and I just believed everything he said in those days. Not anymore. But I believed him, and I was very young, so he must have known. So it was that simple. Chillag: So, how do you feel about having been part of something so . . .? Hopkins: It's amazing to me that it turned out to be so wonderful. I thought once smallpox had been eradicated from Africa, no one would care that it had been eradicated. But smallpox now represents the first disease eradicated from the world, and I played a part. But it was a great time! Chillag: Does Don talk about it a lot? Hopkins: Oh, he still talks about it, but he's now trying to eradicate another disease, Guinea worm. So I think he's very excited about that disease now. But I believe the idea that Guinea worm disease could be eradicated was based on his work with the smallpox program. Don is very proud of the time that he spent with the Smallpox Eradication Program. Chillag: It sounds like it affected him. Hopkins: Yes. He wrote a book called Princes and Peasants: Smallpox in History. It came out in 1983, and was nominated for a Pulitzer in the history of medicine category. It was out of print for a while, but the University of Chicago republished it about 3 years ago, with a slightly changed title. It's now called, The Greatest Killer: Smallpox in History. For those interested in medicine or history, I think it's a great book. It shows how smallpox influenced history among both royalty and peasants. So Don was able to write a historical account of smallpox disease. Chillag: Very interesting. Do you have anything else to add? Do you want people to know for posterity about this experience? Hopkins: No, I don't believe so. Chillag: Well, thank you very much. Hopkins: Thank you. # # # </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310126372%3Fsecret_token%3Ds-F609W&amp;color=ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false" frameborder="no" scrolling="no" width="100%" height="166"></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 sound recording - nonmusical interviews Date A point or period of time associated with an event in the lifecycle of the resource 2006-07-14 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/158kj emory:158kj Subject The topic of the resource CDC Smallpox Eradication USAID WHO Life as expatriate wife Format The file format, physical medium, or dimensions of the resource 322884912 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Chillag, Kata (Interviewer); CDC; Anthropologist Hopkins, Ernestine (Interviewee); CDC; Wife of Medical Epidemologist Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of West and Central Africa Smallpox workers (2006 : Atlanta, Georgia) Title A name given to the resource HOPKINS, ERNESTINE Description An account of the resource Ernestine Hopkins, wife of Don Hopkins, who was the Medical Epidemiologist for the Smallpox Eradication Program in Sierra Leone. Ernie talks of traveling with her husband to the field during the week, adjusting to life in Sierra Leone, meeting people with smallpox in the villages, and the ways in which the experience has impacted her life. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/856ae8e9debcf0a0fb88fad7eec1217f.jpg c4496bf89f802d44f19921c5977ef646 https://www.globalhealthchronicles.org/files/original/84ddaacdfd3a2e0353d387af7eea8d34.mp3 3ace9d384155207cd1d834f6b9c8e3ea https://www.globalhealthchronicles.org/files/original/62c38e3955439f427d51ca7b3a2385ff.pdf 1279ef2ab906908d12145d08f49aad64 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> This is an interview with Ilze Henderson on July 13, 2006, at the Centers for Disease Control and Prevention in Atlanta, Georgia, about her involvement with the West African Smallpox Eradication Project. The interview is being conducted as part of a reunion marking the 40th anniversary of the launch of the program. The interviewer is Alicia Decker. Decker: What I thought would be an interesting way to begin is for you to just briefly describe your early life, some of the major factors or influences that affected you as you were growing up. Henderson: That's a question that's hard for me to answer. I was born in Riga, Latvia, and my life was very normal until age 7. Then the world fell apart. Now we call it genetic cleansing. It was Soviets shipping out people to Siberia. They just missed my family, so we had to flee to my grandparents, to the country. But that was the first time I realized that you can't depend on anyone. Then the war started. Finally, we fled to Germany and we stayed there, in southern Germany, until the war ended, and then spent 5 years in displaced persons camps. We came to the United States. Immigrants are sponsored. Well, our sponsor had become a drug addict, and he was losing his own job. So we managed. Finally, my father got a job in Milledgeville State Hospital, the largest hospital in Georgia, if not anywhere else, and,despite being a surgeon, he became a psychiatrist. Then I went to the University of Georgia, degree in pharmacy, and worked here in 1965, met Rafe Henderson [Ralph H. Henderson]. And he went off to Africa for a while and came back, and we got married in May of '66. In October, we went off to Lagos, in Nigeria. Decker: Wow! So you were married in May 1966, and then in October 1966, you moved to Africa. Henderson: Yes, yes, we did. Decker: Wow! Henderson: And I started a journal. Decker: Oh, wow. Henderson: And I can't stop it, so I've been doing it ever since then. Decker: Forty years. Henderson: Yes. An interesting part is that we left Atlanta October 13, 1966, and then we had the weekend off because the plane to Lagos left from New York. So we did this wonderful trip, well, Pan Am to Dakar, Roberts Field, stopping every few places, and we arrived on October 19 in Lagos. It was hot, humid, colorful, smelly, I'm saying. We got there at 2:00 pm, and we were very tired. The weather was hot. We were provided with USAID [U.S. Agency for International Development] houses, which was like living in Florida, and we had a cook and a small boy and a gardener, a night watchman, and day watchman. So that's where it started. Decker: Wow! Did you write in your journal every day? Henderson: Yes. And this is 4 years on 1 page. Now I have 1 year on 1 page. Decker: Wow! So, as newlyweds, what was the motivation for you and Rafe to pack up and to move to Lagos? Henderson: Well, he was an EIS [Epidemic Intelligence Service] Officer, and he came to Atlanta in July '65, and he did the usual EIS things. And then there were a couple of people, Mike Lane [J. Michael Lane] and Larry Altman [Lawrence K. Altman], who were already in West Africa, and I guess Larry was coming back. And they needed somebody else. So they said, "Do you want to go on this smallpox-measles thing?" And so Rafe did. He came back and married me. Decker: And when you got married, did you know that you were going to be going off to Africa, or was it a surprise? Henderson: Oh, yes. No, it wasn't a surprise.. Decker: Was this your first time to Africa? Henderson: Yes. Decker: How much notice did you have between finding out that he wanted to go to Africa and your actually leaving? Did you have a lot of time to prepare mentally, physically, emotionally? Or was it a very quick transition? Henderson: At that age, you don't care about those things. You know, "Let's just go." Decker: Just do it. Henderson: Yeah. Decker: That's great. Henderson: I have a scrapbook in the meeting room where we got briefed. And we got French lessons, of course-we were going to Lagos, which is English-speaking. We got lists of things as to what we were supposed to take that's supposed to last us 3 years, as if we were going to the end of the world. Anything and everything. That was a summer of preparation. Decker: Okay. So it's just a few months. Henderson: Yes, July to October. Decker: So, then, what were some of the greatest challenges you faced upon arriving in Lagos? Henderson: The heat. Humidity. Not knowing where anything was; different money; the new languages being spoken around you. Oh, and also, looking back, one flies a lot and one has colds in Lagos, and we had colds, and we had viruses, and we had diarrhea, and we had trots. In the 30, 40 years, I've only had 3 bad attacks of diarrhea, whereas my husband had a lot more. And other people. I mean, in this group . . . Decker: Healthy bunch? Henderson: No, no. We had to take what we called Sunday-to-Sunday medicine, which is chloroquine every Sunday. One of our group said one of the side effects is going deaf, and Margaret Grigsby [Margaret E. Grigsby] did. Of course, now we don't take it anymore because it's not good. I mean, they said it developed resistance, so you had to take other things. It wasn't ever a normal life for me. We started the morning with salt pills, vitamins, and aspirin (because we rode around in trucks a lot and we got shook up). The program covered 25 countries in West Africa, and everybody did not start work at the same time. There was a lot of travel for the regional office and people coming in and going out to the bush. So, we lived in Lagos, but it was mostly to regroup and wash up and then go out again. What was real different with me was that we didn't have-we don't have-children, so if we had enough money, I could go with Rafe, and that was fantastic. That s ort of subnormal life lasted until the end of April of '67, when Don Millar [J. Donald Millar] sent a cable saying, "You're supposed to be in Delhi with Dr.Lyle Conrad and Dr. Gordon Reid to put out the smallpox epidemic in India, like yesterday." (We called Conrad "Conree" because we combined the 2 names.) Decker: So this was in May of 1967. Henderson: Yes. Decker: So you had been in Nigeria for less than a year. Right? Henderson: Yes. Decker: From October '66 through May '67. And then you went to New Delhi? Henderson: Yes, because, seemingly, India was out of smallpox vaccine, and theirs was the kind that you apply with a rotary lancet, which is really an instrument of torture. But D. A. Henderson [Donald A. Henderson] from Geneva had said that "we will give you all the vaccine you want, but you have to use the Ped-O-Jet." So he said, "We're going to send 3 people from CDC-Atlanta to vaccinate India." Well, it turned out that that was the sort of demonstration project, vaccinating a whole lot of people like the police and the school kids. They were all already vaccinated, and that was what we did. When they sent the vaccine, they forgot to include the diluent, and the first demonstration project too! Many of the public health people had been saying, "This is a test and it doesn't hurt." Well, the vaccinees were all cringing and grabbing their arms because the vaccine was reconstituted with water and not saline. Decker: Oh, because it was freeze-dried, and so you had to reconstitute it with saline. Henderson: So they had to make their own saline, and from then it went a little better. And it was pre-monsoon. It was very hot and dry. . Whereever we went, we were given tea or Orange Spot or Pop Cola or Pee Cola, which tasted not so good, but, you know, it was liquid. India had thrown out Coca-Cola . So I think we survived that and came back to Atlanta for debriefing, and that was one of those wonderful flights, like New Delhi, Tehran, Ankara, Istanbul, Rome, New York. And we rushed from 1 plane to another and got back to what was the Sheraton Emery back then. I think it was like a 33- hour flight or something, so exciting. Decker: And when was this? Henderson: It was June 4, 1967. The next day, we had breakfast in the CDC cafeteria and lunch at CDC, and we slept a lot, and we're awake at 3:00 in the morning. And the war in the Middle East was starting, and RFK [Robert Kennedy] was shot in L.A. And I guess we had a little vacation for some reason. Then, on June 23, Rafe went to Lagos, and I stayed here for some reason. And then, in July, I went back to Africa. And then the Biafran War started. Decker: So July 1967, you returned to Lagos. Henderson: Well, no, to Accra. Decker: To Accra first, and then Lagos? Henderson: No. I can't remember the date of the start of the Biafran War, but it looks like that was a time when dependents could not go back into Lagos because it was too dangerous. Although there was only 1 small plane that tried to bomb Lagos, and that didn't work too well. So then Rafe was given or asked for a job to do assessments of the different programs in West Africa program. So I don't think I got back to Lagos. .. This was really wonderful. This was sort of like camping out forever. But I didn't get back to Lagos for a long, long time, to the point where it was becoming financially difficult because we had to pay for my tickets, and Rafe was sort of at wit's end and saying, "I'm just going to quit because this can't go on." And then they said, "Well, do some more assessments," and that worked out okay, and that was really a lot of fun in Niger and northern Nigeria and western Nigeria. And the trucks breaking down. The Dodge trucks were guzzling gas and were not made for the roads that were there. There was a trip from Niamey to Kaduna on which I think we broke like 5 things on the truck. Usually it was just washboard roads, you know, so you were really shook up all the time. But near Kaduna, there was a paved road or asphalt. But the truck was so bad that we couldn't hold it on the road, so we had to drive 2 tires off the asphalt and 2 on. And by the time we got to Kaduna,, we drove up to Hogan's house and they couldn't recognize us because we had red dust all over. Really fun. Decker: How exciting! Henderson: Yes. In western Nigeria, the assessment was during rainy season, so we got stuck coming and going. There's a picture downstairs where Rafe is crawling into the Dodge truck through the window. We went to a village-this famous survey where you pick out the village and you check people in their houses for vaccination scars. So there was this nice road, and then we got to what looked like a puddle, but it was big ruts, so we got stuck. And the villagers came and looked, and they said, "For 2 pounds, we'll pull you out," and they did, and we were very thankful. We came back, and we got stuck again in the same place. Decker: Fifty pounds. Henderson: No, five. Decker: Oh, my. Henderson: And just some fantastic meetings of the emir of Yelwa, which is on the western part of the country. People were fighting over their land or their churches or whatever, like last year. But the emir back then, I guess he was 40, had been to Oxford, but he still wore his robes. In Yelwa, there were these fantastic markets, where all kinds of people gathered and we did market surveys. I helped a little bit, to look at arms. And the first group was usually the butchers because they were the first ones in the market. The meat was all raw, and ever since then, I really like it well done. And they were very accommodating. It was a cold early morning, so the people wore many layers, and you had to stand there, and the aroma of the meat was overwhelming, until till they took off all the layers of clothing so we could see their arm with the vaccination scar. But other people then started coming. The busiest time, I guess, was between 11:00 and 2:00, when the sun is at the hottest. And most of the different groups didn't mind showing their arms. Except we met some ladies. Now we'd say they were dressed in leather miniskirts with cowry shells. I don't think they had spears, but they had some kind of a weapon. And, of course, they wouldn't, certainly, let us look at their children. And they didn't talk to us, and we knew not to ask if we could take their photo because they were really tough. Decker: Was this in Yelwa? Henderson: Yes, the Yelwa market. Decker: So you were really on the front lines with Rafe the whole time? Henderson: Yes, I guess partially because of the Biafran War. Decker: So you got to see everything that he got to see? Henderson: Yes. Decker: Instead of staying isolated in a compound somewhere. Henderson: With air-conditioning. Decker: How interesting. You're my kind of woman. I like that; I definitely like that. So, some of the challenges. . . Did you have to learn how to fix the Dodge trucks yourselves? Henderson: No. They did. Decker: They being the men? Henderson: Well, you finally had to rely on the driver because the driver was the most competent. I mean, some of the people who went, like Rafe, could kick the tire and look under the hood. Although once we broke down in a rubber plantation in Sierra Leone or Liberia. There was this feeling that we'd been losing brake fluid, and eventually the brakes didn't work. So what they discovered was that the Dodge was designed where the brake-fluid line was right next to the engine block, so of course when you shook on the washboard roads, it eventually would rub a hole in there. So, what do you do? Well, we had a first-aid kit which had cotton, and we found some thin rope somewhere, and we said, "Well, that won't do. But, look, there's a rubber tree, with rubber." So they got some rubber and cotton, and then they wound the twine or the rope around the line, and it held for some time. Decker: So you bit off part of the rubber tree, chewed it off? Henderson: No. The rubber itself, because they tapped the rubber tree. Decker: Oh, and it's like syrup, it's sap. Henderson: It's like chewing gum, almost. Decker: That's right. That's a great story, that's a great story. Henderson: All true. Decker: So, when you went back in '67, back to Lagos finally, that's when you started traveling around the region? Henderson: No, it was before that. It was from the time after India, after Atlanta, and then we started traveling. Decker: Okay. And then, after the travels around the region, you came back to Lagos? Henderson: Yes. And it was nice to meet all the MOs [medical officers] and the OOs [operations officers] everywhere. There was something about Jay Friedman [Jay S. Friedman] bellowing for his driver named Benson , who was supposed to come pick him up. The driver finally showed up and he said, "Well, my watch didn't work," which was not exactly right. . . And in western Nigeria, I think we did part of the assessment iduring the war with Biafra, so there were roadblocks everywhere, every few miles, manned by the local police and usually drunk soldiers. And they didn't get along among themselves very well. And there was, of course, a curfew. Wherever you were going, you had to be there by 7 pm. So when you get stuck in mud on the road and you can't quite get out . . . We had 1 very uncomfortable checkpoint stop where the police and army were arguing with each other. We had to take everything out of the truck, and they went through everything. And I think one probably wanted a little gift, and they couldn't agree, until Rafe finally said, "This is an American Embassy vehicle, and I need your names because I have to make a report," so that sort of stopped them. And they thought a bit and they said, "Look, just go on." Decker: Oh, so you were in an embassy vehicle, or did you just make it up? Henderson: No. Well, I guess, you know, USAID is part of the government. Decker: That's true. Henderson: And the embassy is our thing in the country, so, yeah. Decker: Clever, very clever. So, what were some of the challenges of working with your local country counterparts? I mean, you talked about some of the physical challenges of living in Africa. What about the interpersonal relationships with the Nigerians? Henderson: The regional office was regional, so the Nigeria program was a country program. Decker: Oh, okay. Henderson: Dr. Foster [Stanley O. Foster] and Dottie [Dorothy Foster] were working with the Nigerians, so we really didn't interact with the Nigeria program. Decker: Oh, you didn't. Okay. Henderson: Well, at dinners and receptions. And I'm sure Rafe had some interaction, but that was a big program. Nigeria is a big country, so it was Dr. Foster who did it. Well, whenever we went to a country, we'd stay with either the MO or the OO. It was just wonderful: an exhausting day and a delicious dinner and fall in bed. Decker: So your husband was the regional epidemiologist? Is that correct? Henderson: He was Deputy Director of the regional office. And George Lythcott was the Director. And Don Millar was the counterpart here in Atlanta, and then D. A. Henderson in Geneva. Decker: Okay. Were you and your husband actually administering vaccinations yourselves, or were you supervising teams that were doing that? Henderson: I didn't. I took pictures and observed the ambiance. Decker: Have you written a book, published a book? Henderson: No. This "Any Year Diary" I am holding, is my book. Decker: It sounds like you have amazing memories.. . . Henderson: The OOs and the MOs were all epidemiologists. So when Rafe went to a country, he'd make a checklist as to whatever was going on and the problems, the accomplishments, the unsolvables, all that. And , we all would volunteer , sometimes, to be vaccinated. I've been vaccinated so much. So that was my only involvement. Decker: Okay. Can you describe a typical day, or was every day different? Henderson: Every day is different. Decker: Every day is different. So you were always moving around? Henderson: Yes. Decker: So, then, was it difficult, I suppose, to form attachments with local friends? Henderson: Well, not in those years in West Africa because we were all friends. We were all like a big team. No, that was no problem. It was a unique experience and situation. Decker: What are some of the things that you or your husband would have done differently, looking back on the program today? I mean, obviously, it was a great success. But are there any elements that you would have changed if you could do it again? Henderson: Probably the orientation wasn't that realistic. But in any travel, they give you a sheet of things that are supposed to go on, I mean, and it doesn't really. And I don't think anyone can really know, unless they send someone to do exactly what you're going to do and they come back and they report. But their report sometimes is very different from what really goes on on the ground. Back then there were no emails. Phones didn't work very well. I think if you'd called from Lagos to Cotonou-which is like, what? an hour away or so?-the call went from Lagos to London to Paris to Cotonou because the French had their system and the British had their system. And there were no satellite phones, of course. The mails were not reliable. So communication is always a problem. And when there's that breakdown, people in Atlanta had a different idea of what was going on in West Africa. And, of course, we thought the Atlanta people really didn't care much about us. That's putting it politely. Decker: Yeah. Henderson: And we had broken equipment. I mean, the trucks just weren't meant for West Africa. There were many times the Land Rover had to pull us out. Just to get spare parts . . . And there was a time we broke an axle-I mean, everybody was breaking axles, and it happens on a washboard road out in the middle of nowhere. And finally somebody comes by and pulls you into a town, and then you get a cable from Atlanta saying, "Well, 3 months to get a new axle." Decker: And what do you do? Henderson: Well, you can raid another truck, that kind of thing. And, when Atlanta came to West Africa, but it was rather ceremonial. I mean, they came for, I guess, the ten-millionth vaccination and the twenty-fifth million. Decker: I read about the ceremony that they had, Henderson: That was very good. Decker: They had a big observance: they vaccinated a young girl. Henderson: Yes. I was there. Decker: Could you describe that day or the event? Henderson: Oh, it was fantastic! Other than hot. It was a little bit up from Accra, so maybe it was higher, so it wasn't so humid. But all the chiefs were coming in. Each chief was under a ceremonial umbrella, of course, just red and gold-I guess Ghana used to be called the Gold Coast. These umbrellas were like what we have on our patios. And, of course, the chiefs were preceeded by the bearer and the person who carried the paramount chief's insignia and all that, and then probably a praise singer. Finally they got seated, and somebody had to hold the chief's arms because they were so weighed down in gold. And then we all sort of filed by and shook hands. And that's when the visiting cards were exchanged. And the drumming and the dancing! There was a group of women who pulled my husband into their midst and formed a sort of a circle, and I think they took turns dancing with him. I'd better not describe them, but they liked my husband. Decker: So it was a big event. Henderson: Yes. Decker: And the folks from Atlanta, like Dr. Sencer [David J. Sencer], flew in. Henderson: Millar, Dr. William Stewart, the Surgeon General of the United States, then. Decker: Oh, right. Henderson: And here are just wonderful pictures. [she is showingpictures] Decker: That's the Ogden book that you're showing me? Henderson: Yes, it is. It's the 10th anniversary. Decker: Okay. I just got done reading that book. Henderson: A letter from Billy Griggs is saying, "Sorry that you couldn't be with us," December 2, '87. And then James Mason, the CDC Director, was talking about the smallpox warriors in a special exhibit. Decker: Wow! Is this a letter that you would be willing to photocopy and give to the museum? Henderson: Sure. Decker: Okay. Henderson: And this mentions, in the first paragraph, the people who came. And here is a picture of the 3 instruments for vaccinating- the rotary lancet, jet gun, and the bifurcated needle. And this is where they're learning to repair Dodge trucks. Decker: So your husband was in one of photos? Henderson: Right there. And Bill Foege [William H. Foege]. Decker: So you're all just young-young, fresh, energetic. That's great. What an experience. How many years total were you in Nigeria and the region? Henderson: Three. Decker: Three. So you came back in . . . Henderson: July of '69. Decker: '69, okay. So I read that Nigeria was smallpox-free by May 1970. So you came back before it was completely eradicated. Henderson: Yes, because things were slowing down. Decker: Okay. It was just that final little pocket in Nigeria. Henderson: Yes. Decker: Okay. So, at what point did you actually think or believe that the smallpox would be eradicated? Henderson: Day 1. Decker: Day 1! So you were an optimist from the get-go. Henderson: Well, I think everybody thought that, except for maybe Millar, and, D.A. I don't know. Decker: Did you recognize the magnitude of what you were trying to accomplish at the time, or only years later? Henderson: Well, it's a horrible disease, and to see what it was doing to the villagers. There was one village that we went to, with either Jean Roy [Jeannel A. Roy] or Andy Agle, that had a smallpox epidemic. I don't know how many died. And the chief felt so responsible for it, felt that the smallpox was his fault, that he burned down his house. And he didn't have very much to start with. And in India we saw hemorrhagic smallpox, which is just on the skin. It's like having very thin skin. All the capillaries are just about to burst. The hospital in Delhi had a special ward for the people. It's an awful, awful disease. Decker: Was there an understanding among the folks on the ground of how smallpox was transmitted? Henderson: Well, not in those words, no. Decker: What was the local understanding of the disease? Henderson: If you go to the village level, it's just something that comes every year or every so many years. That's just part of life. Decker: Was it attributed to a particular god or act or witchcraft? Is there a way that people explained the disease? Henderson: Well, we really never got into it too much because you had to have several interpreters. And by the time the answer came back, it probably is not what was said at the end of the line. So I don't know. Decker: That's the anthropological side of me probing you here. Henderson: Well, Nigeria, or the Yorubas - Lagos, in Aboekuta, , Ibadan, had a smallpox cult that had been going for several hundred years probably. And maybe the priests or the Fetisheurs had been using variolation because they didn't get smallpox. So they could say, "Well, I'm the special person, and the chief of smallpox, but if you give me some gifts, maybe smallpox will not attack you. There are 2 kinds of smallpox; with one, your skin will break out; with the other, your mind is affected. So a little gift would help. And if it doesn't, then I'll just take care of you after you're dead. But I will need to be paid with your possessions." The British finally outlawed the cult, I guess, in 1905, but they had some outbreaks after that. Shapona is supposedly the smallpox god. The Fetisheur has a little sort of a shrine where he has the god, a special smallpox pot, and bottles of gin and vodka and things like that. I have a history of the Yorubas that I bought in a market. We all loved markets. Other than checking for vaccination coverage, I mean, they're just vibrant places and had wonderful stuff. There's the medicine and the Juju [phonetic] part of it, and all of the different things you can eat from these huge snails that must weigh 3 or 4 pounds, dried rats, and all the delicacies. Decker: Were you able to partake in eating all of the delicacies? Did you tend to live an American lifestyle in terms of diet, or did you jump into the culture with both feet? Henderson: Well, what is that thing that CDC travel book says, unless you cook it, peel it, or -you know, the 3 things-you don't touch. And, well, it's not comfortable to have a lot of diarrhea attacks, so one sort of watched. But we also went to the restaurants. The dishes I cook with ground nuts, too, they're just wonderful. Curries, West African curry, just different from Indian curry, somewhat. Brochettes of things, frog's legs, shrimp, barbeques. In northern Nigeria, they had too many peanuts, so the hogs were fed on peanuts, so that was a very good. Decker: You can tell it's close to lunchtime now. I'm talking about the food. Henderson: Well, yes, the food. And then, of course, there was English food, which wasn't so great. But the French, Lebanese, was just wonderful stuff. I was going to say that we should have tried more-well, we did, we did, but we didn't eat things off the street. I didn't think that was the best. And even then, I got diarrhea. My first diarrhea attack occurred in Accra, between the jet-gun demonstration in January and the 25th millionth vaccination. It was bad, and I took too many Lomotils, and I think I slept probably a whole day. Decker: Did you have major illnesses while you were there or just mostly routine diarrheas? Henderson: Diarrheas, colds, feeling, I guess Brits say, seedy, lousy. I think my husband probably had typhoid fever between Lome and Niamey. Maybe that's why he left me somewhere, and he went off to Lagos. But, well, I guess it was Niamey where the Peace Corps doctor had this big book of tropical diseases. I went down to look in it to see what he could have because he'd been treating himself, thinking he had malaria and he didn't. So he'd be okay one day, and the next day he would be just shaking. There was a nurse who said, "Well, I've met some typhoid people, and sometimes they just jump out the window, it's so bad." But, luckily, the Peace Corps doctor had Chloromycetin, so Rafe got a dose of that, and I think I got some, and he recovered. Well, at that age, you don't think that health is that important. I think it's only after retirement, that that sort of hits people, things that should have been looked at before, like prostate cancer, colon cancer. I don't know if anyone had lung cancer in the group. But back then, we were invincible. Decker: During the time that you were actually in the field, were there moments that you had regrets or feelings such as, "What am I doing here? Why did we do this?" Henderson: No. Decker: No regrets. That's fabulous, that's fabulous. So, it seems like such a silly follow-up question, but in what ways did this experience as part of the project for these 3 years change your life? Henderson: We got sent to Geneva, Switzerland, to WHO [World Health Organization]. Decker: Oh, okay. Henderson: So we got back here in '69. Then Rafe got 2 more degrees, an MPH and an MPP [Master of Public Policy] from the JFK School. And then he came back to Atlanta, and he was given several projects. One involved blood in labs, I think; I can't remember. There's some blood network. It's not the Red Cross. And then Dr. Sencer thought that we should get some taste for how Washington is run, so we spent the summer there. And then we came back and Rafe started supervising the Venereal Disease Division. Eventually, the name was changed to Sexually Transmitted Diseases, and the list of diseases enlarged from just 2- gonorrhea, syphilis-to all the others, ending with unwanted pregnancy. Guess one shouldn't talk about that. And that lasted from '72 to '77. And in January of '77, Dr. Sencer said, "WHO needs an American to create the Expanded Program on Immunization for WHO, so do you want to go?" So Rafe said, "Oh, yes," and he spent the month of January in Geneva justifying why he was capable of doing it and why he would want to do it because WHO had many experts, over 50 or so, because they'd done everything and they knew everything, and then this young American comes. Decker: And Rafe was in his 30s, right? Henderson: Yes. And so, finally, they said, "Well, okay." I think D. A. Henderson was coming back, and that created the slot. And Rafe came back, I think, the end of January of-this is not the book; I have another book. Decker: You must have a line of books in your house. Henderson: I do, yes. I think I'll have a bonfire or something. Decker: No. You should donate them. Henderson: Yes, well. Decker: It depends on your secrets. Henderson: No. Most of them are in a code. Decker: Oh, that's good. Henderson: But it was a Saturday, and, Rafe was in Geneva. Back then CDC was smaller. . Jane and Dave Sencer were really taking care of everybody and supervising and giving wonderful dinners. Dr. Sencer came back from Washington. And this was after the swine flu problem. He'd been up there to brief Hale Champion, who was Undersecretary of Health and Human Services, Health, Education and Welfare, I guess. Dr. Sencer had been briefing him, and he was about to go out the door, and Hale Champion said, "By the way, you're fired." Decker: Wow! Henderson: So Dr. Sencer came back, and there we were all going to have a nice, joyful party, and that certainly put a damper on things. A few days later, Rafe came back, and CDC decided he could still go to Geneva, and they gave us a month to pack up and go, and we did. We went for 2 years, and the contract was renewable every 2 years, so if WHO and CDC were happy with Rafe, and Rafe was happy, it was renewed. So we stayed for 23 years. Decker: Oh, my. Are you still there? No. Henderson: No. We came back October 1, 1999. Decker: Wow! What an exciting life! Henderson: And the interesting thing is that, after the smallpox program, there were all these - in the states and other places. WHO turned out to be a place that had abbreviations for everything and they called the Expanded Program on Immunization EPI. , The old smallpox people were very valuable, so they were coming through EPI all the time. So smallpox and EPI sort of runs together to me, and I can't tell sometimes who's who. Decker: They view your experience in one, not into the next experience. Henderson: Well, the OOs and the MOs, that's what they did. They were valuable in running vaccination programs. So they had this expertise that WHO didn't have. Decker: So WHO needed them for their next thing? Henderson: And, well, Jean Roy is still running around doing that, and he works for the Red Cross and Red Crescent Societies, whose headquarters are in Geneva. Decker: I understand that you're trained as a pharmacist? Henderson: Yes. Decker: Do you practice as a pharmacist? Henderson: No. I retired in July of '66. Decker: Good for you! Had you practiced before you retired? Henderson: Yes. I was a pharmacist at Emory University Hospital pharmacy, and I should have worked about 4 more months so I would get full Social Security, but I didn't, so mine is half of what my husband is. Decker: Wow. Did you ever feel that because you were going where your husband was going, you missed out on your own career? Henderson: No, because the West Africa experience was so unique. Who wants to have a 9-to-5 job if you can do that? Decker: That's true. Henderson: And then coming back here for a few years was very nice. And then the EPI experience. I think I said before that I don't want to travel. I've had it. And I don't want to go camping. The only places I haven't been, I guess, are South America and China, Mongolia. We had a big network of friends; some of them, as I said, were from the Smallpox Program and some new ones. I went to so many meetings. And I wasn't welcomed everywhere at the meetings. Finally, we hit upon Rafe's introducing me as his personal assistant, instead of as his wife. There was no problem with that because there were other people who took people along who weren't exactly their wives. But, no, that was fantastic. Decker: Wow. So you were definitely a member of the team. Henderson: Yes, in a sense as being a personal assistant, taking photographs. Well, I'm also sort of a people watcher, and it's wonderful to see the people, what they say and what they do and how they perform. Decker: Did you have an opportunity to learn any local dialects? Henderson: No. We weren't there long enough. Decker: You were moving around too much. Well, you've done amazing things. Henderson: I wonder if I've forgotten something I wrote down but no, probably not. Decker: One of my last questions was actually going to be whether or not you would like to add anything that we haven't discussed? Henderson: I think the EPI experience is interesting. Decker: The EPI is the one in Switzerland? Henderson: No, global. Decker: Oh, the global, okay. You'll have to forgive me with the acronyms because I'm on the academic side over here with historians. But what incredible opportunities you've had. Is there a particular story that you can conclude with, of like the greatest challenge or the toughest moment or the most exciting moment? Henderson: All of those! Decker: And it all happened on 1 day. Henderson: Just about. Decker: Were you able to stay in contact with your family back in the United States? Henderson: Yes. At first it was just postcards. I have them on the desk.downstairs. And then I took home leave every 2 years. I would visit everybody for 2 weeks, and then collapse, emotionally, psychologically, and physically. And airplane travel isn't that great. But then it used to be better. But 1 thing I forgot: Rafe and I developed a hobby that we both participate in. The thing is that it's a hobby that you have to do together. It's bird watching. It started in Lagos. In Lagos, it would be dark and all of a sudden it would be sunny. And then in the evening, 6:00 sunset. Decker: Yes, the 12-hour days. Henderson: So we would be woken up to this bird outside our window-well, our windows were closed, but it was loud enough. And the bird was saying, "Quick, doctor, quick!" and it kept on and on and on. And Rafe said, "What in the world?" Well, it was a bird. Luckily, there was a little book that we found, The Birds of West Africa, I think, and it had that bird in it. It was a common bulbul, and it's the Omar Khayyam's nightingale. It's a nondescript bird, and it's not like the European nightingale. And then we saw all these other birds out there in the garden, and sure enough, they were in the book. They were all colorful and loud and great. And from then on, we started birding, and now we do that. We always had been members of the Georgia Ornithological Society. They have a spring meeting and a fall meeting and a winter meeting in different places in Georgia. So now that we're back here, we're going bird watching and we meet these unbelievable people who just know what's what and hear a sound, and they say, "No, that's not it. That's what that is." Decker: So you traveled the world and found . Henderson: Yes, but this is just in Georgia. In August, we're going to Jekyll, Tallahassee, Kennesaw, Columbus. We don't do all the canoeing and kayaking, and we're not that good, because each continent has different birds, but we're learning. Decker: What a fun hobby. Henderson: Yes. Oh, the thing is that if you see a bird and you say that's what it is, well, someone has to agree with you, so that's the hobby that we can do. Decker: And do you ever fight over it? Henderson: Yes. Decker: And who's right? Henderson: This spring, he was. He saw an orange-crowned warbler, and you can't see a crown and it's not orange, but that's what it was. Decker: That's great. So Africa comes back to you again. Well, thank you so much. Henderson: Well, thank you. Decker: Thank you for your stories, thank you for your time. You're just a firecracker. Henderson: Yeah, on vacation. Decker: Yeah, well, that's great. So thank you for your time. # # # </pre> Player html for embedded player to stream video content <iframe width="100%" height="166" src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310125697&amp;color=ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false" frameborder="no" scrolling="no"></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 text interviews Date A point or period of time associated with an event in the lifecycle of the resource 2006-07-13 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/158jd emory:158jd Subject The topic of the resource WHO Biafra War Life as expatriate wife CDC USAID Smallpox Eradication Format The file format, physical medium, or dimensions of the resource 699002640 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Decker, Alicia (Interviewer); Emory University; Graduate Student Henderson, Ilze (Interviewee); CDC; Wife of Deputy Director of Regional Office Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of West and Central Africa Smallpox workers (2006 : Atlanta, Georgia) Title A name given to the resource HENDERSON, ILZE Description An account of the resource Ilze Henderson, wife of Rafe Henderson who served as Deputy Director of Regional Office, in Nigeria. Ilze tells of immigrating from Latvia to the United States and meeting her husband, Rafe, during college and moving to Lagos, Nigeria shortly after they married. Ilze went with Rafe on assignment to India, and then back to Nigeria. Ilze speaks of the Biafra War in Nigeria, traveling with her husband on assessment surveys, adjusting to life as an expatriate, Rafe's later career with CDC and WHO, and life and hobbies since the years spent working on smallpox eradication. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/f6c18e9dd450faa83afa9f0244d0b85e.jpg b77a45cec35285408854f749ee7fa489 https://www.globalhealthchronicles.org/files/original/773af72412b35b19ffeb3e0caf818550.pdf fd6cc275654113293071c9e2e5b12efb 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> This is an interview with Jay Friedman on July 13, 2006, at the Centers for Disease Control and Prevention in Atlanta, Georgia, about his involvement with the West African Smallpox Eradication Project. The interview is being conducted as part of a reunion marking the 40th anniversary of the launch of the program. The interviewer is Diane Drew. Drew: Would you mind giving me a little bit about your background, where you grew up, what's your education, that kind of thing? Friedman: I was born and raised in New York City, in the borough of Queens. I went away to college at the age of 17, to Florida State University in Tallahassee, Florida, where I graduated in 1961. Drew: And what was your field of study? Friedman: I majored in business administration-not that I was so business oriented, but I wasn't a great student and thought that was an easier path to grey hair. I was the equipment manager of the baseball team, which was a championship team. And, as equipment manager, I had a full scholarship, which my father loved, which is why I stayed at Tallahassee. Following that, I went to law school for a year. But I didn't like it very much, and joined the Peace Corps in 1962. I spent 2 years in Sierra Leone, West Africa, mostly teaching English, math, and motor mechanics- Drew: That's quite a combination. Friedman: -in a vocational high school in the city of Freetown. Motor mechanics because I had put my way through college working as a mechanic at an Oldsmobile dealership in Long Island, New York. Drew: How cool. Friedman: Learned how to work on cars, which perplexed my father totally. Drew: That's a very handy skill to have. Friedman: Yes. One problem is my knowledge of cars ended when I graduated from college in 1961, so I know nothing about newer cars, just old ones. Following the Peace Corps, in 1964, I went to American University in Washington, D.C., majoring in international relations and economics, and, if you like, a minor in French, which I learned to speak fluently. I spent 5 months in France to that end. Drew: What part of France? Friedman: I was in Paris, then in a small town called Boulogne-sur-Mer, which is right on the English Channel. From the high part of the town, you could see the White Cliffs of Dover. Drew: Oh, wow! Friedman: We used to go on weekends in France. Drew: So you were really immersed in France, I'm sure. Friedman: Yes. I was living with a family in Boulogne. The husband was a fishing-boat captain. And Boulogne is the world's capital for mussels. So I had mussels smothered in loads of butter at night and gained lots of weight. Thankfully, though I still love mussels, I left the French way of cooking behind. I finished at American University with a master's degree in 1966, at which time I didn't know exactly what I wanted to do. I was approached by the Coast Guard to become a Coast Guard officer, which I seriously considered. I had been getting a Peace Corps bulletin for returned volunteers, which came every month or so. And at this very juncture of my life, the issue that was delivered to my apartment in Washington had an advertisement from CDC. They were looking for people who had lived in Africa, who could speak French, and who could fix a car. Drew: This sounded like it had your name written right on it. Friedman: It just jumped off the page. Drew: Really. Friedman: So it had a phone number in Atlanta. And this was in the days-I don't know if you remember these-when making a long-distance phone call was a big deal. Quite a big deal. So I dialed the phone number and got a gentleman named Leo Morris on the phone. He was the assistant branch chief or the assistant chief in the smallpox program. He was coming to Washington the next day for some unrelated reason, and we made an appointment to meet. We did. He interviewed me, and he hired me on the spot. Drew: That seemed so fateful. Friedman: But I don't think at CDC today, anyone can hire anyone on the spot. Drew: That's true, that's true. Friedman: And certainly not anyone without any public health background whatsoever, who could merely speak French, fix cars. I don't think such qualifications would get you anywhere today. Drew: But it's the perfect combination. Friedman: Right. And Leo said, "You're hired." I don't know what bureaucratic shortcut he used, but that certainly was the case. And 2 weeks later, in July 1966, I was here in Atlanta. I flew down from Washington and rented an apartment-an apartment, which I believe is where this very building, Building 21, is now. If you're looking at the buildings, to the right of the building they just tore down, there was an apartment house. CDC was much smaller then. Drew: Sure. Friedman: And there's still a pine tree growing right there, which was right next to my bedroom. Drew: Oh, how funny. Friedman: The tree is still there; nothing else. Drew: That's funny. Friedman: In any case, I was the closest person at CDC to the office. We met every day in the auditorium, which has just been torn down. And I literally awakened at 10 to 8:00 and would be sitting in the place where we had our training course 10 minutes later. Drew: You had a really easy commute. Friedman: I had an easy commute. The apartment became a motel later. Drew: Didn't CDC take it over and have offices there? Friedman: The motel closed, and there were CDC offices there. Through the '80s. And it was only in the '80s, I believe, or the early '90s that they built Building 21. But, thankfully, did not cut my tree down. I have a picture of me in front of it in 1966. Anyway, I began at CDC as a trainee in the Smallpox Eradication Program in July '66. Leo Morris, the guy who hired me, was my boss. Drew: And you were in the public health advisor series? Friedman: Yes. There were 4 of us hired through this Peace Corps advertisement: myself, Jean Roy [Jeannel A. Roy], Tony Masso [Anthony R. Masso], and Mark Pointe, all of whom are going to be present at the reunion. And the others-I think all of them-were public health advisors for the VD [Venereal Diseases] program, the VD branch, who had been chasing syphilis up and down the streets of New York City. Drew: Yeah, [looking for] the contact persons. Friedman: It was felt that their expertise in that regard would be useful in smallpox. The 3 other guys and I who were coming from the Peace Corps did not have that expertise, but we knew the language and other things, fixing cars. Tony was with the Peace Corps in South America somewhere. But Mark, Jean, and I had all been in Africa and all spoke French. Anyway, we started a training program here in Atlanta, which went on for several months. We were taught epidemiology, the epidemiology of smallpox in particular, which was very simple, actually, in the scheme of things in the world of epidemiology; and administration, how the government works. We would be going to 19 countries. The majority of them were French-speaking countries, French colonies in West and Central Africa. Drew: And did you know ahead of time which country you were going to go to? Friedman: Not at the very outset. When the program began, I think none of us knew, although I assumed, having learned French, I'd be going to a French country. At some point during the training course, which went on for 3 months, we were told. Originally, I was to go to Niger, and then, for various reasons-I forget what they were-I was told I would be going to Mali. In most countries, we had both a medical officer and what were called operations officers, of which I was one. Our jobs were to assist the medical officer with the epidemiologic work- ups of smallpox outbreaks. More importantly, we were in charge of the logistics of the whole enterprise because the people who organized the program-D. A. Henderson [Donald A. Henderson], Leo Morris, Henry Gelfand, Rafe Henderson [Ralph H. Henderson], and others-wisely realized that smallpox was not so much a medical problem as a management and logistics problem. The means for fighting smallpox were mostly known, not totally. Its epidemiology is very simple. Vaccination is an absolute preventive measure for varying periods of time. It's a simple disease epidemiologically in the sense that only human beings are the reservoir, meaning the virus doesn't lurk in water or in insects or in the environment in general. The virus is only found in humans, which makes a huge difference. Once you interrupt the chain of transmission from human to human, you can stop the disease in its tracks, which had been done in much of the world by 1966. The major foci, or the focus-I'm not trying to impress you- Drew: Hey, I'm already impressed. It's okay. Friedman: Remaining in the world were foci in Brazil and East Africa, which was variola minor; an attenuated form of smallpox, and variola major, the real smallpox, with a 25% death rate, in West and Central Africa, the Indian subcontinent, and Indonesia. Almost all other countries had eradicated smallpox through vaccination activities. And it was, of course, eradicated in countries with the best-and I'm going to use this word loosely- management. Drew: Sure. Friedman: So, naturally, in developed countries, they had mass-vaccinated enough of the population years before that it never really even got a foothold. Well, we had it in the United States, I guess, in great amounts in the 19th century. In the 20th century, there were just sporadic outbreaks. I remember as a child in New York City, there was a scare, around 1947, right after the war. I think there were a couple of cases of people coming from other countries where it was endemic. There were 1 or 2 cases in New York City. But the entire city got vaccinated immediately, including me. I remember it well as a child. I believe the last cases in the United States were in the very late '40s, I think in Texas. They might have been imported cases from Mexico. I don't remember exactly. In Europe, there was an outbreak in the '70s in Yugoslavia of some Muslims. I believe it was involved pilgrims from Mecca to Yugoslavia. Most cases outside the endemic areas I named were imported, usually traveled from an endemic area. Mecca was a big point for the transmission of many communicable diseases because masses of people gathered there. But there were other areas where smallpox cases would come from. Anyway, I went to the training course, and I was assigned to work under a medical officer named Pascal James Imperato, known as Pat, who's going to be here also. In fact, he and his son are staying at my house. Pat and I went to Mali. I went in December of '66 and Pat a month or so later. And the original strategy for eradicating smallpox in West Africa was to use mass vaccination of the population with jet guns. Drew: Right. Friedman: Now, you've heard of these. They were developed by the military to quickly vaccinate the recruits, I guess anyone in the military. Drew: Were these the ones that were powered, that required electricity?? Friedman: Mali had a measles control program, also directed by CDC people, including Rafe Henderson, that began a year or so before; it used the military jet guns. And the jet gun consisted of a thing that looked like a gun, 2 hoses, and then a pump to pump hydraulic fluid into it and charge it, to load it, if you like, against a spring. The military once had an electric pump, which ran at 110 volts US current. To use the military jet guns in West Africa, you had to use a transformer and plug them into the wall, or, in this measles campaign, which predated smallpox, they had International American trucks with a refrigerator and generator mounted on the back. The generator generated 110 volts, and they could use the electric guns in the field. This was all very unwieldy. The trucks would break; the generators would break. The electric pumps were very well made, made on a military, I believe, cost-plus basis so they were very solid. And the guns themselves rarely broke. Drew: It was all the other things they were connected to? Friedman: Yes, the refrigerators, the trucks, even though Internationals are very good trucks. They decided, wisely, that the electric guns weren't the way to go with smallpox, although we had a number of them in Mali. We assigned those to fixed health facilities, where they could plug them in the wall and transform them. Drew: Where people could come to you. Friedman: Yes. This was mostly in the capital city. Everywhere else in Mali, and everywhere else in West Africa, they used something called the Ped-O-Jet. It was the same gun part, upon which you put a bottle of vaccine and a needle. But instead of the pump on the ground, the 2 hoses coming to it being powered electrically; it was a pedal. The operator would step on the pedal-and I'm making a stepping motion. Drew: Yes, right. Friedman: I'm telling the recorder that. Drew: Please note. Friedman: And it would charge the gun, and the bottle of vaccine, of course, would be on the top. And then you pulled a trigger, and the vaccine would be injected forcibly into the skin of the vaccinee. We had 2 types of nozzles on the guns. One was for intradermal smallpox injections, right on the top of the skin, and one for the measles vaccine, which was intramuscular, where it would go straight in as if it were a needle. Smallpox, you just deposit the vaccine on the surface of the skin and then prick the skin, normally with a needle. And this nozzle on the jet performed that function. Unfortunately, the Ped-O-Jets were not made for the military. They were made for CDC by a firm in New York, and I don't think they were up to the same quality level. The guns would break-not so much break, as their internal valves and springs would wear out or get stuck. The nozzles would clog, for which we had special wires to ream them out. And especially the pedal, the pedal pump. I think they were made of aluminum with Teflon O-rings acting as piston rings. And this aluminum, being a soft metal, would wear out very quickly. Being an ex-mechanic, I had to fix them all the time, although I trained Malians to work on them, which is not very difficult. And we spent a lot of time fixing these Ped-O-Jets. In fact, in Mali, we had 1 guy, a vaccinator, assigned full-time to work on Ped-O-Jets that were being used out in the field. So we had to transport them back to the capital to have this guy work on them. The simple repairs could be done in the field. But any time the pedal pump broke, you had to send it in. You had to re- machine the whole piston when that happened. Drew: Sure. Was this whole process of doing the foot stroke on the pedal and shooting the gun difficult to coordinate? Friedman: Yes. That's a good question. In the French-speaking countries, we were very fortunate. The French had set up decades before something called a Service des Grandes Endemies (SGE), which in English is the Endemic Disease Service. It consisted of mobile teams of male equivalents of registered nurses, which in French are called Infirmier d'Etat, which is literally "state nurse," but it really means registered nurse. These are very high-level people with excellent training. These groups of Africans would go in the bush, as we called it in Africa, on vehicles, sometimes walking or on horses or whatever, and attend to the public health needs of the population on a scheduled basis. Drew: Making rounds in different areas? Friedman: Yes. And it was run as a military service. The workers in it had ranks, and they were, by and large, headed by French military doctors with military ranks. And under them were-it sounds very racist today-what they called in French Medecin Africain, which means African doctor. These were Africans trained in the university in Dakar, Senegal, to be medical doctors, but on a lower level. Shall we put it this way: they received less training than a medical doctor in France. So the heads of the Endemic Disease Service were usually the French medical doctors, and sometimes the French medical officers were in charge of actual teams. But, more frequently, they had what they called these African doctors, who, in my opinion, were superb people in the field. They really knew medicine on a field level. But, in fact, when you were sick, you didn't go see one of them. And they really had good training. Drew: Well, it sounds very systematic, too. Friedman: It was very systematic. And they had a load of military [unclear]. Below them were the nurses, the Infirmier d'Etat, the male nurses. And below them were other ranks, vaccinators and so forth. Everyone had a rank. And these teams were, as I say, run in the military way. A team would line up in the morning in front of the Medicin Africain, or the senior guy on the team, to show their fingernails and show that they had cleaned them the night before. Etc. etc. It sounds colonial and semi-racist, but it worked. They actually eradicated sleeping sickness. Drew: Great! Friedman: The formal name of sleeping sickness is trypanosomiasis, and the Africans used to call it the trypano service, service de trypano. And over the years-I think this began after World War I- they added other conditions and other diseases to the service, among which was treating lepers. They had lepers who would wait, for example, under a certain tree every month to get a drug called, I believe, Lomidin, if I'm not mistaken. I may have the names of the drugs wrong. So the guys on the teams would refer to them as "my lepers." Drew: Because they'd meet with the same people on a regular basis? Friedman: Yes. The leper had to wait by a tree, by a bush, or on the side of the road, or a certain spot every month. The team would pass and give him his drugs. And they managed to control leprosy. I remember going with some of these guys in the field, and you'd see some leper walking down the road. He'd say, "That's one of my lepers!" They knew them personally. They treated leprosy. They started vaccinating against yellow fever, with BCG against tuberculosis, which was never used in the United States. They'd treat malaria patients. When I got there, we wedded our resources-our trucks, our jet guns, and our smallpox and measles vaccine-to the Endemic Disease Service. Drew: You kind of integrated into that existing system? Friedman: Exactly. And at one time, they were doing 5 vaccinations at once. They were looking for malaria, leprosy, sleeping sickness. Of course, there was smallpox, measles, BCG, yellow fever . . . What was the fifth one? I don't know. There was a fifth one. They'd go into a village. They'd announce that they were coming. They'd send a runner or something. They'd say, "We're coming next week," or whatever. Believe it or not, the team would arrive in the village, and the villagers would be lined up by age and sex. Drew: Wow! Friedman: I mean, this was fabulous! The head of the team would climb on the top of a truck and make sure everybody was lined up. They'd go to the whole village. I've seen this; it's almost unbelievable. And the villagers were lined up by age and sex because each cohort of people and each age group got different vaccines and different treatments. If the teams were looking for sleeping sickness, they'd feel under the chin for swollen glands or something. (I think that was for sleeping sickness. These are other diseases I didn't know much about.) And these guys dealt with everything. They'd feel everybody. They'd palpate under the chin and they'd feel for sleeping sickness and leprosy. We had a vaccinator arranged on each side of every person, and they'd get different vaccinations in each arm. Drew: And the indigenous people apparently were very cooperative and willing? Friedman: Yes. And this operation was run like the military. The village chiefs were, of course, [unclear], and they loved us, and the people loved us. Anyway, that's how we did our smallpox vaccinations in Mali, and it worked very well. And the chief of one of these teams was a very senior guy. He'd climb on the top of the truck and start barking orders, and they'd actually obey them. Anyway, Pat Imperato, the doctor I worked with in Mali, was an anthropologist also. He had actually written books on African culture and stuff. Mali was very complicated because there were nomadic peoples in the country in what was called the delta of the Niger River, which is a big swamp area. It's not a delta at the mouth of the river at the sea; it's a delta in the middle of Mali, in the desert area, where the river would just spread out into a big swamp 100 miles across and then re-form as a river 100 miles later. There were nomadic cattle keepers in this area. And one of the major challenges we had was how to vaccinate those people. So Pat, the doctor I worked under, studied them and figured out that they moved with their cattle in different ways and in different directions. Drew: There was some pattern? Friedman: Yes, there was a pattern to their movements. Drew: It wasn't just like a random kind of thing. Friedman: No, not at all. In fact, he did this along with Malian colleagues who knew all this. Pat sort of systematized their movements, on paper, and figured out how to position these vaccination teams in order to get these people when they were accessible. I think at certain times of the year they gathered in larger groups when the river got dry, which would be in April and May, just before the rainy season began. They'd sort of come together in a much smaller area in large numbers, where the remaining water in the river was present, where the cattle could graze and water. So Pat figured out that's the time of year when they should vaccinate the nomads. The word for their movements in French was called transhumains [sp.], trans humans. I'm sure there's an English equivalent word, but I don't know what it is. I've never talked about this topic in English. But Pat was studying that. In any case, we vaccinated the area. Drew: And did you have the same degree of cooperation? Friedman: Probably a bit less among these nomads. Not living in villages- Drew: And kind of not having the structure of like a chief per se- Friedman: Exactly. That's an excellent question. I didn't even think of that. Not living in villages, they were much less easily ordered about, if you like. In fact, you couldn't order them about. They did their own thing with their cattle. And that was the challenge. And so the normal tactics used in villages had to be modified. I would suggest you alert the interviewer who's going to work with Pat to ask him about vaccinating the nomads in the Niger delta. He's a very serious anthropologist. He's written books about this. He'll talk your ear off about it. All right. So we finished vaccinating Mali. By this time, I had been there 2 years. It was September or October of 1968, and I was transferred to Gabon in Central Africa, which is around and below the [unclear] of Africa. It's a totally different country from Mali, which was semi-desert with many logistical problems. I'd spent a lot of time in Mali working on trucks, fixing them, and fixing jet guns, and doing a little bit of epidemiology on smallpox outbreak investigation. We did have a couple of smallpox outbreaks. When I went to Gabon, there was no smallpox, and my job was very different. First of all, there was no American medical officer there. I was on my own. I was working under a French military medical officer named Jean Claude Jeel [phonetic]. I was sort of his advisor on smallpox and measles vaccinations. There, I got involved in surveillance, looking for smallpox. I also did maintenance for the jet guns and the trucks, although the French in Gabon and my predecessor in Gabon, Mark LaPointe, had set up an ongoing training course whereby the French and the Gabonese trained people on jet guns, so I didn't have a lot to do with jet guns. And I didn't have a lot to do with trucks. In Gabon, which was a much more economically advanced country than Mali, there were lots of garages in various towns, and it was possible to get things repaired. We didn't have to have our own mechanics, as we did in Mali, working on the trucks. If a truck broke, you'd move it to a garage and they'd fix it. I learned a lot about surveillance, but I didn't have a lot to do, really. I mean, besides surveillance, there wasn't much. Plus, in May of '69, we achieved an interruption of the transmission of smallpox in West Africa, and I arrived in Gabon in late '68. So there was really less of a threat of smallpox transmission anywhere in West Africa. We were still looking for cases. I stayed in Gabon from late '68 until April of 1970. So I wasn't there all that long, 18 months. And then 2 things happened. Personally, I got married to my first wife, Lindsey Craper. She's British and was a professor at a university in Ghana. We met at a party given by George Lythcott, who was our CDC regional smallpox director. George lived in Lagos, Nigeria, where I went for a meeting in May of '69. Lindsey was a friend of George and his wife Jeannie. Lindsey was at the party, too, visiting Lagos from Ghana. So anyway, Lindsey and I met at this party. And, to make a long story short, a year or so later, we got married. Interestingly enough, Jean Roy told me, the Jean and Betty Roy told me - you have to confirm it with him - that they met at the same party. Drew: Oh, how funny! Friedman: You'd better confirm it with him. But I believe . . . Drew: Was it a New Year's Eve party, by any chance? Friedman: It was in May of '69, when we had a big meeting in Lagos. Drew: Yeah, so it wouldn't have been New Year's Eve. Friedman: No, because we had achieved . . . Drew: Because I may be mistaken. I was thinking that Betty told me that they met at a New Year's Eve party. Friedman: A New Year's Eve party. Drew: But I may be mistaken. Friedman: I may be mistaken. One of us is mistaken. Drew: Yeah, hey. Friedman: Anyhow, I think Betty knows. Drew: It still sounds like a nice situation. Friedman: Betty knows. If Betty said it was New Year's Eve . . . Maybe it was at George's house for a different party. Drew: Yeah, yeah. Friedman: So, anyway, Lindsey and I got married, and my term in Gabon ended, and it was decided there was no need for any further CDC operations overseas in Gabon. But Nigeria had been the site of the last outbreaks of smallpox. It was a very large, very populous country, and it was felt we should really do much more intensive surveillance in Nigeria. Nigeria had just reorganized itself politically, the entire country. Instead of large regions, there were now states- I think there were 11 or 15 or something like that. And they wanted an operations officer in each one of the states to be in charge of the surveillance efforts and continue with mass vaccinations (although, at the time, we were switching away from mass vaccination). Drew: And Nigeria was colonized by the British? Friedman: Yes. It was an English-speaking country. But my first assignment, Gabon, was French-speaking, of course. Nigeria is my first English-speaking country. Drew: My son says that the health care systems left behind by the respective colonial powers were somewhat different in terms of how well or maybe not so well they worked. Friedman: Exactly, very different political and health structure in Nigeria from the French, ex-French colonies like Mali and Gabon. Anyway, I was assigned to Kano state in northern Nigeria. It's at the very northernmost part of Nigeria. So my new wife Lindsey and I moved to Kano, where I was assigned to what was called the Epidemiology Unit in the Ministry of Health of this state of Kano. My boss was the chief medical officer of the ministry, Dr. Patel; he was Indian. Northern Nigeria is an interesting area. The people are Hausa-that's the name of the ethnic group; it is a very large ethnic group. And the Hausa language was spoken all over that part of Africa, even among people who were not Hausa ethnically. It's a much simpler language than the languages further south in Africa in that it's Hamitic. It's more like Indo-European languages. So foreigners tend to learn it to a greater or lesser extent. My wife, Lindsey, learned it perfectly. Her field is linguistics. I learned it a bit, enough to talk to villagers. In any case, our job was continuing mass vaccination, although, as I started to say, we were switching to what was called the surveillance-containment approach to eradicating smallpox. Instead of vaccinating everyone, we'd merely do surveillance for smallpox outbreaks. When we found an outbreak, we'd do what was called ring vaccination around the outbreak area, including the immediate contacts of each case. Eventually, this strategy was adopted for the rest of the world, especially in the Indian subcontinent. And that was the strategy that eradicated smallpox. In densely populated countries, including northern Nigeria, mass vaccination really couldn't work. It really couldn't get everybody, get enough of a herd immunity whereby by the disease transmission would be interrupted, especially in India. You could never mass vaccinate there. So, in any case, we started doing surveillance-containment in Kano state and continued vaccinating, continued looking for cases. We never found any. All the while, we were doing vaccinations against measles also. The problem with measles was the vaccine. It was much less heat stable than the smallpox vaccine. The measles vaccine had to be kept frozen. With the smallpox vaccine, we learned that (although officially it was supposed to be kept cold) because it was freeze-dried and very heat-stable, you didn't have to keep it cold. It stayed potent. You couldn't have it out in the sun, but as long as you kept it covered, it would stay potent for a long time. But with measles vaccine, in spite of our best efforts, I'm certain that there were occasions where we were vaccinating with impotent vaccine because the cold chain, with the fridges and little cooler boxes that the vaccinators carried to keep the measles vaccine frozen, just broke down. Drew: Sure. Friedman: We did control measles in certain countries. Gambia was 1 example. But in other areas, we had greater or lesser success with measles control. It was never thought we'd eradicate it, although they did in Gambia for a while. In any case, I spent 2 years in Kano, which were delightful. I was newly married. It was a very large and well- developed city with an international airport, direct flights to London and elsewhere in Europe. I joined a British club, which I thought I'd never do, learned to play squash; I really had a nice time in Kano. I mean, I worked very hard, but the state of Kano was very heavily populated, and the area was rather small. So I rarely had to spend the night out in the bush as I did before. Drew: You could do what you needed to do on certain day trips? Friedman: Exactly. And so I slept at home most nights. And my older daughter, Laraba, was born. Laraba is a Hausa name for girls born on Wednesday, which we had chosen from the pantheon of girls' names-7 of them, one for each day of the week; well, there's more also-before we knew, of course, what day she was going to be born on. It was a 6:1 bet. She was, in fact, born on Sunday, but .she still wound up being named Laraba. Drew: A very pretty name. Friedman: Which is the name she retains to this day, of course. She is now 35 and living in London. What else happened in Kano? We had a very congenial work experience there. The epidemiology unit that I worked with was headed up by a man named Al-Haji Mohamed Kozoray, he and I became quite good friends. We worked together well. Everything was nice in Kano. I liked it. Drew: And so your eldest child basically was a toddler in Kano. Friedman: She was an infant. She was actually born in the U.K because my wife was English, as I mentioned. Laraba came to Kano in northern Nigeria at the age of 2 weeks. And we stayed there until April of '72, which was the end of my West African sojourn. I went on to do smallpox eradication in Nepal, which is not the topic at hand. So I guess I ought to end right here. Drew: Well, it's a shame because I'd love to hear that story too. Friedman: Oh, really? I'd be glad to tell you that one. Any other questions? Drew: Well, are there any other things that you can think of about your experiences that you'd like to share? Friedman: The only thing I could say about my experience is that it introduced me to public health. As I said at the outset, it was not my field at all, unlike the other operations officers who had come from the VD branch. Eventually, after living in Nepal and then the Philippines, where I was in the Expanded Program on Immunizations, I came back to CDC in 1978. I joined the Division of Reproductive Health and spent 25 years working on contraceptive-prevalence surveys, largely in foreign countries. But towards the end of the 25 years, I was also working on behavioral risk-factor surveys on Native American reservations. We had monies from the Indian Health Service to run surveys on Indian reservations similar to those I had done in foreign countries on contraception. We looked at behavioral risk factors. As you know about Native Americans, smoking, diabetes, and other conditions related to behavior are important. So I would say my last 5 years at CDC, before I retired in 2003, were spent working on Indian Health Service stuff, surveys; and they paid half my salary. So I had a rather diverse career. Drew: It sounds really interesting and rewarding. Friedman: I think so. And I think I was lucky. As a public health advisor, I was never pushed up into administration like so many people were. I remained in science my entire career. I never had to supervise anyone really, which I found much more enjoyable than working in administration, which is not my cup of tea. So I had a very rewarding career. I always liked going to work in the morning. Never in my wildest dreams, before coming to work at CDC in July of '66, would I have thought I'd work in anything having to do with health, public health, epidemiology, survey data analysis, and everything else I did here. So I really had a very rewarding career at CDC. Drew: That's great. And that's very interesting to hear about, and I really appreciate it. Friedman: You're welcome. # # # </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310125121&amp;color=ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false" frameborder="no" scrolling="no" width="100%" height="166"></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 sound recording - nonmusical interviews Date A point or period of time associated with an event in the lifecycle of the resource 2006-07-15 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/158h8 emory:158h8 Subject The topic of the resource USAID Endemic Disease Service Ped-O-Jet Smallpox Eradication WHO CDC Operations Officer Format The file format, physical medium, or dimensions of the resource 495841584 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Drew, Diane (Interviewer); CDC; Nurse Friedman, Jay (Interviewee); CDC; Operations Officer Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of West and Central Africa Smallpox workers (2006 : Atlanta, Georgia) Title A name given to the resource FRIEDMAN, JAY Description An account of the resource Jay Friedman, served as an Operations Officer in Mali, Gabon, and Nigeria. A former Peace Corps Volunteer, Jay came to the Smallpox program by responding to an advertisement in the Peace Corps bulletin looking for people "who had lived in Africa, who could speak French, and who could fix a car." Jay speaks of his work assisting medical officers in investigating outbreaks and managing the logistics of the eradication effort, using Ped-O-Jets, the structure of the national Endemic Disease Service in countries where he worked, tracking Malian nomads, doing surveillance in Gabon, and finally life in Kano, Nigeria. Jay went on to do smallpox eradication in Nepal, and joined the Expanded Programme on Immunization in the Phillipines before returning to work for the next 25 years at CDC in Reproductive Health and Indian Health Services. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/b9b83bfd3b6aacbe19923616d2ac1f53.jpg d76b262f53586773bb099f4f0c75d12c https://www.globalhealthchronicles.org/files/original/dce1934d690883ba00beedcd2696038b.pdf 83847124f5f38046f59cde7abfd4cf94 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> This is an interview with Bob Baldwin, on July 13, 2006, at the Centers for Disease Control and Prevention in Atlanta, Georgia, about his role in the project to eradicate smallpox in West Africa in the 1960s. The interviewer is Melissa McSwegin Diallo. Baldwin: Thank you. My name is Bob Baldwin, and I know that I am being taped during this interview. Diallo: Okay, fantastic. All right, well, let's go ahead and get started. Baldwin: Okay. Diallo: To start out with, can you talk a little bit about how your upbringing and education led you into the field of public health? Baldwin: That's a very interesting question, because I guess I was fortunate enough to stumble on a career in public health. It wasn't anything that I aspired to from early childhood. I grew up in an inner city in the Northeast, in New Jersey, and amidst poverty, and went to the university. And when I had an opportunity to be interviewed by a number of companies, as I was about to graduate from the university, the one from CDC was the most attractive, and that meant working in sexually transmitted disease in New York City, where I met a number of people who you will meet in the next couple of days, who were working there also. So that's how I got in to that, and then once I started in New York City, I became aware of this opportunity in the smallpox eradication program. And I was fortunate enough to be selected for this, because there were a lot of people who competed for this, these positions. And I was in the about second or the third phase of this effort, and I was fortunate enough to be selected, and that really made the difference that shaped my whole career in public health. I just retired about 2 years ago from CDC, and I had the good fortune of spending at... More than two-thirds of my career working in public health, and I attribute that back to those early days in the smallpox eradication program. Diallo: And what was your degree in? Was it... Baldwin: Now that's a funny question, because people say what, with all the experience that you've had over these 40 years in so many different parts of the world, and so many different disciplines, what did you major in? I said, well, I was an English Literature major at Rutgers University. And it always really just baffles people, it throws them. They say, well, how can you... How can you have done this? And today you probably couldn't. You couldn't, no. You do have to have a master's degree to get in around here in public health, and to do the things that we did, but we were fortunate in our generation to be able to get in at the ground level and learn by doing, and applying, and making the stakes, and that sort of thing. Diallo: Could you name one, if you can, one influential person in your life that, maybe how they inspired your early career? Baldwin: (unint.) Bill Foege [William H. Foege], who you haven't met, you will. And he's an imposing guy, a tall guy. Very visionary. And just being around Bill is, in a sense, inspirational. And when I was in the smallpox eradication program, Bill was then the director of the program, and he'd come out from time to time and spend, you know, visit with us in Cameroon and all that. And he later became the director of CDC. But Bill's been sort of a hero, a role model to... So he was very influential, I think. Diallo: So how do you think... You said that you started out with CDC in sexually transmitted disease. How did the smallpox eradication campaign interest you? What motivated you to join it? Baldwin: Well, ever since I was a kid, I always had this desire to go to Africa. You know, I had probably read too many Tarzan novels and saw too many Tarzan movies, and I've always wanted to go to Africa. It was the mysterious, dark continent. And so, when this opportunity came along, I said, this is an opportunity of a lifetime. I would never forgive myself if I don't try, at least try, to get accepted for this program. And also, the lure of participating, even in the small way that I did, in an accomplishment like this. The eradication of a disease from the world. I mean, this is, I believe, a major accomplishment in the history of mankind, and certainly in the history of medicine. And I said, if I could be part of that, I would really be... I would be really happy. Really happy. And I was overwhelmed when I was chosen. And so I went to Africa, and that was a definite eye-opener, because when I arrived in Africa, there are so many things about Africa that you remember. The smells, which are entirely different from any other place on earth. The heat, when I stepped out of the airplane in Lagos at 8 or 9 o'clock at night, and set foot on African soil. It was like you were walking into Saran wrap. You were enveloped by the humidity and the heat, and you felt like you couldn't breathe. There was fog on the windows in the airplane, and all that. And then I met the African people, who were nowhere like... Nowhere near the people in the Tarzan novels, and all that sort of thing. I mean, they were friendly, they were open, they were outgoing, they were creative, resourceful, and survivors, and I thought I'd known poverty, living in New Jersey and working in New York City. I started in Harlem and worked in Spanish Harlem in the Bronx. Well, when I got to Africa, I really saw poverty for the first time. And I saw people making do with very, very little. But doing it in a nice way, and not in a resentful way. It was just a great experience, and it... As I said, it influenced me to continue on in public health, because it broadened my perspective, my appreciation for different cultures, and for different perspectives, and it shaped me. I mean, I'll always be grateful for having had that opportunity to play a small part in this disease, and it inspired me to continue on. And so when I left here two years ago, I was Associate Director in the Office of Global Health, and I had responsibility for very wide geographic areas of the world, like the former Soviet Union, China, Eastern Europe, and that sort of thing. Diallo: Okay. Actually, you've already answered some of my next questions. All right, so can you tell me about... You said you were assigned to the (unint.). Actually... Baldwin: Yeah. I flew into Lagos, but I was on my way to Cameroon, because my assignment... Well, my initial assignment was supposed to be the Central African Republic, but the ambassador there said, this program is drawing to an end soon. I don't want to have another American coming in. Is there some way that we could avoid that? And so the program got very resourceful, and they said, well, let's assign Bob Baldwin to a regional position. They didn't have any regional positions other than... We had a regional office in Lagos, but we didn't have any regional operations officers, so they decided to assign me to a French military organization called OCEAC, which in English stood for The Organization for the Great Battle... The Battle Against the Great Diseases in Central Africa. And this was located in Yaounde, Cameroon. So they said to me, well, we're not going to be able to put you into CAR, the Central African Republic, we're going to send you to OCEAC. And from there you will be responsible for Cameroon, for Congo, the Central African Republic, Chad, and Gabon, what was formerly French Equitorial Africa. And so we had in the past, either we had operations officers there. Russ Charter [Russell Charter] at one point was in Chad, and then he left and went on to Guinea. So they started pulling those operations officers out of there, and put me into Yaounde, and they said, and you're in... And this was in a consolidation phase, when surveillance for the disease was intensified. And any time there was a suspect case of smallpox, we jumped on it like fleas on a dog, and we got to it as fast as we could, investigated it, and tried to determine whether it was smallpox or chicken pox, which was an imitator of smallpox. And so that's how I got into Central Africa. And working... Speaking French, as it did, and I had studied it in the university and in high school, I had an opportunity then to exercise it there, because I was working with a French general, who was the Director General of OCEAC, and he was a physician, but he also became a general, because the French military ran French assistance and health in French-speaking Africa, as opposed to the British system, which was totally different. So I was working there, and the other thing that I remember, in addition to being a regional person, was the fact that throughout our days in smallpox eradication, we were funded by the United States Agency for International Development. And it was always this pull and tug, this relationship that was very cantankerous, it was combative between the two agencies. And people in Washington resented the fact that we were the technical agency, that we, in a way, were getting more credit than they were, even though they were funding the whole activity. So there was always this push and pull, and this battle between AID and CDC. So when I got to Cameroon, I was thrown right into that. And I ended up having four bosses. I had the Aid Mission Director, who was really a good guy, but a stickler for detail, and questioned everything that we did. I was working for the General at OCEAC. I was also accredited, though, to the Ministry of Health in Cameroon, so I had to answer to the Cameroonian government, too, and then to CDC. So I had four bosses, and I had to balance this constantly to try and keep them all happy, and at the same time, try to get the job done. To make sure that there were no cases of smallpox left in Central Africa, in French-speaking Africa. So that was a task that required a great deal of skill, and I don't know where I got that skill from. But I do remember that in my training session here in Atlanta before we left, our... George Lythcott, who is now dead, but who was another important person in the early smallpox days, told the group, when I was there, that we had to be medical diplomats. I remember that. He said, you not only have to know about all these diseases, and about smallpox and measles, and how to fix gun ped-o-jets, and how to repair cars, and clean carburetors, he said, but you have to be a diplomat, too. And so you had to deal with a wide range of people, from the Minister of Health to the Director General of OCEAC, to visiting dignitaries and all. And that was one thing that people back here never really understood. When I came back, and I was assigned to Atlanta, and I sat on a number of promotion panels and reassignment panels for jobs, and I would try to explain to the people who sat on the panel, who had never been outside the country, never worked in Africa, never knew the difficulties of working with, you know, the Minister of Health at one point during the day, and then working with an immunization team later on in the day. And they didn't understand the difficulties and the range of skills that you needed to do that. So they would tend to bypass people for promotion who had been overseas, and say, well we don't know what he did for that 3 or 4 years. We don't understand, we don't know. We don't understand... So that was... I became an, almost an ombudsman for some of our former smallpox people, or people who worked overseas, kind of a spokesman to interpret for those back here who didn't understand and didn't care to understand what they'd done. Diallo: Because you talked a little bit about the training that you had before you left. Could you talk more about that? Baldwin: That was pretty intensive. That was... It involved the epidemiology of smallpox and of measles, and of other diseases that we might likely encounter. It also involved learning how to clean carburetors and fix... Do major car repair work, is minor ones, and also to repair the ped-o-jets, the jet injector guns that we were doing. And in addition to that, since I was going to a French-speaking country, I would spend my evenings over at the Berlitz school, polishing my French. Despite the fact that I'd had four years in high school, it was, you know, academic French, it wasn't conversational. So I had to do all that during the day, and then in the evening, go over every evening about 5:00 till 9:00 to Berlitz, and do this total immersion stuff. Which was good, because in the long run it really paid off. But with all that training that I got, being in the smallpox program was a humbling experience for me, because I found out what I really didn't know. There was so much I didn't know. And when you went to a place like Cameroon, or anywhere in Africa in those days, in the 70s, in the late 60s, you represented CDC. So the ambassador would look to you for any medical questions that he had, and so would the others, the French doctors. For something they didn't understand, they'd come to you. And for them, you were the expert. So in addition to knowing how to repair cars and ped-o-jets, you had to know about a whole slew of diseases. And what made that difficult is that we weren't, we didn't... We're not doctors. We weren't doctors. We were operations officers, and we didn't go through all that. So the other thing that complicated it was that, in those days, there was no email, it was difficult to make telephone calls. The way we communicated, when you needed, really, really needed something, whether it was a car part, or whether it was knowledge about a certain disease or condition, or how to intervene in a situation, you had to send cables. That's how we existed. We communicated by sending cables. And they had to be very precise, and very pithy and to the point, so what you had to do was to... When you had a difficult problem or situation, you had to size that up, and be able to be very focused as to what you thought you needed to know, and to put that in the cable in this very terse language, and hope someone in Atlanta understood just what it is that you wanted to know, what you needed. So that, you know, was the age... It was well before the age of emails. Today it would be so much different. I could just sit down at my computer and send an email off, and... As I've done here, in my work with the former Soviet Union. I'm talking with a colleague in USAID, and I say, let me send you this, and while we're talking, the message gets (unint.). That's right on this computer. Didn't exist then. It didn't happen. We had to... And phone calls, you know, you never... There weren't satellite phones in those days, it was just the early days. And once you got out in the bush, it was even worse. You were totally on your own. So you had to be very resourceful, and, as I say, it was an unbelievable experience, because, you know... I could write volumes about the things I did and that I learned. And to do it in the... And the other thing that complicated it, too, was that you were doing it in a foreign language. It wasn't just English. Diallo: Right. How did you find, since you were working with francophone countries, and the former French colonies, how did you find that that colonial legacy affected your work in smallpox? Baldwin: Oh, it's funny you raised that question, because I thought about that too. There were two different systems. The French system was, I felt, very humane. The French system was what they'd call prospeccione# (ph.), or... Every year, they would go out in teams, in mobile teams, and visit a third of the country. They would visit village by village, and they would immunize, treat every disease they saw, and so at the end of three years they'd have covered the entire country. Now, that was very humane. The British system was one where they made fixed posts, or hospitals, or clinics, outpatient clinics, and that sort of thing, and if you could get to them, fine. If you couldn't, well, too bad. So those are the two different systems. But the French system tended to be sort of patronizing, in a way. And my relationship with the French, and everybody's relationship with the French, and I can say this and hopefully it won't be published widely, is one of a love and hate relationship. And I worked with these guys on a daily basis, and even the doctors who were in the Ministries of Health were French military assignees in those days, because the Ministries hadn't been totally Africanized. So you're dealing with French doctors who were military also. And so we had this hate, love-hate relationship. Some days you just thought they were the greatest people in the world, and other days you'd say, oh, these guys are so arrogant, they don't understand, what is it they aren't understanding about this? We'd have these debates about how valid the smallpox vaccination was. They would say it was good for lifetime, we would say it was good for 7 years, or, you know, we'd have these kinds of debates. But they also... The difference too was when I had the opportunity to go out into the bush with some French teams from OCEAC once or twice. And when these guys went out into the bush, they would have tents, they'd have tables, they'd have tablecloths, they'd have wine, they'd have all these dishes and napkins and all that, and it was like, you know, we're going on a picnic, and we're going to go first- class. And when we went out in the bush, you know, myself, and I had two different... Through my stay in Cameroon, I had two different epidemiologists. But when we went out in the bush, we had cans of what they call koskuit #(ph.), you know, cassioulet (ph.), which was like baked beans and frankfurters. And we'd eat out of these cans, or, if we were fortunate enough to get them heated up, we'd eat, and then we'd drink warm beer, and... Instead of French wine. And we'd sleep on cots that fortunately had mosquito netting, but we'd sleep out under the stars, and... Which was fun. And I had a beard at the time, which was very useful, because if you ever had to shave, you never shaved. But if you've ever had to shave with cold water, you know how uncomfortable that is. Diallo: I've bathed in cold water. Baldwin: Yeah, bathing in cold water. Bathing was another thing. We... Sometimes we'd go for a few days without bathing, and wearing the same clothes, and that was an interesting experience, too. But we went out into the bush, and that's what we called it, going into the bush, and when you remember... You always remember the first experience riding through what they call washboard roads in Africa. They were dirt, they were laterite red clay, and they were up and down, up and down, like a washboard, if you've ever seen an old washboard. You'd just go on for miles like this, sometimes holding the windshield with your hand, because if there was a car in front of you and it's kicking up rocks, it could shatter your windshield. And so you remember that, and you remember getting... Having to go into villages to immunize, and you couldn't drive in. You had to leave your truck, and you had the truck, and you had to carry your equipment, your ped-o-jets, your vaccines in the cold chest, into the village and walk for miles, 3-4 miles to get in to the village. And sometimes you'd have to take a boat, a dugout canoe, to get there. And meanwhile, as you're trudging through the bush, you're... In Cameroon we had green mambas, which are poisonous snakes that come out of trees. They don't live on the ground, they live up in trees, and so you always have to worry about whether, you know, looking up to make sure you weren't getting a green mamba coming out at you. But those are the memories that I had, and those are just... You just can't take those away. Those are fond memories, and the people... The other thing was the concept of crowd control. I think they didn't tell us enough about that here before we left. I do remember being out there and immunizing kids with a ped-o- jet in each hand, smallpox in this gun and measles vaccine in this gun, and I'm pushing down on the foot pedal for this gun, to charge it and give the kid an immunization, and the other one with the other hand. And they're crowding around, and crowding to the point where you couldn't work. The Africans were so afraid that you were going to run out of vaccine, that their children weren't going to get immunized, that they would just... And so I had to, a number of times I had to stop and just say to the headman or to the chief, you've got to get the people lined up, in a line. I can't work here. I mean, if I can't work, I can't immunize them. So that concept of crowd control. And the other kind of memories that I remember, you know, when you're going into the village, before you go in to immunize, well, we had to do a survey, to do a vaccination survey. You'd have to sit and palaver or talk with the headman or chief, and he'd get all the village elders, and you'd sit around on these stumps, these chairs, and they'd take this big jug of palm wine, which is... They'd go up a tree for, and they'd drink this palm wine, and then pass it around. In those days, we didn't think about, you know, whether you could get a disease like HIV from mucous or things, you know, and so we ate, we drank our palm wine, and it would be very disrespectful to say no, and to refuse it. And then if you came across a more educated person in the village, I remember very distinctly one Saturday morning going and trying to do an immunization survey in a small village, in the Central African Republic, and the educated person in the village was a schoolteacher. And he had... And I had a guy from Atlanta with me at the time, my supervisor, and he and the schoolteacher wanted us to sit down and have a drink with him before we began our work, and so he pulls out this bottle of scotch. And it was a very nice bottle of scotch, and I'm sure it cost him a lot of money, and we had to drink scotch with him at about 9:00 in the morning, warm scotch, and if you have more than 2 of those, it kind of sets your day off. So those are... Those were fun times, though. Diallo: How did you... What kind of challenges did you face in working with your African counterparts, coming in as an outsider? Baldwin: Well, fortunately, see, my counterpart was designated as my driver. His name was Simon-Pierre Ndenge (ph.), and he was not a driver. And I never did treat him as a driver, or use him as a chauffeur. Only when we went out into the bush. When we went out in the countryside, it was recommended to us, in fact, it was told, don't drive. Because there had been instances where people had, and I just heard of one of these, just the other day. Where people had hit children with a car and gotten stoned to death, in kind of a retribution thing. So we always let the designated driver or chauffeur drive when we went out. But Simon was not a driver. I treated him as if he was my counterpart. I tried to mentor him in the ways of planning and organization, and management, and that sort of thing. And in return, he mentored me in, you know, adapting to the culture... He could speak 5 different dialects, plus French and English. A little bit of English; most of the time we spoke in French, though. But he taught me about the customs of the various tribal groups, because there were over 200 tribal groups in Cameroon alone. And so, Simon-Pierre, he would just, you know, he was my guardian angel, in a way. And the frustration in there... We never had any problems, personal problems with each other. We always understood each other, he was always there when I needed him, and I hoped I was there for him. Excuse me. But my biggest disappointment was that when I left, I was not able... I had tried, for almost a year to get him a position in administrative health. Because when I left, the work still needed to continue. We were told that we were coming home because we'd done the job with smallpox, but measles... We were on the cusp of eradicating measles in some places in Africa, for instance, the Gambia and others. But when... Before I left, I tried to get him into administrative health, in a full-time position. And eventually I did succeed, but it had a much lower pay than what we were paying him. See, we were using (the ID forms?), and so we were paying people more than the local economy would bear, so for a man of his skills, he could have made much more money in working for a pharmaceutical company. He could have made a lot more money, but he wanted... He was there to cater to that, too, and he actually did get a job with the Ministry of Health for less money, than... Now, as I continued on working in Africa well after this into the 80s, in a large program called CCCD, or Combating Childhood Communicable Diseases, we had other talented people like Simon who weren't able to get picked up, and they ended up going off to WHO, or to UNICEF, or to the Institute Pasteur, or a drug company. And they wouldn't necessarily be there to help the country itself. You know, their country, it'd be assigned here or there. So you'd still be in the health field, but it wouldn't benefit, say, Cameroon, or Chad, or Central African Republic. So that was really a disappointment, there. I never had any great difficulties in dealing with the Africans that were my counterparts. Diallo: That's good. Did you have, or could you talk about adjusting to living in Africa? Baldwin: Oh, yeah. Okay, I didn't write that down in any of my notes, but that's a good point. That, you know... Diallo: You had never traveled there before, had you? Baldwin: No, I hadn't. But since then, you know, since that experience, I've been to 48 different countries in Africa. But getting to Africa, as I say, was an eye-opener for me, because it just wiped out all the stereotypes that I had. But they kept telling us here, you're in for a culture shock, don't be surprised at this or that happening, and I didn't have any problem. Not at all. I did not adjust. I had my culture shock when I came back to the United States. And I think a number of my colleagues did, too. We just sort of accepted what was there, and we didn't get excited about it. It's Africa, and there was an expression that we had in French. "C'est l'Afrique." That's it. "C'est comme ça." It's like that. Or when something went wrong, we had another expression you might hear called "WAWA". And that stood for West Africa Wins Again. Because there were things beyond your control. If you expected your vaccine to arrive at a certain time on this plane, and that plane had to come from the United States and make 3 or 4 different stops, 2 or 3 in Africa, and you expected it to arrive at this time, because you were told, you had got a cable that said, your vaccine will arrive on Air Afrique, flight number 421, arriving at... And so you went to the airport, or Simon went to the airport, or I went to the airport to get it, and it wouldn't come. But then we had to trace it. Where was it? You had to go down the line and find out, send cables, find out where this vaccine was, because it was such a fragile thing, and you couldn't allow to be sitting on a hot runway somewhere, because somebody just offloaded it and didn't put it back on a plane. Or parts. So when that kind of stuff happened, and it was 2 or 3 days before we finally located where it was, or it never arrived, the old expression was, WAWA. West Africa Wins Again. Those were some of the frustrations, because, as I say, this was 1970, the late 60s, and each... During that time, it was a period of emerging nationalism, emergent nationalism, and each country felt like it had to have its own airlines, too. No matter how good or bad they were, or how substandard, they had to have their own, and the country's name had to be on the airlines. So that was an important thing. The other thing we did encounter, though, from time to time, was some suspicion, because there are... There was a faction of people who felt that if you were associated with USAID, and at the time AID was pushing contraceptive devices and birth control, that perhaps you were part of a plot to keep the African population down. So we... At times we encountered that, but I think most of the time people knew we were good folks and we were doing good things. Trying to do good things. Diallo: And were... Did you find that people in the villages were generally accepting of the vaccines? Baldwin: Oh, yeah. They were very accepting and very generous, and that was almost very embarrassing, because they would try to give you things, what little things they had, whether they were food, or chickens, or bananas, or whatever, to take with you when you left as some token of their gratitude. You knew they had so very little, and you know that you could get this stuff back in the capitol city when you got back. And so, well, we couldn't refuse it, though. We would take it and we would express our gratitude for the meals they provided for us if they did, or for whatever they gave us, and then usually I ended up giving to Simon. Now Simon had the fortune, I guess the good fortune of having 4 sets of twins in his family, so he could use this stuff. Or if he couldn't, we'd give it to a few other people on the vaccination team, that sort of thing. Once we were out of range of the village. Because people were just so generous, and you remember that. You really do, because they had so very little. But they gave freely. Because they were just so grateful you came. Diallo: Did your family travel over there with you, to Cameroon? Baldwin: They did, I had my wife and a stepson. But they didn't get out into the bush too much, because we went to some... You know, we did vacation kinds of things, but never out in the bush. It was... Diallo: How did they adapt to life in Africa? Because they were, I imagine, living still in the city, but if they were... Baldwin: Yeah. Well, it was a difficult adjustment for my wife, because she came from the New York area, and so, I mean, Africa, New York, two different... It's like two different worlds. And she had some difficulty. She also had some difficulty even adjusting to the French language. And so she felt at a disadvantage. She eventually acclimated and was able, say, on Monday morning to go down to the market where they slaughtered the beef that had been driven down from Chad, and be able to pick out... Among the blood, the meat that we wanted to have. And then having to filter water, and that sort of thing. And the other adjustment that we had to make was that it was normal, pretty much normal, for people to have household staff to... It was a form of employment, you know, you would employ household staff and a cook, and we started off... And a night guard. And we started off with a cook, who, fortunately or unfortunately, was... Had been a cook for the Vice President of the country of Cameroon. And he insisted on making these big meals at noontime. And I just could not get used to that. And he was a nice guy, and he really was, and so we were able to get him placed with some other family, preferably a French family who would like those big meals. I couldn't... The thing I never could get used to, when I was in the city, was these, the hours. We worked from 8 in the morning until 12, and then we went home, and from 12 to 2:30, you're supposed to eat and have a siesta. Well, I could never lay down after I ate and just fall asleep, and do that. So I never could do that. And then, when I started eating these big meals, I said we can't have it. So we actually placed him, got him placed at some other family, but we did go on with the house person. And that was an adjustment for my wife to make, too, having a house person around. The guardian, though, was absolutely essential, because you... There was thievery. And people would... I mean, it stands to reason that people would, are living in abject poverty, and they look in through the fence and see what this very nice house, and you have guests coming in, and food, you know. So you... That was pretty normal. Diallo: And in general, when you think back on the smallpox project, how did participating in that particular program change your life? Baldwin: Well, I think it really did change my whole outlook on life, and it really wanted... Made me want to continue to work internationally. I know there are many, many problems here in the United States, and when I did come back, I did work for a while here in sexually transmitted diseases again, in Pennsylvania, but I just... I was just itching to get back into international health. And back in 1980, I came back into international health, and worked at the project that we called "sheds", it's SHDS, with Boston University and AID unit transitioned over into the Combating Childhood Communicable Diseases, the CCCD project. And then I started, because it was the period of famine in Africa, and extreme famine in the 80s began, so I got into coordinating CDC's international disaster and refugee work. And I did that for 10 years, the international stuff. Some of it I was still doing the CCCD stuff, too, and supervising people in Africa. So that got to be too much, so I did (unint.) into emergencies and disasters totally. And from there I just transitioned into the former Soviet Union, because by that time, in 1991, the Soviet Union had collapsed, and we had a terrible problem, in the 15 republics of the former Soviet Union. So I got involved in coordinating the CDC's activities in that. I was probably... I was in the first wave of a few of us who went over right after the collapse of the Soviet Union. But what it did was it just taught me that there was a bigger world outside the United States, and there are... I have very competent colleagues here, who could handle the domestic side of things, but I felt that my skills were better applied internationally. That I could do the diplomacy thing, I could still help to make life better for some of those people who have much, much less, by just showing them how to do things, and that was it. It was trying to just show people, and transfer tecnhnologies. Not to do it for them. The one thing we got accused of doing in the smallpox eradication program by our colleagues in AID was, well, you guys did a great job. You eradicated smallpox, but you didn't leave anything behind. You didn't leave any institutional memory behind. But that's not entirely true, because, as I said, I've tried to get Simon-Pierre hired, and others in other countries tried to do the same thing. So we did train people and try to leave an institution behind, but the overall effect as far as AID was concerned was, we accomplished the mission, but we didn't. We didn't build infrastructure. So as we got to the point of the SHDS project, and the CCCD project, and everything else since then, the objective has been to teach them how to fish. You know, to teach them how to do it. And teach them what has worked. And that has always worked for me, I mean, successfully in my dealings with people in the former Soviet Union, who are always very distrustful of Americans, they thought we were all CIA. But... And some of them just couldn't believe the approach I took was, I'm here, I'm going to show it to you, what we've done in the United States, what we've done in other parts of the world, and it's worked, and then also, here are some things we did in the United States and other parts of the world that didn't work. Now, it's up to you to take these things, if you want, and tailor them to your own environment, and see if they'll work for you. And find a way. Let's modify and find a way, see if they'll work for you. Well, that was baffling for people in Russia and former republics. They said, why are you doing that? People would come up to me, I would be chairing a large meeting, and a man comes over and he said, you need to be beating your own drum. You need to be telling people they have to do it this way. And I said, yeah, but you see, they're used to it. For 74 years they were told they had to do things this way, there was no other way to do it, and so they were so surprised at that. And they were also surprised at us talking about our failures, because if you did that in the former Soviet Union, if you even revealed that you'd had a failure or a #(unint.) he'd send you off to a gulag. You'd go to Siberia, or you'd get demoted, or your pay would be taken away. But anyway, you asked me that question, it's helped... It shaped my whole career, it's influenced the way I look at things in the world, and it made me a more tolerant person, a person who's much more culturally sensitive, I think, than I would have been if I'd just stayed in New York City, or New Jersey, for that matter. Diallo: So what would you say... You've talked a little bit about some of the difficulties that you faced. What would you say was the biggest problem that you faced, and how did you work to solve it? Baldwin: Well, I think it was the lack of good communications in those days. I mean, back and forth to where you needed, either to alert people that you were coming to a certain village on a certain day to immunize, or it was communicating to Lagos, to the site we needed certain ped-o-jet parts, because, you know, 10 of our guns are down, and we really need these for the next campaign, and the rainy season is coming, and we need them tout suite, you know, right away. Or communicating back to Atlanta. For instance, when we had cholera. When cholera broke out in Cameroon, and I knew nothing about cholera. That was one of the diseases they didn't tell me much about. And we had a pandemic of cholera, and so I had to try to get as much information, for myself and for the epidemiologist, fortunately I had an epidemiologist working with me, who was, you know, so that we could deal with this, because the American ambassador was asking us how we'd deal with it. Because the ambassador wouldn't hesitate to call you at 2:00 in the morning, 3:00 in the morning, if something urgent came in. And you were the CDC person. You've got to know the answers. You have to know the answers. And so, you know, it was communications. It was trying to get that information you needed. Either from people or out to people. And I think that was the biggest challenge. And then, of course, the political infighting was also very challenging, between AID and CDC. And, of course, you know, the push-and-pull of the French, too, they had their own way, they looked at medicine much differently than we did. So there were all kinds of challenges. It was... As I say, there was never a day without challenges. And fortunately I did have, during the time I was there I had 2 different epidemiologists who worked with us. And they, themselves, presented difficulties, at least one of the two, in getting along with the French, because the style was, like, totally different. This guy was very good, but he was very informal, and he just didn't, you know, fit in to the French system, you know, where they're very formal, and all. I had said... So I had to sort of be a buffer between him and the French, too, I had to get in the middle from time to time. You became very resourceful, you tried to become very resourceful, and very inventive, as much as your abilities let you be. But we... As I say, we weren't physicians. We were, you know. Diallo: Right, right. Was there a particular point... Well, first of all, what years exactly were you...? Baldwin: I was there between '70, the beginning of '70 and the end of '72. Diallo: Okay. And was there a particular point during your work with smallpox where you knew that it was a successful program, and that smallpox was going to be eradicated? Baldwin: Yeah. I think it was when I left the country, and we didn't have many cases of smallpox, which, in a way, it's difficult to say this because it's a disappointment for me in many respects, I never did actually see a case of smallpox, because by the time I got there, we were in the consolidation phase. The hard work had been done by those who went before me. What my job was to be, it was to maintain and keep everyone vigilant, looking for smallpox, and... Because it could occur any time, and in any place. And so I'm not only in one country, as most of the people have, I had 5 countries to worry about. And I had to stay in communication, again, this communication issue, with each of these countries to make sure they were immunizing on a regular basis, on a monthly basis I would get vaccination figures done, and I needed to know that those teams were out there daily. They were not only immunizing against smallpox and measles, but they were looking for cases of measles occurring, and that they would alert us as soon as some suspicious case, you know, came about. And so we would jump on those things, and with a high degree of anxiety we'd drop everything and just run out to wherever it was, where that was said to be a suspect case of smallpox. But fortunately, we didn't see any. And so when I left, I was pretty much assured that things were going well, but you couldn't be totally certain that smallpox wouldn't just rear its ugly head in some small village that was missed, or among some person who, when the vaccination team were in the village, he wasn't there that day, or he was out in the field, you know, working, so you just never knew for sure, and we didn't know for sure until 1977 and that last case occurred, and then when they certified it years after. There no certainty, you know. I mean, we felt we had done a good job, but we couldn't go home and say, we eradicated smallpox. You couldn't do that, we never did. You could never say that. Diallo: So thinking back now, you know, with the blessings of hindsight, is there anything that you would have done if you had been running the program? Is there anything that you would have changed, if you were Bill Foege, for example? Baldwin: If I was Bill Foege, would I have changed anything? I don't know, you know, Bill did his utmost, and he had the support of David Sencer, and Dave, as our director at CDC, really went above and beyond the call to try to support us all in the field. Because he realized the magnitude of the effort, and he knew... He knew better than any of us, I think, what the eradication of smallpox would mean to the world. So he was as supportive as he could, within the boundaries of the the rules(unint.), the administrative limits. I mean, there were things that we could have used, two-way radios maybe, walkie-talkies, communications kinds of things, or others that we were bound by regulations that we couldn't purchase, or buy. It was the same way with the vehicles. We had these great Dodge trucks, they called the Great White Whales, that had 2 gas tanks, and they were big, but they were American cars. So we were constantly needing to have American spare parts. And we weren't allowed to buy, say, French cars, which would have an abundance of spare parts... Or, French trucks, that sort of thing, which would always be available. And so we had limitations there. And Dave did everything he could, and so did Bill, I think, to push down the restrictions#(unint.), but I couldn't... Not being back here in Atlanta, I couldn't tell you if there were any things they missed or not. But I think they did a great job, and... Diallo: With what they had available. Baldwin: Yeah. With what they had available, and they pushed as far as they could, and tried to make the system as flexible as they could make it. But laws are laws, you know, and the government has regulations. But years later, I mean, in our work in Africa, we still tried to get waivers from this Buy America act, because it just made good sense to be able to not have a car... You know, when a car went down, when a truck went down, and you couldn't get the parts for it, you had to go out and eventually cannibalize others, you know? And so eventually, you'd go, you'll see pictures here of trucks that are either wrecked, or they're sitting in a garage, or in a field, in a yard, and they're all down, you know. People are taking parts off of them to make the other cars work. That's cannibalization, not in the sense that you'd think of it, the cannibalization in keeping things moving. So that was a challenge, too. Diallo: Okay, I have one final question, and then you can add anything else that you would like, but what were some of the important lessons that you learned from the smallpox eradication program, that you were able to then apply to your other work in international health? And you've talked a little bit about some of that, but... Baldwin: Yeah, I think I have... I mean, the ability, I think... To develop the ability to actually hone in and focus in on what the real problem might be, or is what it appears to be, and what the alternatives, or the alternative solutions might be, and then trying to find a way to make those solutions happen, because sometimes the solutions are there, but, as I say, your system doesn't allow you to do that, or to... And so I think that's one of the biggest skills that I had to learn how to do. And the other thing was just to learn to be diplomatic and understanding of different people's culture, and their perspectives in looking at things. And they don't always see that the way we do, and they don't have necessarily the same work ethic. Now, I don't know, that's neither good nor bad, but in later years, as I was on a (yaws?) assessment for six weeks in 1980, I think, in the Ivory Coast, and it really hit me because I had a young EIS officer with me, and he was taking... It was his first trip to Africa, and we were working really hard. We had six weeks to do an entire assessment for the entire country, and we were working 10, 12 hour days. And, you know, finally the driver we had said, I refuse to work. He said, we don't do that here. You guys are Americans, maybe you do that. But we don't operate that way. And, you know, that just really hit me, because they don't. And you have to respect the way they do things there. But at the same time, you still don't lose sight of your goal, and you still try to accomplish your goal. So that is a challenge for you, to find your way, to incorporate, within their... Within the parameters of their own system, of their own culture, how you can accomplish what it is that you need to accomplish without offending them, and still get it done within the time frame. Sometimes it's possible, sometimes it's not. Sometimes it's gonna take a little longer to do. So that... Diallo: Well, that's great. Baldwin: That was a skill we had to learn. Diallo: Right. Well, if you have anything else that you'd like to add, I don't know if you want to look through your notes and see if there's anything particularly... Baldwin: Not too much, no. I mean that patience, developing that patience. Because I remember later, in '82, '83, when I was in the CCCD program, and I was hiring people to go out, to work in Africa. And I went and interviewed a number of people, and I settled on this one guy, who had been in 90-day experiments in smallpox. And I'd known this guy throughout the years, and I thought, well, he'll be perfect. He'll be perfect for this job. So, sent him to Africa, to West Africa, to the Gambia, small country. He had difficulties adjusting from day one, because things just didn't happen the way he thought they should happen. Even to the point where we met, and (unint.) before we went down, and we had dinner, and he ordered white meat and got dark meat, you know, and I said relax, relax. Because you know, you're going to get a heart attack, you're going to get an ulcer, if you don't just sort of, you know, be a bit more accepting and a bit more patient. And if they say your car will be ready tomorrow and it isn't ready, and it's going to be 3 days before it's ready, you know, you don't... You can still keep bugging them, but don't let it bug you. So it's... Even when the guy had worked overseas, he just hadn't had the patience, because it's different. You know, a different ball game. Well. Let me see. Is there anything else? I mean, the language skill was also a challenge, too. Diallo: Did you learn any local languages? Baldwin: Oh yeah, I did. I learned French like you wouldn't believe, and many French customs, too, and French-African customs. But, you know, all in all, I just... I just thought... I wouldn't do it any differently if I could, you know, if I had an opportunity. But this kind of always reminds me of this Robert Frost poem, you know, "Two roads". Have you ever heard that one? "Two roads diverged in a wood, and I/ I took the one less traveled by." And that's made all the difference for me, and it's been great, it's been a great experience. It's the... When I look back on my professional career, I think it's the most important thing that I've ever done professionally, in the smallpox eradication program, and I'm the proudest of it, even though it was a relatively minor role that I played. Well, we all played our roles, we all did our share, and some more than others, but, you know, it was great. And you know, I used to sometimes, in the former Soviet Union, as an example of how countries can work together. Because this whole issue of the smallpox eradication program, and the eradication of smallpox from the world was first brought up by the Russians, in early... During the Johnson administration, when Johnson was President. And Brezhnev was the Premier in Russia, and he had this idea surface at WHO several times, that perhaps the United States and Russia could do this worldwide effort, this global effort to eradicate smallpox from the world. First couple of times they threw that on the table, they didn't bite, you know? But a little later on, the Americans decided, okay, let's do this. And so, as a result of this, you had the two major superpowers of the world, I mean, these were the two big gorillas in the world, working together, and they got other people to work together, because other people saw them working together, to eradicate a disease from mankind, and this just hadn't been done before. So when I go into Russia, I used to tell that story, and people were kind of impressed, because they didn't know it. They didn't know that the initiative actually was suggested by the Russians. And so that... You get some political mileage out of that. Diallo: Well, that's great. Baldwin: Well, I guess... Diallo: Yeah, thank you very much. I think this is great. I think this is fine. Baldwin: I hope you get something you can use. Diallo: Oh, yeah, all of it. All of it. Baldwin: You're very nice. And I wish you a good career, too. Diallo: Thank you. Baldwin: I mean, you know, I have an edge on appointment over there, and it's always refreshing to talk to folks like yourself, because you bring a whole total new perspective, and, you know, as I said, I say it to students, I say you know, you're not going to make the same mistakes we did. Because hopefully we'll tell you about the ones we made, so you're going to make your own mistakes, all new ones, but hopefully you'll have the benefit of our experience, so that you won't go out... At the same time, that you don't go out and reinvent the wheel, either. We can tell you what we did, and what worked and what didn't, and what you... What you ought to think about modifying, and all that. And the smallpox experience was a learning experience for all of us. The surveillance, the containment, the ring containment... Ring vaccination. Everything was a learning experience. Every day was a winding road. Diallo: Well, thank you very much. Baldwin: All right. Well, thank you. Diallo: No problem. </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310122873%3Fsecret_token%3Ds-RvxYD&amp;color=ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false" frameborder="no" scrolling="no" width="100%" height="166"></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 sound recording - nonmusical interviews Date A point or period of time associated with an event in the lifecycle of the resource 2006-07-14 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/156mg emory:156mg Subject The topic of the resource Smallpox Eradication USAID WHO CDC Operations Officer Format The file format, physical medium, or dimensions of the resource 596867040 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Diallo, Melissa McSwegin (Interviewer); Rollins School of Public Health; Graduate Student Baldwin, Robert (Interviewee); CDC; Operations Officer Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of West and Central Africa Smallpox workers (2006 : Atlanta, Georgia) Title A name given to the resource BALDWIN, BOB Description An account of the resource Bob Baldwin, served as an Regional Operations Officer in French-speaking West Africa. Baldwin makes comparisons between poverty in the US and Africa, speaks about working as a Regional Operations Officer with OCEAC, and life as a "medical diplomat." In 2004 Bob retired from a long career with CDC in international health. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/7caccf7d31d87f29d9254d48fd266cb3.jpg 55676ea7b6bbf7b686871a6a40c769c7 https://www.globalhealthchronicles.org/files/original/5140a423b116905593143d0e2f83bf5d.pdf 0cebed1f61d26318afcf5a7fd2442c2d 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> This is an interview with William J. White, Jr., about his activities in the West Africa Smallpox Eradication Program. The interview is being conducted at the Centers for Disease Control and Prevention, on July 14, 2006. This is during the 40th anniversary celebration of the launching of the Smallpox Eradication Program. The interviewer is Kata Chillag. Chillag: How did you come to public health as a career? White: When I graduated from college, I was looking for a job. During an interview, I was asked, "Do you want to go to New York City and talk to people about sex?" So I went to work for CDC as a Public Health Advisor in the syphilis eradication program in '62, right out of college. Chillag: And how did you come to work in smallpox? White: I had been working for CDC recruiting personnel to work in the venereal disease program. I was getting a little bored, and I went to visit a friend who was at CDC operations in Hartford, Connecticut. He said he had heard that CDC was getting involved in smallpox, in international work. And I said, "Well, that sounds like something really interesting to do." So I put my name forward and said I was interested in being part of the group that was going to be looked at as possible candidates to work overseas. Chillag: Had you worked internationally? White: No. I had not even traveled outside of the continental United States. Chillag: So it was a big change. So, what were your expectations of the work before actually doing it? White: I thought that it was going to be an opportunity to be exposed to a different culture and a different environment. Then the project became more exciting as we went through the training in Atlanta before we went overseas. Chillag: And your role was what? White: I was to be the Operations Officer, based in Conakry, Guinea, but there was a disagreement between USAID [US Agency for International Development] and Guinea about assigning a team to that country. So the next assignment I was offered was in Upper Volta, which is now Burkina Faso, inland from the Ivory Coast . Chillag: And you were paired with a Medical Officer? White: Yes. I was paired with was Chris D'Amanda, who had responsibility as the Medical Officer for both Upper Volta and Ivory Coast. When I found out I was going to Upper Volta, I had a chance to meet and talk with a person who had been a US ambassador to Upper Volta, Thomas Estes. At that point my wife was 6 months pregnant. So we asked Estes, "Can you give us some insight into Ouagadougou, and whether or not it's even possible to think about delivering a child in the hospital there?" and he said, "Oh, yeah, no problem." Fortunately, my daughter was born stateside. Chillag: Did you come back, or you hadn't gone yet? White: No, we hadn't gone yet. It was clear that there was going to be a delay in the assignment and clearances and a whole series of things. There was an interim assignment arranged in Pennsylvania. So our daughter was born in Harrisburg. And then we went from there to West Africa. Chillag: What experiences, skills, and training from the VD program-and it doesn't just have to be that-were most relevant in terms of what you did next in Upper Volta? White: Even though I started off in the venereal disease program, I think that the next step, my assignment in Pennsylvania, was more critical because I was involved in recruiting for CDC on college campuses. The capability of interacting with people in a setting other than just a VD clinic was more useful. But I also think it was just kind of an understanding of what I was interested in at that time. It was the late '60s and getting beyond the United States and looking at international issues seemed to be relevant, at least for the folks that I knew in my generation. Chillag: If there was such a thing, what was a typical day like in your work in Upper Volta? White: Some of it was boring because it was basically office work and staying on top of issues, such as the budget. But other parts were interesting, such as the interaction with the vaccination teams, the development of the training of the teams, making certain that they understood what was expected, tackling issues like where we were going to store vaccine in a country, and looking at the cold chain. I did not understand, when I got in-country, what the issues were going to be in terms of being able to store smallpox and measles vaccine. We wound up having to find a large locker in which to store vaccines, and the only large locker that could keep things cold was at the abattoir, the slaughterhouse. So the vaccine was stored there. So when vaccine came in from the airport, getting it from there to the slaughterhouse was one of the major undertakings of the day. Chillag: And I assume part of your role was to negotiate things like storing it in the slaughterhouse. White: Yes. And that was made easy by being able to negotiate with the French, who really still formed the underpinning for the government agencies and were helpful in some ways, racist and hostile in other ways. I think that they were competitive in some ways with the American team there, but at the same time they wanted to see success with smallpox eradication. Chillag: So the remnants of the French infrastructure, is that who you primarily dealt with? White: No. There were Africans, but the French influence permeated a lot of the areas in the ministries, finance, health, and other agencies. This was in the late '60s, and the underpinnings were very much French. They still subtly controlled what happened in the economy and the government infrastructure, at least in Upper Volta, and, my understanding was, in some of the other francophone countries as well. Chillag: What were some of the challenges in dealing with Africans there? White: In our preparation for going overseas, there was a lot of attention paid to our becoming aware of the vehicles that we were going to be using and the maintenance and operation of those vehicles. Well, as it turned out when I got in-country, you could hire very qualified drivers and mechanics for relatively small dollars, and so it didn't make a whole lot of sense for me to figure out how to repair a Dodge truck. I also had political interactions within the American Embassy as well as within the French structure and with the Voltaic government in general. Chillag: So, starting out with the government in general and the French infrastructure, what were some of the politics that you faced? White: Initially, as I said, there was what I would regard as-jealousy is not quite the word-concern among the French that the Americans were there not just to do the job they were there to do but to basically insert ourselves between the French and the Africans who were ultimately in charge of the country and of the government. Even though there was a president then in Upper Volta, there was always the potential of a revolution. Interaction within the American community was also a concern because when we arrived, my family was located in Ouaga. There was a sense that we were somehow not just with the USA and USAID and not just with the Public Health Service. There was some suspicion that because we had learned some French, we were somehow connected with an agency based in Langley, Virginia. The suspicion was enhanced because our housing was outside of the immediate American compound. The other thing that made it complicated was that, as the smallpox/measles team, we had freedom to go almost anywhere within the country. And that was unusual; other Americans in the country had more limited passage for their visas. Chillag: So, how did you deal with those things? White: Ignored them, basically. I expanded and made changes. I just thought it was kind of funny that I would be considered as linked to the CIA [Central Intelligence Agency]. That connection was not anywhere near where my interests and politics were. So, I mean, it just made it kind of funny and interesting. I think the other challenge was being able to deal with the USAID infrastructure and how they perceived what we were there for-that we were really part of their operation but not quite part of their operation. I generally had a style of ignoring a lot of the paperwork and a lot of things that they were concerned about. My issues were public health issues-dealing with what we needed to do to train the teams, to get the vaccines out there, and to get out to assess outbreaks. I didn't pay a whole lot of attention to the USAID and embassy bureaucracy. I remember just the complexities of living. When we got there, I have a fairly vivid memory of getting off an airplane at like 5:30 in the morning, having left Harrisburg about 2 days before with a stopover in Paris. When we left the United States, I think it was probably about 30°F. When we got to Upper Volta, it was probably 30°C. I had second thoughts after we got off the plane and got located, and the housing we were supposed to be in wasn't ready yet. I'm thinking, "Wait a minute. My daughter is 6 weeks old, my son is a little over 2. What the hell did I get everybody into?" But then I think that there was a lot of interest in the American community, of seeing that somebody new had come to town. The Americans in-country were welcoming, even though it was a small community. So I think that that was helpful in adapting. But just learning that the electricity was going to out for so many hours, that the water was going to be out for so many hours, and that when the water was on, it was going to be on for a very specified period of time during the hot season- just coping with the living experiences in some ways helped us deal with things there. And we eventually realized, in spite of what former Ambassador Estes had said, that the health service and health options that were available in the community were not first-class or even second-class. Chillag: How did your wife feel with all this? White: I think that initially, she had some anxiety. She was nursing our daughter when we got there, and she had some concern because she had not been successful in nursing our son. But basically it was in some ways more relaxing and less stressful there than it was stateside; so she was able to get comfortable nursing our daughter. I think the next thing was that Claire needed to be able to find something to do, and that was unusual because I think other American wives who were there didn't necessarily feel that way, but Claire did. So she went out and found something connected with the USAID program and was able to work on that part-time. By background and training, she was a teacher, and so she arranged for Africans to come to the States through the African American Institute (which turned out later was funded by the CIA). That gave her a role in activities outside of the home. Both of us came from middle-income backgrounds, so it was ironic that one of the things that we were expected to do was to hire servants. Initially, we balked at that. But it turned out that it was an expected part of being in the community because you were contributing to the economy. So even though we hired a blanchisseur, which is basically somebody who did laundry and housework, you were expected to at least hire somebody to do some of the cooking and cleaning within the house. It turned out that you were paying the house staff the equivalent on a monthly basis of what the per capita income for the country was on an annual basis. It was complicated for us because the first thing that you learned was that they refer to you as patron, which means master, which didn't quite fit with who we were or what our self images were. It took a while to get the house staff to change that to monsieur. And they weren't quite comfortable with that initially but learned. So we learned to cope in an environment where things that you would normally expect that you'd have available, like fresh milk, weren't. There were things that you learned about shopping and buying things in the open market and things like that that made life interesting, fascinating, tolerable, and sometimes just really a huge pain in the ass. Every time you cracked an egg, you found blood in it. Chillag: You've alluded to some of the expatriate-like cultural differences, but were there other cultural differences that were really striking in the work or that affected your work? White: Mainly getting an understanding with the French that we weren't there to usurp what their authority had been. That we were there to contribute. That we were there because we wanted to encourage and teach the African teams that we were working with ideas that we believed they needed to know to be able to be effective in doing vaccinations and follow-up checks. It was clear that you could go back and check on the smallpox vaccinations and determine whether or not you had a take. You weren't always able to do that with measles, so you did the dipping of the fingers into-I forget what it was at that point, some kind of silver nitrate. Part of it was even learning to adapt and deal with the official American community that was in the country because it was a small community, but at the same time it was expected that you interact with them. Chillag: So your base was there, but I imagine you traveled out around the country. Is that correct? White: Yes. The base was in Ouagadougou. In the first several months we were there, we traveled to other areas of the country because we had a number of smallpox outbreaks. It was important to be out there with the teams if we were going to be able 1) to try to identify where the incident case came from and 2) to do the vaccinations and/or curtail what we thought might be spread of the infection. So I probably spent, on average, maybe 40%-50% of the time outside of Ouaga. The next largest city I spent time in was Bobo- Dioulassou, which was where the African/French regional health operation was located. Other parts of the country that I visited depended upon where there were outbreaks or where the teams were working. Travel slowed down some in the rainy season. Chillag: What were the biggest rewards of the work for you? White: I think part of it was realizing that there were opportunities to make a difference. We had conversations about this even during the course of the training in Atlanta. That, if we were successful in eradicating smallpox and controlling measles (measles had a 20%- 25% mortality rate then), what was going to happen in those countries? We weren't doing anything to change the economy; there wasn't necessarily anything else that we were doing that was going to change the larger health structure. And so from a philosophical point of view, one of the questions we asked ourselves in late-night conversations with wine and cheese was basically: What were we accomplishing? And I think we accomplished something for the United States in that it took away an infectious disease that could have come here. But the real question was: What was the real benefit in the areas in Africa that we were working in? I think some of the techniques that we taught folks about disease follow-up, learning about putting in place some modest epidemiology and epidemiologic approaches in surveillance and assessment of coverage, stayed with some of the teams. So I think we contributed to their having a better understanding of those things. But the ultimate, I think, was just the psychic kick of being able to demonstrate to myself that I could able to learn to function in a different culture, learn to function in a different language, and learn to be leading a team in accomplishing things. I wonder, frankly, with today's instant communication, whether or not the freedom that we had to go ahead and make decisions and take action would be allowed under today's circumstances. There were times when I was out in the field and I would come back and I would find a cable asking for one thing, and then 3 days later there was another cable countermanding that request, and then another cable saying, "Forget those two. They're not important." Today, if you had wireless access or a cell phone and a satellite communication or anything else, somebody would want instant response to things that may interfere with what really needed to be done . Being on the ground and being able to make the decision with the available information was key. The other thing that in some ways shaped my experience there was the fact that our son was discovered to have an illness when we were there, and the nature of his illness was congenital. It was Hirschsprung's disease, and that meant that he had a section in his colon that needed to be resected. This condition is usually discovered within the first few weeks of life, with newborns. In his case, it wasn't discovered until later, and so there were constant questions about whether or not there were parasites infecting him or something else causing his symptoms. And that caused a significant amount of stress for my wife and for me because you don't like to see your kid in pain and discomfort. And when his colon got enlarged, he had to have frequent enemas and other procedures to disimpact him, and they just weren't very satisfactory, and it was a difficult way for a child to live. The dilemma occurred when the State Department physician, who was the first one who came up with a best assessment as to what was wrong, determined that it wasn't a reason for medical evacuation because it was a condition that was congenital in nature and should have been fixed before we were overseas. That, on the face of it, seemed preposterous. The folks like George Lythcott and others in the regional office backed the decision to allow my wife and son to leave the country on early R&amp;R; (rest &amp; recreation) to Germany. There, at Landstuhl in Frankfurt, they did a full evaluation; they weren't quite sure that what they saw was correct and sent them stateside. So I wound up being in- country probably about 4-6 months by myself while they were in Germany, then in the States, going through all of the diagnostic procedures as to what was really happening because it wasn't clear. Finally, Children's Hospital in Boston recognized the condition and corrected it. The other difficulty incurred by that situation was that some challenges were made to the State Department on its decision, not by me but by my brother, who was a physician in the States. He sort stirred up some shit-excuse the Spanish. The State Department got very huffy and essentially at one point made a note to the record that described my then-wife as a morale problem, and they would not allow her to return to post. The reason for that was that there were a few other Foreign Service officers at post who also had very young children, and they had seen circumstances in which they had seen a mother with a child who was somewhere around the same age as theirs who was not dealt with fairly, in their mind, by the State Department. The parents raised all kind of hell with the Ambassador, who just got all very huffy about the decision. The State Department rallied around itself and said that its decision was correct and there was no way to reverse it. So that changed the circumstances in terms of whether or not my wife was ever going to be allowed back in-country. She had been designated as persona non grata by the Ambassador and therefore DOS. And so that pretty much ended my career in terms of being part of the international group. From the CDC perspective, there were other opportunities to go overseas. One of them was Afghanistan at that point, which was not a likely choice, given the fact that I wanted to spend some time with my spouse and kids, and Afghanistan was not a post where that was going to happen. Chillag: So, one of the questions that we ask sort of follows from this in a different way: How did your experience working on smallpox affect the rest of your career and your life? White: It's a good question because one of the things that I saw coming back stateside, I think there was a lot of preparation done for us going overseas. There was a lot of instruction about things that you hope never happen to you and infectious diseases that you hopefully never come in contact with, around anti- malarials and getting your kids to take the meds; information about the smallpox program, and USAID relationships, and all of those things. When I came back stateside, I was dealing with relocating my family stateside, and the East Coast seemed to be the place. And since I had spent time in New York City before then, getting relocated in New York made some sense. The domestic side of the CDC operation had little, in my estimation, appreciation or understanding, at least from the perspective of what Operations Officers learned to do overseas. And questions around promotion, questions around understanding of those things, and, at least in my experience coming back, were not well understood by the domestic operations side of CDC. When I came back, they sort of grudgingly accepted me into the tuberculosis program in New York. But it wasn't clear, at least at that point, that the experience overseas translated into a kind of integrated career pattern within CDC. I would say the other thing, just from a personal point of view, that pissed me off even when I joined the tuberculosis program is that, what I was looking for was an opportunity to get into graduate school so I could get at least a master's level, beyond where I was, in public administration or public health. NYU [New York University] at that point offered the program. When I requested CDC to pay the tuition, that I was going to be going to school in the evening, so there was no time away from work, they denied it because they weren't certain that I had career potential within CDC. So I then went to work for the Office of Economic Opportunity and worked in community health centers and a variety of other kinds of things. I stayed in public service until sometime in the early '80s. When Joe Califano was Secretary of Health, Education and Welfare, I was the point person on his office for the Childhood Immunization Program. That caused some folks at CDC to be anxious because there had previously been somebody from CDC based in Washington who was heading that up. I wasn't at CDC then-I was in the other part of the Public Health Service-and there was a concern that I harbored ill feelings towards CDC, and I didn't. I mean, I just realized that they were going one way and I was going another way, and that was fine. I think that as far as I was concerned, I learned a number of things when I worked with CDC. I had a great experience from a personal perspective overseas in learning that I could go ahead and make decisions, and I could make decisions in complicated political and other environments that made sense, and I don't regret that experience at all. I don't. In terms of my kids and as far as what their perspective on all of this is, they purport to remember their time overseas. My daughter was 10 months old when she left Upper Volta, yet she still seems to have memories of that. I don't know if it's from family conversations or whatever. But both my son and daughter have spent a fair amount of time traveling internationally or working internationally and living internationally. My younger son, who wasn't even part of the group at that point, also has worked and lived internationally. In fact, my daughter lived about 8 years in Russia, and my son for 9 years. In fact, he's back there with his wife and daughter now. So I think they grew from that experience. You know, people perceive themselves as being more international in how they see the world. Chillag: I suspect you've touched on some of the things that would be the answer to this question, but if you had been in charge of the program as a whole, what would you have changed in terms of the approach or any dimensions of it? White: This was really CDC's first effort in international public health in any major way. I think the training of folks leaving country was pretty reasonably well done. I think training people about how to reenter and how to interact with folks domestically was not as well integrated as it could have been. Maybe it's changed now and maybe the career paths and the way that one can take a look at things are better thought of and better defined. Chillag: At what point did you think smallpox could actually be eradicated? White: Well, I think it was pretty clear. I mean, I never thought when I went to work for the syphilis eradication program, that syphilis was going to be eradicated, particularly given what I saw in New York, and at that point homosexuality was so hidden it was unbelievable, in '62 and '63. But I thought that given the availability of vaccine, if we could figure out the cold-chain issues, if we could figure out the trainings of teams and the distribution and early knowledge of what one could learn about managing the containment of smallpox outbreaks, smallpox could clearly be eradicated. The strategies were modified over time, and the availability of the bifurcated needle and better vaccines and all the rest of that really helped, but I think it really was in many ways sort of a simple disease to eradicate. That's why, frankly, I couldn't understand the hysteria around scurrying around and looking for millions of doses of smallpox vaccine that went on in the Tommy Thompson era. It just struck me as really stupid public health and a waste of monies and dollars. But I don't feel strongly about it. Chillag: Do you remember hearing about the last case of smallpox and how you felt? White: Yes. In my career I've been involved in eradicating syphilis and eradicating poverty, and the only thing I've ever been successful in eradicating was smallpox. It's not the only thing that I'm proud of, but having been part of the group of people who were able to contribute in some way to that, yeah, I think it's an impressive thing. My godson is getting married tomorrow, and the real question was whether or not I was going to come down for any part of this reunion. So we came down today, and we're going to go back up early tomorrow morning for the wedding. But it was important to see folks who were here and also just to reconnect with some people who were part of something I think that was a very interesting and I think a significant effort in public health. The other thing that I will say that has been a point of unhappiness for me in the last several years is the erosion of CDC as an agency that is seen as a significant presence in public health. I worked in Massachusetts for the Department of Public Health up there, and they don't look to CDC for direction and guidance. I think the agency, over a period of time, has become increasingly politicized in the appointments of its directors and its missions. I think some of that's been allowed by Congress, and a lot of that's been allowed by the secretaries. I think that that's unfortunate. Now it's even worse because it's happening at NIH [National Institutes of Health]. But it's an unfortunate legacy in the last 15 years or so in terms of what's gone on with CDC. Seeing Tommy Thompson out on television talking about anthrax, I just wanted to reach deeply into my throat and retch on the floor. The man had no reason to be that. You needed a scientist out there talking about that and reassuring people of what was going on. Chillag: And you feel that was very different at the time you were with CDC? White: Yes. I think that there were people here who were connected to the science. I don't care if it was Alex Langmuir, when he set up the EIS [Epidemic Intelligence Service] or Carl Tyler, when he was there and I was working with the Family Planning Program. They came to agreement on things that they could contribute to and make life better in the delivery of reproductive health services. I mean that the Reagan era began to deviate from science in the area of reproductive health, and I think it continued a little bit in Bush one and I think it's gotten worse in Bush two. And public health science is just not here. Chillag: So, is there anything else you want people to know for posterity about your experiences? White: Yes. I was 26, 27 years old at the time, and I was in an environment in which I was perceived as being in charge of a significant part of the development of a public health program in a country, and that was pretty heady stuff. We were the folks that people came to when the new Peace Corps group was coming to town because we were really the first American presence in that country that had gone outside of the major parts of the city. And when the Peace Corps came, I think that our presence there made that more accepting. And as long as you made it clear to folks that we didn't work for the CIA, I think it was ultimately fun. Chillag: Thank you very much. It's been a pleasure. # # # </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/309983164&amp;color=ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false" frameborder="no" scrolling="no" width="100%" height="166"></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 sound recording - nonmusical interviews Date A point or period of time associated with an event in the lifecycle of the resource 2006-07-14 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/1591f emory:1591f Subject The topic of the resource Smallpox Eradication USAID WHO CDC Operations Officer Format The file format, physical medium, or dimensions of the resource 389484144 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Chillag, Kata (Interviewer); CDC; Anthropologist White, William (Interviewee); CDC; Operations Officer Contributor An entity responsible for making contributions to the resource Reunion of West and Central Africa Smallpox workers (2006 : Atlanta, Georgia) Title A name given to the resource WHITE, BILL Description An account of the resource Bill White was an Operations Officer assigned to Upper Volta (Burkina Faso). Bill describes his work in Upper Volta, the complexities of daily life, his son's illness, and negotiating CDC infrastructure once he returned to the United States. Bill reflects on the impact living abroad had on his children and the role of CDC today in public health. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/c94ee16f0fe062dc2da1379e349d96b8.jpg f7d78b88df4e468df04a13d6b5b8f263 https://www.globalhealthchronicles.org/files/original/6694d28bb4c79519c6abba7901ef5ee7.pdf 7147e664c0423651fb3e8a269569a621 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> This is an interview with Joan Thompson about her activities in the West Africa Smallpox Eradication Program. The interview is being conducted at the Centers for Disease Control and Prevention, on July 14, 2006. This is during the 40th anniversary celebration of the launching of the Smallpox Eradication Program. The interviewer is Linda Harrar. Harrar: Would you describe your early life, where you were born and your education through high school and college? Thompson: I was born in North Dakota, in a small town. My father was an educator, and so I actually lived in 3 different small towns in North Dakota, but I spent most of my time in a town of about 600 from age 8 through high school. Harrar: And so you went to high school in North Dakota. Thompson: I went to high school in Portland, North Dakota. Harrar: I understand that you're married to Dr. David Thompson. Thompson: Right. Harrar: So how did the 2of you get involved in the smallpox program? Thompson: Well, we were interested in working overseas, both of us, before we even met and were married. When he was doing his internship, he applied to the Public Health Service; he was thinking about maybe working on a reservation in preparation for going overseas. It was during the Vietnam War, and there were no positions available. Then we applied to the Peace Corps, and there was nothing there. And David said, "Well, I guess I'll be going to Vietnam." But he didn't want to go to there, and even more than that, we were looking already at going overseas and thought that would be a good thing. And then totally out of the blue, he got a telegram one day that read, "Are you interested in going to Africa?" And we didn't know what it was for, not anything. He just responded, "Yes." And then he got a phone call, and D. A. Henderson [Donald A. Henderson] came to Minneapolis to interview us. There were, I think, 3 spots left to fill, and D. A. was interviewing I don't remember how many people. Dave was just finishing his internship, and we were extremely happy when we were accepted. Harrar: Who sent the telegram? Thompson: It must have been somebody in the Public Health Service. I can't remember. I just remember he came home from work and he said, "You'll never believe what I got today." Harrar: Wow, amazing. Thompson: So it was a very amazing story of how we ended up in this program. And it really changed our whole lives. Harrar: Oh, I bet. Where were you living at the time that you were accepted? Thompson: Indianapolis. Harrar: And so you get the telegram and you have the interview, and then he's told, "You've got the position." What next? Thompson: He was in the internship that finished the end of June. Training down here in Atlanta started the beginning of July, so there wasn't much time. We just made plans to go. We were very excited. Our families were excited for us. Harrar: Did you have children at the time? Thompson: We had one very young son, newborn practically. He was 6 months when we came to Atlanta for training. Harrar: So when you were in Africa, where were you stationed? Thompson: Initially we were in eastern Nigeria. We flew into Lagos, and there was some training there. Probably one of my vivid memories is of when we were staying in an apartment. Dave was off from early in the morning till probably 5 in the afternoon. I don't remember exactly, but all day. And I was really sick. I got traveler's diarrhea. Our baby was about 8 or 9 months old by then. I just remember lying on the floor in that apartment and closing all the doors so he couldn't get into anything, just thinking, how am I going to survive? And Dave felt like he couldn't stay home. He had to be at this training. That was my introduction. Fortunately, I had been in Africa once before, so it wasn't like totally new. Harrar: So Dave went out every day. So tell me, other than being sick when you got there, what did you do every day? How did you spend your time? Thompson: Well, I was sick for 3 or 4 days, and then I would just take the baby and go out walking. It was hard to find time to fill the days, during those early days. Harrar: So you were living in a small apartment. Is that where you stayed the entire time? Thompson: No. We were just there a matter of days. And then we went to Enugu in eastern Nigeria. Harrar: And you were there for how long? Thompson: We were there for about 8 months. I can't remember if we arrived there in September or October. We were evacuated at the end of June. And when we arrived at that airfield and got off the plane, the airfield was ringed with men with machine guns that were just trained on us like this as we walked in. And that was kind of an unnerving feeling. Harrar: I can imagine. So, is this at the time before the Biafran War? Thompson: Before. But they already had the guns and things, the security. There was a lot of unrest. There was a lot of fighting in the north, and people were being sent back on trains to the east and being pulled off and killed. Harrar: So, were you there when the war broke out? Thompson: We were there. We have pictures of that Independence Day parade where they declared independence, and then the women and children were all evacuated. Harrar: Including yourself? Thompson: Yes. Harrar: And what was that like? Thompson: Oh, that was a nightmare. We knew it might be coming. They'd told us that there was a possibility, and I think we had 2 days' notice. We were allowed to take one carry-on, and I packed all our pictures and a couple changes of clothes for our son, who by then was a year and a half. And I was 8 months' pregnant. And we drove to Port Harcourt and loaded the plane. I mean loaded it. Every woman had a child on her lap. There were not enough seats for every person. We were flown to Lagos. And there we waited. We had thought that we would be flying out immediately, but it was during the Six-Day War in Israel, and planes were all being diverted over there, so we had to wait for a plane. We stayed with a family in the smallpox program in Lagos. They were incredibly good to us. And then one night maybe 9, 10 o'clock, came word that a plane was on its way, and we went to the airport. We were all women with kids, and we were in the airport all night waiting for this plane. And early in the morning, the plane arrived. And thank and food goodness for Bill Shoemaker [William Shoemaker]. He carried water and food around all night. I don't know if I would have made it otherwise. We got on the plane, and we flew to Monrovia for refueling. We were not allowed to disembark. On this plane, I think everybody had a seat. But we'd had nothing to eat. When we left Monrovia, we sat on the airstrip there for what seemed like 2 or 3 hours, but my memory might not be right. When we got in the air again, they announced that because the pilot would now have too many hours to fly to New York, we would be diverted to Puerto Rico. So we flew to Puerto Rico, and because it was a US port of entry, we all had to disembark and go through customs. Here we were. I'm pregnant; I'm carrying my son, carrying a suitcase, and I remember the guy says, "Put it up there. I want to look at it. "And I was so tired, and I said, "If you want to look at it, you have to put it up there." And then we loaded the plane again and flew to New York. We got into New York about midnight. By now it was about 23 hours' travel time, and we were just dead. Things at the airport were closed as far as booking oncoming, ongoing flights. So somebody met us, and they took us all to a hotel. When we got to the hotel, they had been told that there were refugees coming, and they had to put at least 2 families to a room. And I said, "You know, I'm not going to do that. I know that USAID [US Agency for International Development] is going to pay you for a room for every single person, and I want my own room," which I got. But then, in the morning, we got up and went back to the airport. We spent most of the day in the airport because we had to go there to make our ongoing reservations, and we finally got into Minneapolis the next night. It was an experience I wouldn't want to repeat. Harrar: So from the time you boarded the first plane, when you were evacuated, until the time you arrived. . . Thompson: In New York, it was 23 hours. Harrar: Twenty-three hours. No food, and with a baby. And 8 months' pregnant. Thompson: Yes. Harrar: Amazing. Thompson: I mean, there were other people who had 2 or 3 children, you know, maybe an infant or a toddler. Harrar: So where was your husband during this time? Thompson: The men were not evacuated. They stayed behind. They stayed in Enugu, and then they eventually went to a meeting. I don't even remember where it was; it might even have been out of Nigeria. And when they came back, they did not let them go back to Enugu. But Dave didn't come back to the States until August. He got back a week before our daughter was born. Harrar: So, how long were you actually there in Africa, the 2 of you? Thompson: Well, we were in Enugu 8 months, and then we came back here and we were down here at CDC from August to January, and then we went to Liberia. Harrar: Okay. Thompson: And then we were in Liberia for 2-1/2 years. Harrar: Other than the stories that you just told me about war breaking out and everything, were there any other unique occurrences that you could tell me about that you went through, either then or when you went back to Liberia. Thompson: Well, there were a lot of experiences. Of course, we were in Liberia much longer. There was a women's medical auxiliary, which I was part of, and that was Nigerian expats, so that was a great experience. With that auxiliary, we were invited to have tea with President Tubman up on the top floor of his palace. That was a very unique experience, marvelous. When I was involved with this medical auxiliary, one time we were setting up a display of some kind; I don't remember what it was for. I left to go home and change clothes to come back for whatever the event was. It was very close to the president's palace, and I pulled out onto the road, and all of a sudden the president's security came zooming by, and I had an accident with them. Oh, my goodness. They didn't have sirens or lights or anything. They just came zooming by with some dignitary and his whole, huge entourage. Wherever he went, it was with a huge entourage. But it was like, well, whenever there's an accident with that, it's always the expat's fault. Harrar: Of course. Thompson: But it turned out that that was one advantage of working with the government. They took care of everything. But, oh, it was very unnerving for me to realize what had happened. One highlight was our involvement with an orphanage there. We lived initially in a duplex. A couple lived on the other side of us. He was American, and she was Italian. He worked under USAID as an advisor to the treasury. They became very good friends. And she had some connection somehow. So with her, then, we got involved in helping out in an orphanage. I was asking our oldest son, just this week before we came, if he had any memories of Liberia, because he was 4 when we left. And he said, "I do." And one of the things he mentioned was the orphanage. He said, "I remember going there, and the kids, and playing with them." It was kind of interesting. Harrar: What kind of things did you do there? Thompson: It was a small orphanage. It was a lady and her son, and they had maybe 6, 8 kids. We would take them to the beach, have a picnic. I remember we helped get them a washing machine; they did all their wash by hand. We helped out with clothes, had them over to the house, just those kinds of things. Her name was Eva Deline [phonetic]. I can't remember her son's name. Harrar: I'm sure she remembers you. How do you think this participation in the smallpox project changed your life? Thompson: Oh, as far as our life together, I think it totally changed the direction of our lives. We had been interested in going overseas to work. I think we had thought in terms of probably working with a mission in a hospital. But Dave, after working with this program, was just convinced that there was nothing to do but public health. So we came back and he got an MPH [Master's in Public Health] at Hopkins, and then he did a pediatric residency, and then we went back and worked in public health for 12 years in Chad. One other real highlight of being in Liberia was that every Saturday morning we'd pack a lunch and we'd go to the beach. It was just like having a vacation every week. We'd leave maybe 10 in the morning and come back around dinnertime. That was just marvelous. I said to Dave recently, "I wish we could do that now." We had a couple of incidents that happened at the beach. Our daughter almost drowned. We were there with a number of other people, and there was a lagoon on one side and the ocean. Kids were playing in the lagoon, and we were playing cards. And all of a sudden one of the women looked over and she said, "I [unclear; pls fill in] Christen." And she was just floating. I was sure she was dead. I didn't even get up. I was just shell- shocked. My friend Ruth is an anesthetist, and she ran and grabbed her, and Christen wasn't breathing. And Ruth turned her over and hit her on the back, and water came out and she began to breathe. Harrar: Oh, my goodness, how frightening, how frightening. Thompson: Yes. We kept a close eye on the kids after that. Harrar: And how fortunate that the woman was there who could do that. Thompson: Yes, she just glanced over, ran and got her. Dave ran too, but Ruth got there first. Harrar: And how old was your daughter at the time? Thompson: I don't think she was a year, but she was walking. Harrar: So she doesn't remember. Thompson: No, no, no. Harrar: I'm sure you've reminded her of that incident. Thompson: You know, I don't know that we've talked about it. When I realized only the day before yesterday that I was going to be interviewed, I said, "Dave, I don't remember anything. I don't have anything to say. "He said, "Oh, you remember way more than you think." So I don't know that we've actually talked about it with her. But I need to write some of these things down so we can. Harrar: You mentioned that there were a couple of incidents at the beach. That was one. Do you remember the other? Thompson: Yes. Our son got stung by a Portuguese man-of-war. Often there would be many of them-it must have had to do with the weather. They would wash up on the beach, and we would be really trying to be careful. But one just got all totally wrapped around him. But where we went to the beach was at a mission station and they had a hospital. We just grabbed him and actually ran up there with him. And he remembers that very vividly. Harrar: I can imagine that was incredibly painful for him. What was the toughest problem that you faced, and how did you resolve it while you were there? Thompson: Probably the hardest thing was that Dave was gone all the time, especially in Nigeria. When we first got there, we kind of knew it was going to be like that, but we didn't know anybody. Paula Foege wasn't there yet. Mary Litchfield was there, but she lived on the exact opposite side of town from me. That was our team. And, yes. They would leave on Monday morning, and they'd come back on Friday night. Sometimes they'd leave on Sunday afternoon because there was a huge smallpox epidemic. Fortunately, at that particular time, we were living in an apartment, and so we got to know the couple upstairs, and that helped. And, again, we had a stroller, and I walked and walked and walked and walked. One of the things I should mention is that in our orientation in Atlanta we had been told that we should hire house help, that we were giving somebody a job. But they told all of us not to hire anybody without papers. Well, when we were in Enugu, this guy showed up at the door one day. His name was Patrick, and he wanted a job. He'd been to USAID and they had sent him over, actually, to us. He'd worked in the north, and he'd had to flee. And so I was very naive, and I asked him for his papers, and he said, "I don't have any papers." And I said, "Well, I don't know if I can hire you if you don't have papers." He said, "Well, I worked for Americans in Kano," but he was Ibo, so he'd then had to flee. And he said, "We fled without anything." He said, "Just try me, and I will work. And if you don't like me, you don't pay me." Of course he was just a godsend. He was just incredibly hard-working. He wanted to do everything. After we moved into our house, we would wake up in the morning and we'd hear him moving furniture. All the floors were washed before we got up. And I'd say, "Patrick, you don't need to come so early." He'd say [unclear]. "I felt like saying, "But I'm not." He was just an incredible guy. And in Liberia, too, we just were so fortunate with house help. We got a young guy who actually lived with an American missionary family. They had left, and he was looking for work. And our kids, their biggest treat for them, which was kind of neat, was if Dave and I wanted to go out in the evening. All I had to tell the children was, "You can have rice with Samuel, rice and ketchup," and they were thrilled. It was weird. Harrar: Did you have to do any of the cooking, the shopping? Thompson: I did the cooking and shopping. I loved doing that. I loved going to market. I still love going to market. I go to farmers' market all the time because it reminds me of Africa. And for Patrick, that was very hard. He wanted to cook. And I said, "But what would I do, Patrick, if you cook? You do everything else." But he had done it for other people. When we were evacuated and he got to cook for Dave, he was delighted. Harrar: What kind of impact or what difference do you think it would have made if they had said, "Okay, Dr. Thompson, you and the men or the CDC employees, whatever, are going to go over, but the families have to stay back in the States?" Thompson: Oh, it would have been horrible, horrible. I think it's important both ways. It's important for the men or the employee, whichever spouse that is, to have family there and someone to come home to on weekends. But I also think it's very important for the family because otherwise that's an entire part of their lives that you're not part of. Harrar: Right, right. Thompson: That would be a big hurdle, I think. There are some broken marriages anyway, but I think there would have been more. Harrar: Is there anything that you would have changed if you had to do it all over again? Thompson: I hadn't thought about that. I don't know. I would have to think about that. Of course, in our later experience, we lived in a very small town, and I was very much more involved with African women and really got to know them as friends, just as the African women I got to know in Liberia were the lady who had the orphanage and then the wives of the African physicians who were in the medical auxiliary. And also my neighbor in Liberia. I wouldn't say I got to know her well, but she came over almost every day, and she'd be in my kitchen while I worked. She said, "I want my kids to play here because I want them to be smart." So her kids were at our house a lot, and it was great. I wanted my kids to have that experience of playing with African kids. So it's funny. Shortly before we were leaving Liberia, she threw out her old mortar. I don't know if you've seen them. They're about this high and they pound their grain. Harrar: Oh, yes. Thompson: She threw it out and got a new one, and she wanted me to come and see her new mortar that she'd gotten at the market. And I asked her if I could have her old one. It was mended with metal, where it had cracked. She said, "You don't want that. You can go buy a new one at the market." I said, "No, I want this one because I'll take it home and then I'll think of you every time I look at it in my house." And she just laughed. She thought it was the craziest thing. She said, "I don't understand white people." That's what she said. But I still have it in my house. I have it in my front hallway. And I do think of her all the time. I wonder what happened to her kids, where they grew up. Harrar: So what impact do you think that the experience had on your children? I know they were young, but . . . Thompson: It's hard to separate this from their other African experience, but it had a huge impact on them, and they are incredibly grateful. The son who was born in Liberia is now in the process of adopting. And when he and his wife decided to adopt, he said, "I wonder if we could adopt from Liberia." So they are going in about 3 weeks to get these children. [show's photo] Harrar: Oh, how precious! Thompson: These are sisters. Harrar: Wonderful picture. And the ages are probably . . . Thompson: Four and 1. Harrar: Four and 1. So 2 sisters from Liberia. Thompson: Yes. Harrar: And they're going to be adopted and come to the States when? Thompson: The beginning of August. And I'm sure they would never have gone to Liberia if my son hadn't been born there, but he said, "If we're going to adopt, and possibly overseas, then let's see if there's any possibility of getting somebody from Liberia." Harrar: Well, they're just precious. You're going to enjoy them. Thompson: Oh, yes. We know that, and we're thrilled. So they're actually traveling to Liberia now to get them. Harrar: And what about your daughter? Obviously, your son was affected. Thompson: Yes. I guess it's hard to separate our experience in Chad from our experience with the smallpox program. All the children finished high school in Africa. So they just have a different world view. They have an incredible interest in international things. Living in Africa had a huge impact on them. And they have said many times, "I'm so glad we grew up overseas." And our son, David, still maintains contact with an American friend, another expat kid, who was his friend there Harrar: So, lifetime friendships. Thompson: Yes, definitely. And all of them had very close lifetime friendships from high school. They went to high school in Nigeria even though we lived in Chad; it went to a mission school, but it was incredibly international. One of our daughter's classmates in high school, who turned out to be a very good friend, was from eastern Nigeria. And it turned out that she was born the same week that our daughter Christen was born, in the same hospital that Christen would have been born in had we not been evacuated. Harrar: Wow. Thompson: And they ended up classmates 14 years later. Harrar: How amazing. Thompson: Yes. Isn't that amazing? It is a small world, a very small world. Harrar: Is there anything else that you would like to add? Thompson: Not that I can think of. It was a good experience. We have great expat friends. And those friendships have lasted the years. Harrar: Well, I want to thank you for your time. This has been very helpful for us. # # # </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310169673%3Fsecret_token%3Ds-7iUW3&amp;color=ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false" frameborder="no" scrolling="no" width="100%" height="166"></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 sound recording - nonmusical interviews Date A point or period of time associated with an event in the lifecycle of the resource 2006-07-14 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/15909 emory:15909 Subject The topic of the resource WHO Life as expatriate wife Smallpox Eradication CDC USAID Biafra War Format The file format, physical medium, or dimensions of the resource 363155856 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Harrar, Linda (Interviewer); NOVA; Writer Thompson, Joan (Interviewee); CDC; Wife of Epidemiologist Contributor An entity responsible for making contributions to the resource Reunion of West and Central Africa Smallpox workers (2006 : Atlanta, Georgia) Title A name given to the resource THOMPSON, JOAN Description An account of the resource Joan Thompson, wife of epidemiologist David Thompson, who served in Nigeria, Liberia, and Chad. Joan relates how it was to adjust to life in Eastern Nigeria, being 8 months pregnant and evacuating during the Biafra War, and life and friends in Liberia. Joan's husband continued with a career in public health and the family later moved to Chad. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/aa014cc376a6743520bc655a55678f97.jpg f7d78b88df4e468df04a13d6b5b8f263 https://www.globalhealthchronicles.org/files/original/eefbb5477fb0a7a8101ccc3f448db3cd.pdf d83cb137dc3e902b249d2bb2db5c5e56 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> This is an interview with Betty Roy on July 13, 2006, at the Centers for Disease Control and Prevention in Atlanta, Georgia, about her involvement with the West African Smallpox Eradication Project. The interview is being conducted as a part of the reunion marking the 40th anniversary of the launch of the program. The interviewer is Diane Drew. Drew: Would you mind telling me a little bit about your background, schooling, where you grew up, that kind of thing? Roy: Okay. I'm from the Midwest, from the Chicago area. I spent all of my childhood in that area. My father was a dentist. We were in, at the time, a small suburb of Chicago, Mount Prospect, Illinois, and he was one of the first 2 dentists in the town. Now, I don't even care to guess how many might be in that area. I did all of my elementary and high schooling in Mount Prospect, and then went on to my first year of university. I was in music at the time and went down to DePauw University in Greencastle, Indiana. And as is true of many young people, you sort of have a change of interest, a change of liking for the university, and I found DePauw and Greencastle maybe a little bit too small. I had done some studying with professors at Northwestern, so I transferred up to Northwestern, and I finished my studies there. Drew: In music? Roy: No, I transferred out of music 1 quarter after being there and went into the College of Liberal Arts and decided to major in French. So I did my studies in French and had to do a catch-up because I lost some credits. So I had quite a heavy schedule for the rest of my 3 years at Northwestern. I finished up at Northwestern, and I was not in education. I didn't have much interest in teaching, which in some ways I think was probably a mistake because I think I should have done that. But I went off to Washington, D.C., and worked-I guess I can tell you-I worked for the CIA. Drew: Oh, that's okay. Now you'll have to shoot me. Roy: It's been quite a number of years. But I worked in D.C. for a year and then went abroad to Dahomey with the "State Department." (I'll put that in quotations.) Dahomey is now, of course, Benin. I worked in the embassy there and had a 2-year contract. And it was in Dahomey that I met a certain young man called Jean or Jeannel Roy, who was working there with the Smallpox Eradication Program. Drew: So your courtship must have been primarily in Cotonou, the capital of Dahomey? Roy: Correct. I didn't meet Jean right away. He was actually in Frankfurt when I arrived, but he was working in Dahomey. But people said, "Oh, you must meet this young man." I said, "Okay." It was a small post, so you tended to eventually meet everybody. Jean was responsible for Dahomey. I arrived in late '68, actually around December of '68. Jean was already there; I think he arrived in '66. Drew: Now, what's dating like in Dahomey? Roy: Well, I don't want to get too much involved. Drew: Oh, no, no, no. Roy: Well, as I said, Cotonou, the embassy, and the whole community are very small, and being a French-speaking country, a lot of French expatriates were living there. In the American community, the embassy was very small, so you met everybody. So dating, okay. I had some overlap with my predecessor at the embassy, and she said, "Oh, you need to meet Jean Roy. He's a fantastic man," and da-da-da-da. So he was gone 3 weeks. But I guess when he came back, he had seen me at the cinema with some French people, and he said, in the back of his mind, "Oh, she must not be so bad if she's in the cinema watching French films with French people. Obviously, she's out trying to meet people outside the American community." Drew: Don't let me make you feel like I'm like probing, but it's fascinating, really, to think in terms of a young woman away from the country, kind of becoming used to that. It really sounds like the makings of a novel. Roy: There were not a lot of people, you know. It's not like you go to a local bar or something and meet people, or through education courses or something.So we eventually met up at a New Year's Eve party through somebody who was with USIS [United States Information Service] and sort of started going out. He had a horse and asked me, "Do you ride?" and I said, "Oh, yes." And he said, "You want to go riding?" and I said, "Sure." So he came by the next day. And he had a group of French friends who he used to ride almost every day with, and so I got involved with that. So we used to horseback ride a lot, and then we used to go to the beach a lot. And then I used to be able to go on trips with him for his work. Drew: This must have been your first exposure to public health. Of course, your father was a dentist, so you would have been a little bit on the periphery of health-related stuff. Roy: Yes. But as far as smallpox, the only thing I knew about smallpox was that I had my vaccination. Drew: Did you feel like gradually you could get to know more about the world of public health? Roy: Yes, definitely. Drew: And there were others there working with him, I assume? Roy: Well, Jean basically set up his own office. He worked under the supervision of Dr. Challenor [Bernard Challenor], who unfortunately has since died. But Bernie was based in Togo, in Lomé. But he would come to Dahomey and Togo. So I didn't get to know Bernie that well, only more so when we eventually went back to the States. But Jean worked under him, though basically Jean was his own boss. He worked with the Dahomeyans. And different people would come through: Rafe Henderson [Ralph H. Henderson] would come by and do certain surveillance activities; and then other people from Lagos came through. I think Bernie stayed with him a while. So I met a lot of the people as they were going through and staying with Jean. Drew: And I imagine over time, I know how it can be around public health people, or anybody who specializes. There's all this kind of inside talk. You probably . . . Roy: Well, that's what I said. I've never worked with smallpox, but I always say I learned about all this through osmosis, you know. Drew: You were fluent in French, but you probably weren't fluent in public health stuff. Roy: Yes. But it was incredible just to hear them talk, and especially when Rafe was there with Ilze [Ilze Henderson]. They spent, I don't know how long doing search and containment, what Rafe called "search and destroy." They had a team of 12 young individuals with motorbikes, and they were going out to search, say, for smallpox and destroy it. So it was a certain tactic, and it was considered the best way to curtail smallpox. I was able to go out on several trips with Jean when they were going up into the villages and looking for smallpox. And I went from village to village with him, from hut to hut. And I'll have to say that if I went around to CDC today, I'd ask how many people have seen smallpox. I mean, you see these children just covered with all the pustules, some inside as well as the outside. And then the miraculous recovery of those who did survive. But, obviously, so many died. Drew: So tell me a little bit, if you would, about living conditions, what it was like living there, what the weather was like. Roy: Well, West Africa if you're along the coast is very much like Atlanta, maybe even more so. I mean, it's hot and humid. You really didn't walk a lot. We didn't. We went horseback riding, which was great exercise. But we'd be just drenched. It was just typical tropical weather. Drew: Did activities tend to slow down around the middle of the day, to avoid the hottest part of the day? Roy: No. I was in the embassy environment, and I just think we all sort of worked the American work ethic, which meant taking their 4-hour lunches. But, no, we probably had an hour and a half. But we'd go out to the beach at lunchtime. It was just a couple of blocks away. Cotonou was right on the coast. Drew: Was it very scenic? What was the area like? Roy: Typical palm trees. People used to come up from Lagos because it was a French colony, and the food was very good. I was really exposed to wonderful French food. But I would have to say it was a hardship that you had to worry about the water. You had to worry about eating anything raw in the way of vegetables and fruits, unless it was peeled, or else you wanted to put it in a bleach mixture. So you had to be very careful. You had to worry about malaria. At that time we were able to take chloroquine, and the mosquito was not resistant to that. So healthwise, you had to be careful. But I never had any problems. Drew: It must have been kind of an adventure, really. Roy: Yes. But you were briefed on all this before you went. You were aware of what you should and should not do. Drew: And I'll bet that was reinforced by the people around you, too. Roy: Oh, yes. You know, you had to worry about amebic dysentery. And I remember 1 man had come down with amebiasis, and that was the last thing you ever wanted to get was amoebas. And the ambassador's secretary eventually died of hepatitis because she had not taken her gamma globulin at the time. So you knew the risks. But I guess being young, I didn't really worry about it. I did what I needed to do. But it didn't prevent me from going off to Africa. My mother never blinked an eye. "Okay, going off to Africa." Drew: Did you have siblings when you were going off? Roy: I had a sister and a brother. I'm the youngest. Drew: So your parents were completely supportive? Roy: Well, my father had died when I was in high school, so it was my mother. I think my mother sort of rolled with the punches when she came to me. I think I always had a few surprises for her, but she was so easy going. She's since died, but, yes, for her, any time we moved, my mother would always say, "Oh, I haven't been to that place." Drew: Would she come and visit? Roy: Oh, yes. She came to Dahomey with a friend of hers. It was marvelous because we stayed in Cotonou for some time. Then Jean had work up in the northern part of the country. And my mother and her friend took the train because Jean thought maybe it wouldn't be as comfortable in the truck, but we did take the truck back. Drew: Are these the famous Dodge trucks? Roy: Yes, yes, yes. Drew: My understanding is that a lot of people became expert at repairing them or whatever. Roy: Oh, yes. Jean had to learn how to do maintenance on the trucks. That was part of the training before they went over. So my mom and her friend came over, and we had a chance to go up-country, while Jean was doing work. We didn't see any smallpox at that time; I think this was further along when the number of cases was greatly diminishing. So she was able to visit different villages while the team was looking for cases. Drew: That's pretty amazing. Roy: The villagers would look at this woman whose hair was, you know, the fashion when you had gray hair with a tint of blue? Bluish hair- they weren't quite sure about that. And you asked me about weather, and what the town was like. It was a lovely little town. They had wonderful local markets, which all of West Africa has, very colorful. And we used to go there to collect lots of African cloth. I have trunkfuls of African cloth. Drew: Do you sew? Roy: I used to. Used to make ties. I used to make dresses. Drew: People would kind of know what they were going to get for Christmas. . . Roy: And a lot of African beads. So the market was something. That was a nice distraction. And the restaurants. We had 1 wonderful restaurant on the coast. Drew; Was it primarily French cuisine? Roy: Oh, yes. It was called Patty Snack. When Rafe and Ilze used to come to town, we'd go to the restaurant. They had wonderful frogs' legs, and so we'd all order frogs' legs. Later, the waiter would come and ask, "Well, would you like anything further, maybe dessert, coffee?" And Rafe and Ilze would say, "Another order of frogs' legs." I'll never forget that. It was the best food. We'd have a full meal and maybe, I don't even know if they had, with the equivalent of a dollar. Drew: Oh, amazing. Roy: It was superb, superb. And the Dahomeyans were just very, very nice people. I had a houseboy, which most people did, at first, but I was not used to having. We inherited him from my predecessor. I had him for a while, and I felt a little guilty when I said I didn't need him anymore, but I was usually not there lunchtime because we'd go off to the beach, and at night I was probably at Jean's, and he did have somebody to help him. So I said, "Albert, you're better off finding a position elsewhere." That was really my first experience having somebody cook for me and clean for me, and to this day I'm not really keen on having somebody underfoot. Drew: I could see where that would be kind of odd. Roy: If I have a special dinner, sometimes in Geneva, they'll have somebody come in and help clean up and serve and things like that. Drew: How long were you there before the 2 of you got married? Roy: Not real long. I initially had a 2-year contract. I was just finishing up my first year by the end of '69, when Jean was scheduled to come back to the States, about October. So I said, "Well, what's going to happen?" Drew: Sort of, "What's your agenda?" Roy: "What is your agenda?" I had to tell my boss if I'm going to continue for another year. With the State Department, if you go before your first year is up, you have to reimburse the government for sending you out there. Drew: That would be a lot of motivation to not go. Roy: So I said, "I'm going to stay my year, but I want to know, am I going to continue here with my career, or what?" So he said, "Well, okay. We'll get married." And he was old enough. Jean was like 29 at the time, time to settle down and get married. Drew: And how old were you at that point, about, 24, 25? Roy: I was 24. Drew: And did you come back to the States? Roy: We thought about getting married there. We had a wonderful ambassador, Ambassador Lorem, who gave us a wonderful engagement party. His wife is a former Rothschild, so we had lovely Duchene champagne, and I don't think I've had any since then. We invited as many people as we wanted. It was very special, very special. So, with all the bureaucracy that was involved in trying to get married, we decided no, we'd get married in the States. And we decided we'd marry in my hometown, Mount Prospect, and that happened in January 1970. So I did break my contract. And, of course, I didn't have to reimburse the government for sending me over there because I'd already been there a year, but I had to pay my way back, and I didn't have it covered. Drew: Where did you live? Roy: We came back to Atlanta. We were here in 1970-1971. Jean worked here in Atlanta on smallpox surveillance. He covered Nigeria, Ghana, Togo, that portion of West Africa, working for Bob Hogan [Robert C. Hogan]. Drew: But basically he was based here at headquarters and then made regular trips? Roy: Yes Drew: And was that your first experience in living in Atlanta? Roy: Yes. Drew: How did you like Atlanta? A little bit of an adjustment maybe? Roy: I basically said I don't know whether I want to come back here to live after we left Africa. Yes, it was very different. It wouldn't have been my first choice. It was very different back then, when you think of the way it is now. Oh, my goodness. You could count on 1 hand the number of ethnic restaurants in the city. In our wedding, we had a young man who was in the Peace Corps with Jean. (Jean was in the Peace Corps in Cameroon for 2 years.) His name was Freeman, and he was a black American. He was in our wedding in the Midwest. And I'm prefacing this because he came and visited us here-he lived in Atlanta, actually. But he'd come to visit us. We had some neighbors who weren't very appreciative of our having this friend of another color. So you knew those sort of thoughts maybe were held up north, but somehow they didn't say it to your face. So it was a little bit uncomfortable. So I guess through choice, I didn't work here. I said, "Well, maybe I should have pursued a career more." I sort of left it. Maybe back in that time, I thought, okay, I'm married now, and you start raising a family at some point. Drew: But that was much more common then. And I think women didn't feel like they had to justify that. It was just kind of the expectation for many. Roy: I had friends in school who obviously have gone on with careers. But we didn't know how long Jean would be here. We were hoping maybe to go back overseas again. Drew: Were you able to travel back with him at all? Roy: Yes. After the first 6 months, he had to go back to Equatorial Guinea, I think, for work. I went back to Dahomey and visited our good French friends and stayed with them. And then we met up in Paris when Jean was finished. So, we were in Atlanta from 1970 to 1971, as I said, working on smallpox surveillance. Then we went to Dakar, Senegal, for a year. Again, it was regional surveillance of smallpox because now smallpox had basically been eradicated from West Africa, and they needed to continue to survey, make certain that cases didn't pop up. But also at that same time, we were working very closely with measles because the ministries of health had told CDC measles was a priority. Drew: Yes. That was kind of part of the deal, wasn't it? Roy: Right. And at that point, because smallpox cases had almost completely disappeared, measles was becoming the bigger killer of children, so the emphasis was on measles along with the surveillance. So we were in Dakar for a year. Dakar is wonderful, just wonderful. The climate is wonderful, only hot maybe in September and October. Otherwise, you always have the trade winds. Beautiful temperatures during the day, and then the night was actually cool. You needed a light wrap at night. So we enjoyed that. Only a year, unfortunately, because the monies just sort of tended to dry up. Drew: Was the funding coming primarily from CDC or from WHO [World Health Organization] or . . . Roy: It was through the US government-to CDC through USAID [US Agency for International Development]. And when administrations changed, the funding would get bigger or smaller-depending on who was in office. So Jean came back to the States, and that's when he started working with the immunization program for CDC. So we went to Albany, New York, where he worked on immunization for the state health department. At CDC, you're assigned to New York to work with the state epidemiologist with the state health department. I was pregnant then. I had gotten pregnant in Senegal. We knew we were leaving Senegal. When we went to Albany, I was probably about 5 months' pregnant. And we had to find a place to live. We had rented an apartment and a car. Finally we found a house, but we couldn't move into it until February 1. Jonathan was due in January. So I went home to mother in the Chicago area. Jean stayed in Albany. We gave up the apartment; he rented a room. And then, when Jonathan was born several weeks later, we came back and we moved into our house. We were in Albany for 3 years. And Jean worked, as I said, with the immunization program. We got to meet and work with Al Hinman [Alan Hinman], who at that time was, I think, New York State epidemiologist. And then we went to Puerto Rico. So we're going away from smallpox, but all of Jean's work with smallpox had been in his relationship with CDC, but to his taking on a position with CDC and then continuing his career until 1998. And in those interim years, I won't go into detail, but we lived in Puerto Rico for 3 years, and we went to Olympia, Washington, for 4 years, where he worked, again, for the immunization program. Eventually he also worked with Oregon, where he helped develop the school laws that required children to have immunizations before they get into the schools. They didn't have those laws then. We lived in Olympia for 4 years. Then we got back into international health and moved to Zaire, Kinshasa, for 4 years, where he worked with the CCCD [Combating Childhood Communicable Diseases] program. And 4 years there. Then we came to Atlanta in '86, and that was our longest stay anywhere, 12 years. Jean was working with CCCD in the International Health Program Office (IHPO). Drew: What part of Atlanta did you live in? Roy: Northeast Atlanta. We still have that home. Then in '98, Jean retired, and we immediately, a couple of months later, went to Geneva, where we are now. He was a consultant to, but now is an employee of the American Red Cross assigned to the International Federation of the Red Cross, working with malaria in Africa. Jean's involvement with smallpox came about from being in the Peace Corps; he did 2 years of Peace Corps in Cameroon. Then he went on to Columbia University Teachers College. Drew: So when he was in Cameroon, he was not a physician? Roy: No, no. And he is not a physician. He's a public health advisor. And at the time he was doing his work in Columbia, he was going to go off to Africa anyway, but he found out about the smallpox program. CDC was looking for people with Africa experience and people who had French for the francophone countries. At that time, he was also possibly having a 1A status for Vietnam. So through various connections, he was able to come on board at CDC with the smallpox program as a commissioned officer, even though he's not a physician. He was able to do his military service that way. Roy: Yeah. He and Mark LaPointe have very similar career paths. Drew: Yes. In fact, I think I'm interviewing him tomorrow. So they must be folks that you know, too. Roy: And Mark's from Maine and my husband's from Maine. Oh, yes, we know Mark and Diane. So, in a nutshell, that's a little bit of what our life has been. Drew: It really sounds wonderful. Roy: I'll have to say-isn't this terrible to say?-that because of smallpox, I guess I've had a very exciting life. Drew Well, but it's interesting because I think it sounds really exciting, but I'll bet it made a lot of demands on both of you in terms of just adapting to different cultures. I would think you'd have to be a fairly flexible person. Roy: Yes. But, again, because I wasn't, obviously, a career person, I didn't have this huge career that I was starting to keep. But when you've been married 36 years, you're always going to have your highs and lows. And when you're in a foreign country, that might put more demands on it. But then, on the other hand, I think we've had so much wonderful advantages as far as making friends from different parts of the world and traveling. Drew: Really a great life. Roy: Yes, oh, definitely. Drew: And I'll bet you both have friends that you wind up interacting with who you've known in different parts of the world? Roy: Oh, sure. We have these friends, in fact, that we've known since before we were married. They live in France. We haven't seen them in a while, but we've kept up those relationships, from Puerto Rico, from Africa. Drew: Can you think of any particular challenges or problems that either of you encountered in terms of living in Africa? Roy: Well, I guess, as I said before, the health issues. I mean, if you did come down with something, in Cotonou, we didn't have a doctor at the embassy. The medical services for that area came out of Lagos. You just hoped you never had to have any medical problem there. Did I want to go to a local doctor? I mean, the French doctors were fine. But, for me, I was still very young and I thought, ew. So that was always a little bit of a concern. Drew: Sounds like you were pretty healthy, though. Roy: Yes, but sometimes you'd have some typical female problems, you know. Do I really need to go? Do I really need to see him? Eventually I broke down. Yes, I need to see him. In Senegal, I had an incident. I was going to the beach with somebody, and this young Senegalese came up. He had a crutch, and he sat next to us. Normally, I never brought anything of any value with me to the beach. But I had a bag with my car keys in it. This man was sitting next to us, and all of a sudden he grabbed my bag. And I thought, "Oh," so I grabbed his crutch. So he didn't get very far with my bag. I think today, in this day and age, the way things are, maybe I'd think twice about living here because of the situation with AIDS and everything. What if you were in an automobile accident or something and needed a blood transfusion? I think now probably many people take their own blood with them. But those are concerns that one might have today. And the fact that malaria is so resistant to medications that one takes... When my son was born, we lived in Zaire. He went with us when we went back to Zaire, when he was about 10. And we spent 4 years there. So for him, those were very formitive years, the middle-school years. And he still has a lot of his impressions from that time. So that's left very much of a stamp on his life. To this day, he loves to travel and spent time in Abu Dhabi for some work, spent time in St. Petersburg for some work, and was never quite domesticated. Drew: And when you were in Zaire, what program were you with? Roy: The CCCD. Which was great. We made some great friends in Zaire, and we were there during the good times. We were there from '82 to '86. And security difficulties started happening but we had very positive experiences. We belonged to a riding club there. We did a lot of horseback riding. And I used to be involved with the international women's club there and was president for several years. I was on the school board, the American school in Kinshasa, for 3 years. So I was very busy. Drew: Can you describe the school? Roy: The American school in Kinshasa was set up by missionaries years and years and years ago. It followed an American curriculum. It was quite good. Jonathan was there basically his 5th, 6th, and 7th Drew: And then you came back to Atlanta? Roy: And then we came back, and he started high school. That was a little bit hard for him, I think. Drew: That's what I was kind of wondering. Roy: Yes. Well, when he started school as a youngster, he'd gone to Montessori. So when we had moved to Washington state, and he was already reading, I thought, "And we're going to put him into kindergarten?" So he was tested and he went into first grade at age 5. But I think it was fine. Whether it was a mistake, who knows? Drew: You just do what you think is best. Roy: Yes. So he went into Lakeside High School at age 14. I think he had a little bit of a hard time adjusting, and he was bored, very, very bored. He couldn't get into certain programs. He's very good in music. He plays the piano, the violin, and the saxophone. But when he wanted to get into music, he couldn't do music. And he couldn't do art because it wouldn't be in his schedule. I was disappointed in the school. The bottom line is, he went there his first year and then we put him in private school, so he graduated from there. Drew: If you can kind of reflect back, did you or Jean have any opinions about things that might have worked better with the smallpox program, or do you think it worked pretty well? Roy: I had the sense that it was very successful. Drew: And that there were enough resources? Roy: Oh, I mean, I'm basically probably just parroting what Jean would say, you know, that they had a budget to work with. Drew: Sure. Roy: This was like $35 million or something, which is nothing today. And they succeeded in their goals in less amount of time than was anticipated, and under budget. So I think . . . Drew: That spells success to me. Roy: Yes, yes. And I think it developed a whole strategy of combating disease. And I think that has carried over into polio eradication, measles, and malaria. AIDS is another issue. Drew: It presents such unique challenges. Roy: But my impressions-obviously, this is not from being involved personally-is that it was terribly successful. I think you had a group of individuals who were so special and dedicated. Drew: It does sound like it. It really sounds like a bunch of really terrific folks. Roy: Yes. Do they exist today? I don't know. I don't know. You still have young, dedicated doctors. But, yes, they were a group of people who really had a goal. And smart. You had the Foeges and the Hendersons. Drew: That's a pretty amazing combination. Roy: Yes, yes. And then, later on, in '71, when we'd been living in Albany, New York, Jean went to Bangladesh for 3 months to work with smallpox eradication because they had the last few vestiges in Bangladesh, India, and probably still in Ethiopia or Somalia. And Bill Foege [William H. Foege] was there. And I remember, after Jean did his 3 months in Bangladesh, I, along with my mother, because we traveled and met Jean in Delhi, had dinner with Foege and his wife, Paula, who was so nice, so memorable. But the experience Jean had in Bangladesh was quite interesting. It was hard on him. It was difficult. Drew: Difficult living? Roy: Yeah, yeah. Drew: I wanted to give you a chance to kind of add anything.... Roy: Oh, just a little anecdote. When we were in Cotonou, Jean had a trip to Lagos for a meeting. This was a May '69 meeting with WHO [the World Health Organization] and CDC. It was quite an important meeting. Jean says, "Oh, do you want to come along and meet some of the other people?" And so I went with him. Unfortunately, this was the time of the Biafran war. The distance between Cotonou and Lagos is not great; if you look on a map, it's a short distance. But due to the roads and the barricades that you encountered once you were into Nigeria, what should take an hour took 4 hours because they'd stop you every 10 kilometers. And the reason they were doing this was that shortly before we went on this trip to Lagos, there had been a bombing by Biafran supporters, people from Biafra, in a USAID vehicle. They'd somehow commandeered a vehicle or else they'd taken a similar vehicle and made it look like a USAID vehicle, with the symbol of the helping hand. So that's the kind of vehicle we were in. It was the Dodge truck, but it had the USAID helping-hand symbol. And so they were always heavily scrutinizing this vehicle at each barricade. They'd open up the back. And they were young soldiers with these machine guns. It was scarey, so many of them. We were with some other people in the vehicle, including Chris D'Amanda [Christopher D'Amanda]. Now, Jean had done this many times, going back and forth, so he was fairly used to it-I won't say blasé, but, you know. But for us, it was the first time. Jean says, "Don't worry, don't worry." We'd stop and he'd say, "Look at this, look at this." Well, at the 4th or 5th barricade, a young soldier looked in and closed the trunk, and then we go on to the next barricade. But when we get to the next barricade, and they're taking us aside the truck, they discover that the soldier, when he examined our truck at the last barricade, had taken his gun off and he put it in the trunk. Drew: On purpose? Roy: No. He just forgot it. Drew: Oh, he forgot it. Oh, my lord. Roy: So we get to the next stop, and it was discovered. Drew: And you didn't even know what you had. Roy: And, obviously, the young man reported that he missed his gun, and it was just horrendous, just awful. It all worked out, but, you know. And then we were in Lagos that night, and during the day the streets were going in 1 direction, and at night, unbeknownst to us, all of a sudden they changed direction. And there was a blackout period. So you were just going by the headlights. So we're going down this street, and all of a sudden a soldier jumps out in front of us and points his machine gun right at us because we were going the wrong way on the street. Drew: A bit of an introduction. Roy: A little excitement. So, I don't know if I have any other notes on smallpox. I think we've covered everything. Drew: Great. Well, I really appreciate talking with you, and you've done a great job. # # # </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310169071%3Fsecret_token%3Ds-7YTvA&amp;color=ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false" frameborder="no" scrolling="no" width="100%" height="166"></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 sound recording - nonmusical interviews Date A point or period of time associated with an event in the lifecycle of the resource 2006-07-14 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/158z2 emory:158z2 Subject The topic of the resource USAID WHO CDC Smallpox Eradication Format The file format, physical medium, or dimensions of the resource 507255840 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Drew, Diane (Interviewer); CDC; Nurse Roy, Betty (Interviewee); CDC; Wife of Operations Officer Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of West and Central Africa Smallpox workers (2006 : Atlanta, Georgia) Title A name given to the resource ROY, BETTY Description An account of the resource Betty Roy relates how she met Jean Roy (Operations Officer in Dahomey) while she was working abroad for the State Department in Dahomey (Benin) and became introduced to the work of public health and the Smallpox Eradication Program. Betty tells of Jean's work in smallpox surveillance and living in Atlanta and Dakar, Senegal and Jean's career working in immunization programs for CDC until 1998 when they moved to Geneva, where Jean now works for the International Federation of the Red Cross on malaria in Africa. Betty reflects, "I'll have to say...that because of smallpox, I guess I've had a very exciting life." Language A language of the resource English https://www.globalhealthchronicles.org/files/original/ff2c1f1c3d3c1897a983062e3a76e2d3.jpg b119c483da7ce5e9c4aff054054e1608 https://www.globalhealthchronicles.org/files/original/fbb5466d1fb6254baf543bb124d2ad4c.pdf 09cf8366c7d7f1119912c3f9050f7d85 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> This is an interview with Dennis Olsen on July 14, 2006, at the Centers for Disease Control and Prevention in Atlanta, Georgia, about his involvement with the West African Smallpox Eradication Project. The interview is being conducted as part of a reunion marking the 40th anniversary of the launch of the program. The interviewer's name is Diane Drew. Drew: Could you start by telling me a little bit about your background- where you grew up, your schooling, and how you got headed into whatever career decisions you made? Olsen: I was born in 1939. I grew up in Danville, Oregon. My folks moved there in '41. All my schooling through high school was there. Then I went off to the University of Oregon and got a degree in science. And as part of the college leaving process, I went over to the placement office. I was thinking, "I know I'm going into the military, but I'll talk to some folks who are here talking about their companies and organizations." I'd never given public health a thought. And a gentleman by the name of E. J. Spyke, Jerry Spyke, was there representing the Centers for Disease Control. I was quite intrigued and thought, "Well, this would be maybe a good starting point." Government service had never really crossed my mind, but I didn't have any money whatsoever and knew I wouldn't have any coming out of the military. I accepted the position that was offered and thought, "Well, I'll do that for a while and see what it's like, and then probably go back to school to get a graduate degree," as people were doing in those days as a matter of course rather than desire, and I stayed with CDC for 32 years. Drew: Wow! Olsen: Never did go back to school. Whatever other education I got was through the organization both in formal education and working in the field. Drew: And when you came to CDC, did you come to headquarters right at the beginning? Olsen: No. My assignment was the first trainee public health advisor to be assigned to the State of Washington, in Seattle. And I was in Seattle for I think 6 months, and then the second co-op (cooperative agreement) came, and I was transferred over to Tacoma, Pierce County. This was all working with the Venereal Disease Eradication Program. And I was there for 6 months. Then I was contacted by the regional office folks in San Francisco, CDC people. They asked if I was interested in becoming a recruiter for CDC, much the same as E. J. Spyke had recruited me. So I agreed to do that and was transferred down to Los Angeles because that was the base of operation for that. And for a while, I was the only one there doing that. Traveled in, I think, it was 9 Western states at the time, going to college campuses and, if there weren't college campuses, running ads in newspapers. Then I was joined by another fellow. And I think I did that for 3 years. Then I was asked if I was interested in going with a program that CDC was taking command of, to a certain degree, the Malaria Eradication Program. So I came back to Atlanta and was in training status. But as it worked out, there were differences of opinion as to who would really have control-USAID [U.S. Agency for International Development], who held the purse strings, or CDC, who had operational responsibility. And because they didn't agree, most of us in that training program never did see work in the field. I was to go to Costa Rica, but in the meantime was contacted by Billy Griggs to see if I wanted to go to West Africa and join the smallpox program. I agreed then to go and take that up as an assignment. I asked what country. It was either going to be Sierra Leone or Liberia, but I requested Liberia, and that's what happened. Carol and I got married just before going over. Drew: So you'd known each other before. Olsen: We'd known each other about a year. Drew: Did she come from Oregon originally, too? Olsen: Wyoming, Cheyenne, Wyoming. She was a civil sanitary engineer. She worked with the city of Los Angeles, CA. We did our training here in Atlanta in the months of July, August, and September, and we were happy to get to West Africa and Liberia. Drew: Was that a francophone country? Olsen: Anglophone country. Olsen: I think there was Sierra Leone, Guinea, Liberia, and there must have been one other. Drew: Nigeria? Olsen: Nigeria, they were already had public health advisors and physicians. But they may have been training some others to go. It's just too long ago for me to remember who all was there. But I do remember those other countries because I was selecting between Liberia and Sierra Leone. Drew: Was there a program already in operation by the time you got there? Olsen: No. Drew: You were basically sort of starting. Olsen: We were. Drew: Was your program like some of them, working with both measles control and smallpox eradication? Olsen: To my knowledge, at least for the group that went over at the time we did in '67, that was always the intention. Smallpox was the overriding issue and disease we were dealing with, but since we were there and giving vaccinations, the measles vaccine was provided, and that was also then administered. Drew: Tell me a bit, if you would, about traveling to Liberia and maybe the first few weeks or months there, both from your point of view and maybe about you and your wife in terms of kind of the cultural differences, who was setting up the program, any of that. Olsen: CDC was really thorough, I thought, and had experienced people to try to prepare us for the differences that we would find culturally and environmentally. And I don't remember that we had much of a cultural shock. We always say we had more coming home after 3 years than we did going. The States were overwhelming again with all the things available to you. You no longer could even make a decision on which tie to select because the selections were too great. But when we arrived in Liberia, I think the first thing that struck us was the architectural development, if you will, which was limited and so different, and just the tropical rainforest itself. You can only imagine these things and see pictures in books. But seeing it, I thought, yes, this is quite different than what we would have been thinking about. We were, of course, well taken care of by representatives from USAID. They were very kind to us and had housing available- not staffed or anything, but with a guest kit to get started. Dr. Shalimar [sp.] was the health officer for USAID; he and his wife were very gracious people. So it was an easy transition. Drew: Did they have a medical officer from CDC? Olsen: Not then. That came later. The issue around that was that a Dr. Pifer [John Pifer] was supposed to come. But there was an outbreak of war, in Benin, Nigeria, and so CDC had to make some staffing changes because the people in Benin, including Dr. Foege [William H. Foege], all had to leave. So Dr. Thompson [David M. Thompson] and his wife-I think they had one child at that time-came to Liberia, and Dr. Pifer eventually went off to Nigeria. But the Thompsons didn't show up for maybe 3 months or longer after we were already in country. For housing, they put us into a compound that had 2 duplexes. There were 2 other Americans there, a fellow with the Geologic Survey, Jim Sites, and Dorothy Deloof, who was a nurse for the Kennedy Hospital that was being built. And I guess they were both up-country or something. So Carolyn and I are there all alone. We have no phone, no outside road, no car. We're just there. The curtains on the windows were actually sheets. And we were then thinking, "All right, it's time to sleep," and then there's a huge thunder and lightning storm, and rain, which, coming off the ocean onto these corrugated tin roofs was extremely loud.. . And all of a sudden, there was a huge bright light and a big bang, and we pulled one of these curtain things back and looked out, and the lightning had hit a transformer on the pole just adjacent to the house. Fire was coming down the line toward the house and all we could do was sit there and watch it. It went out before it got particularly far. I guess one of us turned to the other one and said, "Let's go out to dinner." But we didn't even know where dinner was. We had been dropped off; we didn't know which direction was what, except the road to get back to the airport. The next day, life started to look more normal as we were introduced to the people at USAID. We started hiring staff for the house, which I'm sure Carolyn will be telling more about that than me. The way this usually happened was that some of the Liberian staff at USAID, knowing that you were new, would send their relatives over to see if they could be employed as staff. And there were little financial kickbacks for this. Well, one man showed up to be our houseboy. His name was Timma. He was a nice, gentle, older man. Carolyn hired him, and he was quite willing to work. But he did the laundry one day shortly thereafter, and we noticed that all of our clothing, our whites particularly, were sort of grayish-blue. He was hanging them on the leaves and things; he was seemingly ignoring the clothesline. Well, it turns out that Timma had on a country shirt, and the dyes in it, as he would wring these things out, were coming off on our clothes. So Timma got another job as our gardener. Then we were introduced to a young man by the name of David Parker, who stayed with us for 3 years, which was unusual because most people have several houseboys. But David and Carolyn and I hit it off. Then, work-wise, we were introduced to the Liberian public health system. It was, I think it's fair to say, primitive. It existed in Monrovia, the capital, but there's no infrastructure up-country for public health beyond some dilapidated buildingsand very poorly trained staff, who are not supervised and not really provided with medical supplies. One author wrote that,"Liberia never suffered the benefits of colonialism." Most of the other countries had been colonized and had developed infrastructure outside the capitol city. Liberia was proud that it had never been colonized Drew: I if I remember correctly, Liberia has ties to the United States in a sense, don't they? Olsen: Yes. Back in the 1800s, the 1840s maybe, there was this whole plan to move freed slaves back to the areas in from which they had originally come. This was most likely guess work for the most part. Drew: Sure. Olsen: The capital of Liberia is Monrovia. The then President was W.V.S Tubman. And their government is made up pretty much like the United States. It's a bicameral system, and their flag is a star and red and white stripes, things like that, so a lot of connection. Now, there was a lot of American money that went in to make sure that they had an opportunity to survive . . They were going to farm, but farming never really took hold. For awhile, they lived on the ships that they arrived on. Many people died from tropical diseases, etc. But, overtime survivors and new arrivals settled and developed what is now Liberia. In any event, we then were introduced to the public health system, and I was to have a counterpart, Dr. Thomas, a Liberian doctor. We were to report to a naturalized Liberian, a Haitian doctor, Dr. Titus. As CDC assignees we reported to, and received administrative assistance from, USAID. It all seemed to work reasonably well. It was hard to get things started. Dr. Thomas wasn't particularly insistent. We tried to move things from the training to go up-country, but there was always a little problem with getting gasoline for the vehicles and getting the teams organized. It was just slow- going. I think we were all just feeling each other out. I spent a lot of time in training programs because we were using Ped-O-Jet equipment, and so we spent a lot of classroom time in operations maintenance of it. And, of course, we had to wait for supplies to come in. There was always something in the early days that was keeping us from going up-country. Drew: That must have been kind of frustrating in terms of developing a program. Olsen: Yes. Since there wasn't really anything there, there wasn't a system that you could just tie into and say, "When these other things come, then we will make the changes and augment your program. Or we'll use some of your materials and supplies; we will then supplement that." There was just nothing. So we had to wait for the vehicles; we had to wait for the parts for the vehicles. Things broke down pretty easily. Drew: What was the prevalence of smallpox or measles? Olsen: It was pretty much unknown because the infrastructure wasn't there. There was no reporting system. Drew: So it wasn't that it didn't exist. It was just that you really didn't have any data to know? Olsen: I'm pretty sure that there wasn't much in the way of smallpox that I have heard about. We made early inquiries with the population up-country-the mining organizations and what health services existed (missionary hospitals)-to see, just as a quasi- surveillance system, what was going on. And I'm pretty sure that there wasn't any smallpox at that time. There had been a previous vaccination program run by an organization called Brothers Brothers that had gone through; I forget what years they conducted a program there. I heard varying reports as to how they were managed and what you could anticipate. Measles is a rash illness, and you would hear about it from folks who were coming down from up-country. So what I planned is that, number one, we needed to get the vaccination teams trained and up and running in the field. Surveillance had to sort of take care of itself. We knew there was smallpox in neighboring Sierra Leone, and so our plan was that it was the border that was most likely going to be impacted. We knew that there was an up-and-running program in the Ivory Coast, which was on the southeastern side of Liberia. That border would be much harder to get to logistically; we probably wouldn't leave for there until we could learn more as to where the prevalence of the disease was, if there was any. And as for the Guinea border up north, a couple of mining organizations weren't seeing any rash like illnesses so we weren't planning to go up that way initially. And once we got up and running and got supplies, it worked reasonably well. We had some good teams. We had 5 or 6 actual vaccination teams, 2 assessment teams. Olsen: These team members had to be pulled from other kinds of projects. That's the way it works in these countries where there are a limited number of resources. We established the logistics system to receive the goods and housed them at Mambo Point, which is where the "preventive health services" was. I had to set up a warehouse inside the building and train someone to do the warehousing and keep track of this and that. Vaccines were stored at the American Embassy-they had a huge freezer storage facility-because there was nothing, initially, in Monrovia that we could find. We eventually moved the vaccine supply out of there to a Montserado Fishing Company, which had freezer facilities. So when I went in to get the vaccines-the Liberians wouldn't go into those buildings - it was too cold for them. I had to go in. Drew: Really? Olsen: All the boxes and so forth smelled like fish. But that's where we stored the vaccines. Drew: Apparently, that was one of the difficulties that some folks faced when trying to deal with the measles vaccine, in particular, was . . . Olsen: Cold, always cold. Drew: Yes. Olsen: We helped solve the cold-chain problem, and I'll get to that. But one of the more difficult parts of distribution of the vaccines was lack of communications with the hinterland, no infrastructure, and then getting to and from these places. The road networks were poorly maintained dirt roads. And we had these big Dodge power wagons that were provided. They were far too big for what we needed. They were fine on for paved roads, but we only had like 50 miles of paved roads. So it was difficult to transport things, and a lot of walking was involved. And, of course, there's this cold-chain issue then, getting the ice. We would have been better off had we been able to negotiate for the kinds of vehicles that were going in because we could have used Toyota Land Cruisers, which were smaller. They were not the things that people run around in today with all the plushness and all the comfort]. They were much smaller. And, there was a Toyota dealership with a service department in Monrovia. And we solved, to the best we could, our cold-chain problems because there was a wide distribution of Lebanese merchants in our area. Wherever you'd go, to a village of any size or along the road, there would be a Lebanese merchant. And all of these merchants had functioning refrigerators. Drew: That's interesting. Olsen: And they'd keep them maintained for the goods that they would sell. They acted as the bankers for the locals and any number of different things, and this was all surely in agreement with the government so that they could stay in business. And the Lebanese merchants were kind enough to house the vaccines and give us ice for the chests and all that sort of thing, so that worked out reasonably well. Drew: Because they were sort of dispersed around the area. Olsen: They were dispersed all over the country. Drew: So it would almost be comparable to like being able to go to a bank that was located near where you were working and get what you needed? Olsen: Near enough that you could keep the vaccines cold and make the ice used when transporting the vaccines to the vaccination sites.. And then come back at another time, when appropriate, and get the vaccines and start all over again. Now, it worked as well as it could. There were also missionaries in areas with refrigeration, and they would allow the vaccines to be stored. It never worked very well trying to transport and use the kerosene operated refrigerators that were provided. We did not use them. Maintenance was a problem. If no one was around, the kerosene was stolen, and if you hired someone it just did not work out well. I remember we had a regional project meeting, in Abidjan I believe. Dr. Foege and the regional staff were interviewing us about our programs. And I mentioned to the group that we had this kind of cold-chain system, and Dr. Foege leaned over to someone and said, "Well, Liberia doesn't need more refrigerators. They need more Lebanese." We had our systematic way of covering the country. We had a public health education unit-not that we organized, that was provided through the Ministry of Health. They assisted us from time to time, with a great deal of our encouragement. They would go ahead to the villages and prepare them for our being in the neighborhoods. They would get the people in a central place so it would be easier for us logistically to maintain the vaccines, get there, and vaccinate. And invariably, the local chief didn't want to go to another chief's area: "Come to my area. I'm the chief." Politics works the same way everywhere. So we had a very difficult time getting people to congregate in large numbers so you could use the Ped-O-Jet most efficiently. But you just had to work with those things. Drew: And at that point in the program, wasn't the approach still to just do mass vaccinations? Olsen: Almost all of the time that I was there, 3 years, it was the mass vaccination approach. Just as I was leaving, the search-and- containment approach was, I think, being at least talked about, if not being implemented in some places. I didn't get involved with that until I went to India for the same purposes. There it was all search and containment. Drew: But you were saying that you did have a fairly systematic way of determining where you would go and what you would do? Olsen: Right, we'd sit down and work with our teams. We had 9 counties, if I remember the count. Some of which bordered Sierra Leone, Guinea, and the Ivory Coast And at that time, a good portion of Liberia hadn't been mapped. It was tropical rainforest. So the teams, knowing their areas, would say, "Well, we know that such-and-such exists out here, so here's how we would cover it." And, of course, we had to rely on them. We couldn't be making these plans on our own. So one team would go out in advance to let the folks know that we were coming and try to do these things I just discussed with you, and then also map out where the villages were for sure. Small villages would move when an area had been farmed out. Drew: Why was that happening? Olsen: Farming. They would just move. If it was a sizable place that would be somewhat stable. If the villages were smaller-fewer huts and so forth, and they were temporary-then the people would go off and go somewhere else. But generally they were stable. We would supply the teams based on the teams' knowledge. I would go and do assessments myself. And if we ever had reports of rashlike illness, Dr. Thompson and or I would go, sometimes with a WHO [World Health Organization] assignee, and investigate. It was harder to get the Liberian senior medical personnel to go. They didn't like to leave Monrovia. Drew: I know in some countries that part of the mode of operating was to deal with the village chief or whoever the leader was. Did you pretty much have that type of introduction into the various developed areas? Olsen: Occasionally, if I went to a bigger place, I might see the paramount chief, or stay with the paramount chief, because there was no housing anywhere else. Quite often the teams would visit with the village elders because we couldn't be with the teams all the time. But, yes, the politics all had to be attended to. You didn't just show up and then say, "This is going to happen." You had to let them know that you were coming and let them make the decision. Then they would get their populations organized and motivate them, to the extent that they chose to do that. But that whole network, with the paramount chief down to the village chief, to then get down to Charley Brown's town, as one of them was called. Drew: Generally, were you fairly well received? Olsen: Always, always. I cannot remember a contentious time, a real problem that we couldn't overcome, working in Liberia in the villages. Now, we had lots of hours of frustration and difficulty at the ministry level because they're being impacted by any number of things. I wouldn't even pretend to know all them. They were responsible for providing the teams, they were responsible for providing the petrol and the monies to support the teams, and it was a constant battle. Whether the resources were limited or whether it was just a lack of priority sometimes, I can't be sure. Drew: And these would be Liberians? Olsen: Liberians. The doctors I've mentioned. Dr. Titus was exceptionally supportive. Dr. Thomas, who was our counterpart, the one I mentioned, he soon went off to get a graduate degree at Harvard. But Dr. Barkley, the Minister of Health, was strictly at the top, a politician, and I have a couple stories about that. I remember going to his office any number of times in a fairly short period, trying to get the chits for the petrol. They wouldn't release money. They would release chits, and we'd give them to the teams so they could give them to the operators of the petrol stations. And Dr. Barkley missed any number of meetings and kept me waiting and waiting and waiting. One day I thought I really had it done. I went to meet with him he didn't show up. I was angry. I left his office and when I got in our truck I slammed the door. And my driver, John Massakoui, a Liberian, started laughing. I said, "John, what is so blankety-blank-blank funny?" We knew each other quite well; we were together all the time. And he said, "Well, Dennis, this is just another one of those times when you learn that you're in Liberia, and here we beat the drums." So, okay. Drew: He probably knew, without your even explaining, more or less what had happened. Olsen: Yes. But it was always a fight for everything. And the team members would come to us, of course, because they couldn't get paid sometimes, and these personnel issues were very, very frustrating. You'd want to go, and you had to go, to the government and say, "You know, the teams aren't being attended to, and they need their salaries," and you wouldn't even get excuses. You would just be, more or less, ignored. It's hard to be that kind of go-between. Drew: Was it because they had their own agendas and their own timetable, or was it a certain amount of control or passive-aggressive kind of thing? They wanted to control the resources? Or they just had different priorities? Olsen: I think they may have had different priorities. I always felt that they wanted to support the project, but who knew what kind of influences were on them to do whatever? And I certainly wouldn't want to be accusing them of anything. We had our guesses sometimes as to how the resources were being distributed, for what purposes. You go through these times and you had to work with them, and I think we did reasonably well. Up until the end, we didn't see any smallpox, and I think our coverage rates for measles were as good as one could expect. That was a much more difficult thing to do. You could assess smallpox because of the vaccination scar. With measles, it was by guess and by gosh. You kept your tallies of the doses of vaccine administered, but that wasn't necessarily a true picture. And then we did see, at the end of my 3 years, a case of probable smallpox. My replacement, Mr. Randy Moser had already come into country, and the teams were up-country. I guess it was Mr. Coleman who came down, and he said, "We've got rash illness in this particular area, and we have taken that lady and her child to the hospital." I said, is she in quarantine?" And he said, "Well, to the extent possible. They may be going home at night. Nobody seems to care too much." So Randy and I jumped on a plane and went up there. The lady was there, in what served as the county hospital, and to us it looked like smallpox. So we took our samples. Got the cases properly contained in the hospital, (paid to get that done), took the samples and got them shipped back to CDC. And then, of course, we sent the teams up to start vaccinating. We thought that we had our first cases of smallpox. Then we got either a cable or a call-probably a cable because the phone system did not work well; we didn't have some of these other things that are very available now-saying that there's something strange happening with this sample, so "Get us some more samples." Dr. Thompson had already left, so it was just Randy and I. And I think the WHO representative, Dr. Hans Mayer, was gone as well. CDC sent another doctor from the smallpox program over, Dr. Pat Imparato and he reviewed what we had been doing, and he said, "Well, you've done pretty much all you can do from a medical standpoint. I've seen that you've sent the samples off." We got more samples. We sent them in. And it turned monkeypox. Drew: Oh, wow! Olsen: The transfer of another virus to humans. Drew: Wow, interesting. Olsen: Monkey was part of the diet. We'd already packed our household effects to return to the states. CDC sent people into Liberia then, searching and taking animal samples, blood samples and things, and it turned out to be monkeypox. There wasn't a widespread outbreak. I think it was actually contained either to just that lady and the child, or maybe 2 or 3 other people. Again, I was gone to the States by this time. But it did cause a lot of people to go in looking for a lot of things because I'm pretty sure we were considering that smallpox no longer existed in Central and West Africa. It was kind of a scary thing, thinking here we'd gone all these years, and now smallpox was cropping up. Drew: You're at the tail end, and all of a sudden you get hit by something like that. Olsen: Yes. And it was also at a time when we had to call the teams off of smallpox vaccination because there had been a cholera outbreak in West Africa. I was over in the offices in Liberia one afternoon. Usually, I was the only person in the office in the afternoon. The whole building emptied out. And Dr. Barkley, the Minister of Health, comes in, and says "There's an unusual event for you." I said, "What can I do to help you?" And he says, "What do you know about cholera?" And I said, "Oh, very, very little. I mean, we have some background information, of course, I've got a lot of books here. But why?" And he said, "Well, tomorrow we're going to start a mass vaccination campaign for cholera." I said, "What?" He said, "Well, President Tubman has been on the phone to President Sekou Toure of Guinea, and they have cholera in Guinea. I said, "Have they notified anyone officially?" He said, "They notified the World Health Organization." I said, "Is there vaccine in the country?" He said, "I don't know. I'm going to Evans Pharmacy to find out." This was kind of a British-run pharmacy in town, a very small operation. He said, "I want you to write a plan for the vaccination coverage." Drew: Surely this was at 3:00 pm on a Friday. That's when most everything seems to happen. Olsen: I don't know if it was Friday or not. But said I can write a plan and base it on our smallpox coverage. Find out who might be most at risk of cholera, knowing full well that cholera vaccine was considered by many people to be essentially worthless. But what about the other things: looking at the source; determining how many and what kind of beds the hospitals had? These kinds of things I had limited knowledge about, and nobody to contact on that particular afternoon to put this plan together. Drew: More like you knew the questions but you didn't know the answers? Olsen: Yes, I didn't know the answers. So I had a formulation of a plan that had to be fleshed out later on, of course. Well, Dr. Barkley went off and he reported back that they had 50 doses of vaccine in the country. I said, "It might not be particularly wise to mount a mass vaccination program since you've got no vaccine." WHO sent in 500 doses of vaccine right away. In any event, we mounted a sort of mass vaccination program. The first thing we had to do was go to the executive mansion and present the program to President Tubman. So I contacted USAID saying, "I've been asked to go, but I'm not representing the United States." So they sent the deputy, Dr. James, from USAID. And on the way up in the elevator to the executive suite, Dr. Barkley punched me in the ribs and said, "You're to present the plan." Well, I knew enough that if I, as an American, presented the plan, it becomes an American plan. Drew: So we met President Tubman. I had not had the pleasure of meeting him previously. He was an elderly gentleman in somewhat failing health, but very gracious. The first thing he did was to serve us all a scotch had. Drew: Single malt? Olsen: I don't remember. He sat us all down, and I was asked then to present the program, and I started by saying that, "At Dr. Barkley's request, and with all of us involved, we-we-"have come up with this" formulation"-not my formulation." And then he looked at Dr. Barkley for funding. Dr. Barkley looked at Dr. James. And President Tubman said, "Well, I will provide $50,000 towards this from the monies that the Congress (Liberian) has allowed for my new boat"-his new cruiser craft or something. "And, Dr. Barkley, you find the rest." Drew: Amazing. Olsen: Yeah. Drew: And, of course, $50,000 was more then than it is now, but still probably not a drop in the bucket in terms of what you need for funding? Olsen: It wasn't enough. So we presented the plan, and the only change that the President had was that the vaccine will not simply go to the areas that we have designated as being high risk. It would be distributed throughout the country so that all paramount chiefs and politicians in the regions would know that they hadn't been forgotten. This was a decision for him to make, not for us to make. Drew: Sure, sure. Olsen: Shortly thereafter, either a day or 2, we had the Radio Broadcasting Company of Liberia announce that the vaccines were there. We showed up one morning, and we had hundreds and hundreds of people outside waiting impatiently. The nurses were all ready, and we had the jet injectors to use. The nurses didn't want to use the jet injectors. They said they could go just as fast with the needles and syringes. And people were clamoring over the window casings. The people were required to get a form that was being run off on an old mimeograph machine. And so people were clamoring up the stairs to get their forms so they could come back and get vaccinated. It was utter chaos! Drew: And you knew that you did have enough doses, or did not have enough doses? Olsen: We never knew if we had enough vaccine. Drew: So you had that tension kind of biting at your heels too. Olsen: Yes. WHO was continuing to support the government and getting vaccine to them as quickly as it could. My only interest then was using the vaccines that we had and getting the people satisfied so that we could calm them down. And trying to reorganize at Mambo Point so that we could get the people mimeographing the forms outside of the vaccination area because the vaccinees having to come and go was just causing total chaos inside. Drew: And, of course, back in those times, it wasn't like you could email CDC and say, "Hey, I need some backup." Olsen: But there were cases of cholera, and it was totally out of my hands in planning the response. Thank goodness I didn't have to do any more with it. But all of the resources that were available and needed to be pressed into shape, including the staff at the hospital and the people who were there helping develop the Kennedy Hospital, they all got involved and had proper kinds of beds and so forth. And I left the country, so . . . Drew: Sounds like a pretty exciting time. Olsen: It was different. I mean, you're barely comfortable with what you've accomplished and organized in the smallpox program and the distribution of vaccines and getting people inoculated for measles and smallpox, then this happens. It was so totally disruptive. And you knew full well the limited resources. It was just going to change everything. And had we had an outbreak of smallpox at that time, I'm not sure what would have happened. Which situation would have taken precedence? Most likely the cholera because it's more of an immediate threat, more people being affected at that point. Drew: It must have been kind of amazing to be sort of on the line. Olsen: It was different. But I got to meet the President. Drew: And you got to speak to him?. Olsen: Yes. I was checking out of USAID when I met this gentleman whom I'd never seen at USAID before. He introduced himself. He said, "I understand that you were in a meeting with the President of Liberia last night ." And I said, "Yes. But I'm leaving 2 days from now." And he said, "Oh, damn, all my sources are leaving the country." Drew: And now a woman is President, correct? Olsen: Mrs. Sirleaf. Drew: Right. Olsen: Harvard educated, and she's got her work cut out for her. I think she's at least got a chance. I mean, the country had so many difficulties to begin with, and then this 8 or 9 years of war. One person described Liberia as "the infrastructure was destroyed and the culture was vaporized," something like that. It was just totally devastating. Young kids running around, apparently drugged up, with big weapons, killing everybody. But I had the good fortune of going back to Liberia before all that broke out. I mean, President Doe had already taken over, and the assassinations at that time had taken place. So I saw Liberia once again, in l980. (We had left in '70.) You couldn't see much in the way of change because there had been so little there to begin with. So you didn't see the infrastructure breaking down, but it apparently was happening. The economy was just going to pot. Although potentially it could have been a reasonably wealthy country with its rubber plantations; iron ore that was very pure; and they had this international free port, and a lot of ships sail with the Liberian flag, so there must have been some sizeable income from that.[ Drew: Did you have any children born over there? . Olsen: No. My wife and I didn't. But the Thompsons, at least one of their children was born there. They had a good medical service there with a mission hospital called ELWA:"Eternal love wins Africa," I think. My wife Carolyn and I say that we went to Africa at the right time. The countries were gaining their independence. There was a great deal of enthusiasm for the future. They were getting to make their own decisions and realize their own successes and failures. Drew: And I'll bet corruption hadn't gotten quite as much of a toehold at that point maybe. Olsen: You know, it's easy to see corruption in a smaller setting than it is in a big country like this one, so you could see it happening. There was a give-and-take there. I remember Dr. Titus commenting to me once: "The way the system works here, Dennis, is that the President allows everybody to take a little bit. But if you take too much or it gets reported to him that you're getting too much, then you are going to be jailed." And people were . . . Drew: So it's kind of like this unwritten system. Olsen: Yeah. But we enjoyed our time there. We think very highly of the Liberians. And given the opportunity in a different kind of situation, with what's going on there now, we'd do it all over again if it were possible. And it enthused us so much that we've always had an interest in international work and travel. I was fortunate enough to continue my international work in Africa and Asia. And nowadays we just pick up and travel 3 months out of the year to see the world. Drew: That's great. # # # </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310167954%3Fsecret_token%3Ds-VrOTt&amp;color=ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false" frameborder="no" scrolling="no" width="100%" height="166"></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 sound recording - nonmusical interviews Date A point or period of time associated with an event in the lifecycle of the resource 2006-07-14 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/158xx emory:158xx Subject The topic of the resource USAID Operations Officer Smallpox Eradication CDC WHO Format The file format, physical medium, or dimensions of the resource 563522736 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Drew, Diane (Interviewer); CDC; Nurse Olsen, Dennis (Interviewee); CDC; Operations Officer Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of West and Central Africa Smallpox workers (2006 : Atlanta, Georgia) Title A name given to the resource OLSEN, DENNIS Description An account of the resource Dennis Olsen was working for CDC when the opportunity arose to join the Smallpox Eradication Program in West Africa in Liberia as an Operations Officer. David speaks of arriving in Liberia and starting up the smallpox and measles vaccination effort there - even storing the vaccines in the freezers of a local fishing company or refrigerators of local Lebanese merchants. Dennis reflects on the politics of vaccination in the villages and with government officials, coping with a cholera outbreak, and a case of monkeypox. Dennis went on to have a 32-year career with CDC. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/6d5a1e1404f5438ea282aaaef5ee22f3.jpg bc48be88f6f273f40238ff6efd93d765 https://www.globalhealthchronicles.org/files/original/bea45593d2b48447984e83ae33645ab2.pdf 3f622a9eb6649dd4597eb78826583ba3 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> McNutt: This is an interview with Carolyn Olsen. It's July 14, 2006, and we're at the Center for Disease Control and Prevention in Atlanta, Georgia, and this is about her involvement with the West African Smallpox Eradication Program. This interview is being conducted as part of the reunion marking the 40th anniversary of the launch of this program. The interviewer is Kathryn McNutt. McNutt: I'm glad you're here. The purpose is to do an oral history. We hope to capture for future generations the memories that you have about all of the participants and their families in eradicating smallpox in West Africa. So, essentially we'll just kind of walk through your story and what your and your family's experiences were. You were involved in the Smallpox Eradication Program in Liberia. Could you tell me what years you were there? Olsen: We lived in Liberia from September '67 to May '70. McNutt: And what was your family situation. Olsen: My husband and I had just gotten married in March of '67. We came to CDC for training in July, August, and September, and then we went off to Liberia. McNutt: That's a bit of a transition. Olsen: Yes. We were in California before we came to Atlanta. So the weather in Atlanta was hot and humid, and when we arrived in Liberia, it was actually cooler and less humid. McNutt: Really? Olsen: Even though we were on the equator. McNutt: So, what was your experience? Kind of paint a picture for me. When you first got to Liberia, what were your living arrangements? Olsen: When we arrived in Liberia, the living arrangements were interesting. The house was outfitted so that you had your basic needs until your freight came. We were met at the airport, which was about 25 miles from town, and taken into town. Dr. Shalimar and his wife took us out to dinner. Then they took us to our little house and said that they would come back the next day. It was a Saturday. We were living in a kind of a compound, and right at the gate there was somebody else's packing crate that someone was living in. When your packing crates came, oftentimes the local people would take the box, which was very large, and make it into a house. It was probably 9:00 PM, but when you're on the equator, it gets dark at 6:00 PM and gets light at 6:00 AM. So we were going to go to bed. We had sheets on the windows because, again, we were just moving into this house. All of a sudden there was this bright light. So we opened windows, and a transformer on this pole was burning. We were going to call the fire department, but we realized we didn't have a telephone. So we just watched it and thought, "Well, if it comes to the house, the house is made of cinderblock." But the fire just kind of went out. And after it went out, we realized that we did have a telephone. However, the black rotary telephone that was under the bed had no cord or connection. Since we really didn't know where we were-and our neighbors were gone for the weekend, so-it was probably just as well that the telephone was inoperable. So that was an interesting start. McNutt: Is that when it hit you that you were in West Africa and not the States? Olsen: I think that when we stopped in Senegal before arriving in Liberia, that was when it hit that us that we were in a very different place. And living overseas then was very different than it is now. There was no email or operable telephone. And so basically for 3 years, we did not talk to our family. We sent letters and, if necessary, there was teletype and occasionally a telegram Also, occasionally at work, my husband would talk to CDC. But most of the time we were on our own.[ And, again, we didn't have a telephone-even though we were in the biggest city in the country. McNutt: Monrovia? Olsen: Yes. And on that first Monday, 2 days after we arrived, the USAID van came to get my husband to go to work. There were about 20 men on the porch, and the driver said to my husband, "Oh, they all want to work for your wife. They want to be the houseboy." I looked at them, and I thought, "How am I ever going to choose?" I'd never had house help. So I thought, "Well, I'll just take the first person, and I'll just have a different person every day until I pick somebody." McNutt: You're trying them out. Olsen: Trying them out. And so I told Timha I was only hiring him for one day. And in Liberia, they speak pidgeon English. It's a little different than English. So Timha came to work for me that day. He was an older man. I was only 25, so he probably was 35, but he seemed like an older man. And we didn't have anything in the house, and so I thought, "What can he do? Well, he could wash some clothes." So I had him wash my husband's shirts and a couple of things because we'd been traveling. After he finished that, he hung all our clothes on the bushes outside so that they could get dry. I thought that I could bring them in, so I said, he could go. And then I looked a little later, and I thought the shirts were mildewing because they all had blue and green on them. So I brought the clothes in and I used all the different cleaners to get the spots out, and I was thinking, "Boy, things really mildew fast here." So when Dennis came home for lunch, I told him we had to buy a dryer. Well, the next day came and everybody was on my porch again. Timha was there again, and I noticed that he was wearing a country shirt, made out of indigo. I realized then that when he was wringing the wet clothes, he had put them up against his shirt, and the dye in his shirt had bled on all of our clothing. Well, luckily, the driver had a friend or a brother or something, and he introduced me to David Parker, who then became our houseboy for the next 3 years. He was a very nice man, and it worked out very well. McNutt: You didn't have to try all of them. Olsen: Didn't have to try. And Timha became our gardener. That was the job he wanted. He didn't want to be the houseboy. Another episode with Timha was funny. The farmers do slash-and-burn in the fields. So I asked him to clean up the yard, and all of a sudden I look out and there's fire. Everything he cut down is burning. But other than that, keeping the house was easy. McNutt: You had electricity, you had a stove, refrigerator, a dryer. Olsen: We bought a dryer, and we had a stove that was furnished. The stove used gas, and so we always had to make sure, if we were going to have company, that we had enough gas so that all of a sudden we didn't run out in the middle of entertaining. Somehow, USAID [US Agency for International Development] would only give us one gas canister at a time. But the people were very, very nice. We felt very comfortable. And the American community was nice. But the smallpox program didn't quite fit with the embassy and it didn't quite fit with USAID, so we were kind of our own program. I am an environmental engineer, and so I wanted to find a job. I found one, working for a firm that was doing an extension of the airport. But then someone who I didn't know took a job that supposedly took a job away from a local person. The upshot was that no dependents could work except as schoolteachers or nurses, so I couldn't work. And then they approached me and asked if I would substitute at the American school. So I taught 7th through 12th-grade math. I had never taught before, but somebody told me the first day of school that you need to be really tough. So I was really tough. Any time the kids were not good, I would immediately give them a test. So after about a week, they just knew they were going to be good when they came in. And, having never had any education classes, I just taught them like I was taught. Years later, it was rewarding when I met some of my students who had actually done well. It was a relief that I didn't do permanent damage. McNutt: They can't blame you for anything. Olsen: Right, right. And then, I guess it was the second year, the principal or the superintendent of the American school crossed the Liberian government and was asked to leave Liberia, so I became superintendent. One day I was sitting in my office and the phone- I told you the phones didn't work, but all of a sudden the phone on my desk rang. I was so excited. I picked it up and said, "American Cooperative School," and they said, "Oh, wrong number," and it never rang again. But the thing that was so nice about our African experience, it gave us a feeling not only for Africa but also for what French countries were like, since we took trips, as part of the smallpox program, to Ivory Coast, which is a francophone country. And we were given vacations every 2 years or so. On our first vacation, in l968, we went with a Peace Corps charter to East Africa for 6 weeks. That was when Jomo Kenyatta was Prime Minister of Kenya, and Uganda, Tanzania, and Kenya were on such good terms with each other that they had common currency. McNutt: Really? Olsen: The drought had not occurred yet in Ethiopia. It was a very kind and gentle country under Emperor Haile Selassie. So we saw part of Africa that no longer exists, and it was a very enjoyable, interesting experience. It was also interesting to see how that part of Africa was different than West Africa. Now, we weren't always just going on vacations, but we were able to go to Europe also. Neither of us had been there, and to spend 6 weeks in Europe just wandering around was really interesting. It was winter, so we ended up in a lot of art museums and other museums. It gave us a whole different perspective on the world. McNutt: Sure. Olsen: Those breaks were nice because, when we went back to Liberia, we could kind of look at life a little differently. In Liberia, there were only a couple paved roads, and we just looked at the same thing every day. And as far as the smallpox program goes, I did not go up- country with Dennis because there was really no place to stay. Later on, when we lived in India, I used to travel with him because they had guest houses and different places where we could stay. But oftentimes he would stay with Peace Corps volunteers, and so a lot of the Peace Corps volunteers would then come to stay with us when they came to Monrovia. Toward the end of our stay, we got very excited because cholera was all of a sudden detected in Sierra Leone. They anticipated it coming into Liberia, so Dennis had an opportunity to meet with President Tubman, who was one of what they called an honorable. His parents had come back to Africa after Abraham Lincoln was president, when many of the descendants of slaves in the United States went back to Liberia. So Liberia was never colonized. But Liberia had an American influence. Their Pledge of Allegiance is just like ours, with a few words changed, and their flag is just like ours except it has only one star. And during the Second World War, Roberts Field was used as a base where the planes would fly to Africa from Brazil and then up to Europe. In fact, sometimes you would see houses made of military runway materials. But in theory President Tubman was a benevolent dictator. And when we came back, we were in Washington for a short time. I would tell people that Liberia was the kind of place that, if you went out at night, you always took a flashlight because there were no lights except the Moon and the stars, and you wanted to make sure you didn't step on a snake or step in a hole. You had no fear of any of the people. And at that time in Washington, DC, if you heard someone walking up behind you, you immediately turned to see who was there. I remember seeing the soldiers. They didn't carry real guns; they carried wooden guns. And oftentimes, after a parade, they would carry their shoes on their guns because they weren't used to wearing shoes, but they had to wear them for the parade. McNutt: How interesting. Olsen: But socially, we had to make your own entertainment. McNutt: Sure. Olsen: The last year we were there, they brought in television. But before that, it was the BBC news. And, actually, Liberia was 45 minutes off of Greenwich Mean Time. During World War II, there was supposedly a German ship off the shore that sent word they wanted to meet with the president of Liberia at 10 o'clock, and so Liberia changed its time so that the Germans would be late, as 10 o'clock became 10:45 Liberian standard time. McNutt: No way! Olsen: Yes. But sometimes people would say that Liberia was like a poorly done United States. But we were in our 20s, and it was our first assignment. We had a very enjoyable time and we met lots of people. At the American school, about 50% of the children who I taught were Americans, about 25% were from other embassies, and the other 25% were Liberian students. Of this last group, some had parents, who were doctors and honorables, and some students were on scholarship. So it was a nice blending. We got to know people from all kinds of different embassies, like the Asian embassies. And if you were their child's schoolteacher, you were a very special person. The students seemed to get together very well. They took care of each other. McNutt: So tell me a bit more about the social life. You were probably one of the younger couples there, I'm assuming. What were the social activities that you did? Olsen: There were a lot of cocktail parties, and you found excuses to have parties, like for St. Patrick's Day. The social life on weekends was really out at the Voice of America transmitter site, which was about 20 miles out of town. They had to maintain short grass around the transmitter, so they made it into a 9- hole golf course. The golf holes were sand with a little bit of oil mixed in. People kept the sand raked. So if you got out on the green, it was like putting on the bottom of a sink: the ball went down toward the hole, like water toward a drain. So you really had an unfair advantage. But it was very interesting. And we all had young Liberians as our caddies. They lived near Harrisburg, which was where Voice of America was. My regular caddy was Michael. He would make sure there were no snakes where I was going. But I never had a bad lie because Michael could pick up a golf ball with his toes, and by the time I got up to my ball, it was sitting on top of a nice little tuft of grass waiting to be hit. One year before Christmas, Michael said, "Missy"-they called a man Boss Man, and the ladies were called Missy-"Missy, are you going to get me a Christmas present?" "Well, Michael, what would you like?" And he said, "I was looking in the book, and I think I would like roller skates." Now, there was no pavement. I mean, there was a dirt road to get there, there was a dirt parking area, and there was grass on the golf course. And so I said, "I think that you really don't want roller skates." But in ways it was kind of sweet, the simplicity of life and not realizing some things. Another sweet moment was when we all made curtains. You could always tell when people came to Liberia by their curtains. People who came in the rainy season had bright curtains; people who came in the sunny season had dark curtains. I used to sew things, and I always had material left over. And David, who worked for us, said, "Are you going to use that material?" So I gave it to him. And one day, Dennis was up-country vaccinating in a certain area. David's wife and children were in that area, so he went along so that his children would definitely get vaccinated. And they took a picture. And there were my bedroom curtains-everybody was wearing them. McNutt: Oh, my gosh. Olsen: But I'm trying to think of some of the other social things we did. I remember our going-away party. Usually when you invited people for these cocktail parties, there were always so many things to do that maybe only 50% would come. And just about the time we were leaving the country, there was an outbreak of what they thought was smallpox. It was way out in the hinterland, where you had to hike in. It turned out to be monkeypox. But Dennis and his replacement, Randy Moser and the team hiked in. And so for our farewell party-and the Moser's welcome-to- Liberia party-they were all still up-country. But Barbara Moser and I were putting on this party, and everybody showed up. And our house was just like they used to stuff Volkswagens: it was just full of people. And about halfway into the party, Dennis and Randy arrived in their Dodge truck. One lady, as she was leaving, said to me, "That was a really good cheese ball." "Oh. Did you like it?" She said, "Yes. My friend and I ate the whole thing. We got stuck in the corner and we couldn't get out, so we would get drinks from out the window, and we just ate the whole cheese ball." I think the thing that was nice about Africa is it gave you a totally different perspective of the world and gave you a wonderment for travel, for things you can do-or the things you try to do anyway. McNutt: So it's great to have that perspective in your early or middle 20s. Olsen: Right, yes. McNutt: Changes your whole outlook. Olsen: Some of the people who are here at the reunion I have never met before. They were in the first group in '66. We were kind of the fill-in group, so we had a much smaller group. There were maybe 10 or 12 of us. So, except for meetings that were held about once a year in someplace like Abidjan, we didn't meet the other people because Africa was so remote that to get from one country to the other you often would have to fly to France first. McNutt: I've heard that. That's crazy. Olsen: And, as opposed to India, where we traveled all over, Africa was hard to travel in. But we had a lot of people from CDC come through -and it was always fun people, like Jim Hicks [James W. Hicks]. Then we would catch up on the news, because we were never quite sure what was happening in the world. Bad news travels fast though, so when Martin Luther King was killed, we knew within hours of its happening; the same thing with Bobby Kennedy. Like I said, bad news traveled very, very quickly. And it was hard to convince Liberians that there was actually a man on the Moon. That was happening while we were there. The local people would say, "Oh, yes, Missy, oh, yes, there's somebody on the Moon." But they had never flown; they had never really been aware of so many things out there. McNutt: It was 2 different worlds coming together. Olsen: Right. But, then again, you don't have to be educated to be smart, or to be wise. I think that all of us learned a lot from the different people we encountered. And at that time, since Liberia had a heavy American influence, we would have a lot of American foods. We had 2 supermarkets, run by Lebanese. The Lebanese also were the jewelers. When I went into the supermarket, I would check the cottage cheese to see if it was green or not. Or I would buy one box of cereal and take it home, and if it didn't have weevils, I'd go back and buy a whole bunch of boxes. But weevils and ants were just everywhere, so we kept everything that wasn't canned in the refrigerator. Even when I baked a cake, I took it out of the oven and put it in the refrigerator. If you left it sitting out for a little while, you'd come back and it would have ants all over it. And if I made spaghetti, I had a strainer so that, after it started boiling, I could scoop all the weevils off the top. Otherwise, it would look like you had pepper in your spaghetti. Flour was the hardest thing. You had to sift your flour because the weevils didn't go through the holes, and then you'd throw them away and you'd make whatever you were going to with the flour. McNutt: What did you do for water? Olsen: Originally, we were on a well. We had to boil the water and put it through a filter. We had these big tall filters with clay candles on them. Once a week, the filters would be boiled and cleaned so that we always had water. Now I was teaching school. One day I was taking a shower. I was totally lathered, and the power went off. So the water went off. So I called David, who brought me the water from the dehumidifier and I poured that on. I still needed more water. So then it was ice water from the refrigerator. So even to this day, I wash my hair, rinse it off, wash one arm, rinse it off, just in case. McNutt: Tools of the trade. Olsen: And after that day, we had a large plastic garbage can that we always stored water in, and every couple of weeks we would replace the water. [Toward the end of our tour, we were actually on a water system, but we still boiled our water just as a precaution. We had excellent restaurants. Salvatore's had probably the best Italian food I've ever eaten in my whole life because they had to make everything from scratch. So they had their own pasta, their own cannelloni. When I went to Italy, it was almost anticlimactic because I had better food in Liberia. And eating out was a very social thing. We ate out quite a bit. There was also a Lebanese restaurant. And this is kind of funny. They had an expansion, and the back area-again, you're talking 100% humidity, 90°-100°F-was decorated like an ice cave, with blown white plaster. You'd go back in there, and they'd have air-conditioning blowing down. They made wonderful hamburgers and shawarma sandwiches. And since I worked at the school, some of the teachers were from different neighborhoods. We had a Haitian French teacher, and we had some Liberian teachers. It was a nice way to get to know different nationalities and different people and work with them. McNutt: What did your family think about your taking off at age 25 for Africa? Olsen: Oh, I had already been to Brazil with the Peace Corps,. I grew up in Wyoming and my first job was in Los Angeles, and I had never been to California. Being the youngest of 7, I was a bit of an adventurer. McNutt: So what special training did you have? You mentioned training at the CDC. What prepared you or your husband for West Africa? Olsen: The participants all went through the EIS [Epidemic Intelligence Service] course, so even though my husband is not a doctor, he went through the course that's usually reserved for the EIS Officers. McNutt: Is that a 2-year course? Olsen: No. It was a 3-month summer course. The EIS Officers who were staying then worked with CDC for 2 years. But we went off to Africa. So there was a lot of statistics and epidemiology, even mechanics. The spouses were invited to attend any of the sessions that we wanted to, which was quite interesting. Plus they had another course, one taught by Dr. Waddy [B. B. Waddy], who was very English and had spent many, many years in Africa. He talked about tropical diseases and the African culture. Other people talked about things like the weather. So we had demographics, history, and geography. But when we first arrived in Liberia, we had very, very little because you were only allowed to carry 40 pounds of materials with you. So we had a couple books and a few other things. But then CDC sent some program materials, so, with nothing else to read, I read the book on tropical medicine. And one by one, you followed the pictures and would see the diagnosis. And not being a doctor, I would think, "Oh, I've got this rash." I think I needed something else to do. I had a couple bouts of food poisoning. One was caused by strawberries. They looked just like the kind of strawberries you bought at the grocery store, but they had probably been frozen and thawed a couple of times on their way to Africa. They used to actually send California lettuce and California celery to Liberia. It did not come by airplane; it came by ship. McNutt: And it made it? Olsen: Yes. We would save the lettuce for special occasions. We had these green Tupperware containers. If you took the core out of the lettuce and put the lettuce in a paper towel, it would last. I'm sure it had no food value, but it was like, "Oh, lettuce, lettuce from the States!" And the tsetse fly is in that part of Africa, so they couldn't raise cattle because they would be killed by the tsetse fly. So all the meat was imported. About the only thing you would get locally was chicken. McNutt: That answers a huge question for me because I did not see many cattle when I was in Liberia in June, and I was wondering why not. Olsen: There is some other bug that gets into clothing that is washed. The bug is in the water, and so you have to iron everything. McNutt: Interesting. Olsen: Yes. And at that time, there were parts of Liberia that were not mapped, because the heat would cause steam to rise in the rainforest. We had some friends who were with the USGS [US Geological Survey]. They kept waiting for a clear day. But if you look at the 1967 USGS map, there was a section of the Liberia map , they probably have mapped the area by now because of the satellites. But I'll tell you about one of our regular activities. Everybody wanted to have some African art. It was very "in" in the States to have African art, and so people would buy different things. There was a group of vendors or sellers, who were called Charleys. So there would be Charley number 1, Charley number 2, Charley number 3. And if you purchased something from them, you could actually write check to "Charley Number 3". Liberia used the US dollar. So I have cancelled checks to Charley number so-and-so. The Charley's must have had a great network. You would hear a noise on your front porch, and then you'd hear the doorbell ring. You would open the door, and there would be like a little store. The Charley would have laid down all his artifacts, and then you would look to see if there was anything you wanted. They would often come on weekends when most people were at home, and we would bargain and bargain. The Muslim Charley's, would sometimes take a break and go say their prayers and come back, and you would bargain some more. My husband didn't like to bargain, so I would be out on the porch to bargain, and then I would bring an artifact in the house and he'd, "Oh, that is so ugly, I don't like it in our house!" and I would go bring it back out and the price would be lowered. One day, I started bargaining because I was bored and there was nothing else to do. I was probably at maybe $10 and the Charley was at $15, and after an hour we were going nowhere. And then I decided I would use a different technique, and I said, "Well, $7." And he looked at me and said, "Missy, $7, two aspirin, you give me a headache." And I still have the artifact. It looks like somebody made it out of mud. It's an interesting, kind of strange piece. One time, my husband was up-country. We had night watchmen, so I felt perfectly safe. One of the Charleys that I hadn't dealt with before came to the door. He had a fine Senefo artifact. It was the only piece he had, and so I knew there wasn't going to be a lot of bargaining. I think I probably ended up spending $100 or maybe $125. It's a beautiful piece, and I must get it into a museum someday. But the next night the doorbell rings, and there he is again, and he wants to buy it back from me for $250. So evidently, somebody had heard about it and had offered him much more. But I said, "No, no, no. It is sold." McNutt: Someone within your group heard? Olsen: One of his customers, because we would describe art pieces we were interested in obtaining. The Charley would then try to find them. . If you had company, especially when anybody from the States was visiting, the Charleys knew it. If you were having a cocktail party, all of a sudden you would hear a ring, and there would be tie-dye on the porch banisters and different Africa items at their little store on the porch. And then, sometimes rogues-they didn't call them burglars in Liberia-came in at night. They never hurt anybody. McNutt: While somebody was there? Olsen: Yes. So at night, when you went to bed, you locked the front door, the kitchen door, and every door in the house. You had these big skeleton keys. Then you locked yourself in the bedroom. And if you were lucky, you had a bathroom attached to the bedroom, but if not, you locked the bathroom too. And off to bed you went. The first incident occurred the first time my husband was out of the country. It was my first night alone in Africa and I had locked myself in. I hear this tap-tap on the window, and I think, "My goodness, somebody's coming in." Finally, I looked out, and there was my husband throwing rocks at the window. He had come back early, and when he rang the doorbell, it rang in the kitchen, and I was 2 locked doors away. McNutt: Your husband was trying to break in. Olsen: Yeah. But then one time I got up in the morning, went into the kitchen, to turn the coffee on, and noticed that we had been broken in. I ran out of the kitchen and locked the door, and I said, "We've been robbed." And Dennis said, "What did they take?" I said, "The water filter." And he said, "What?" And I said, "They were in the kitchen. The only thing I could see is that the water filter was gone and the window was gone." (We had these sliding windows). It was just before Thanksgiving, and the embassy had brought in turkeys for us. So we had 3 turkeys in our kitchen freezer, one for Dr. Thompson and his family and 2 for us. Well, the rogues had taken 2 turkeys and a kitchen curtain to wrap them in because they were frozen solid. That's all they took. We all had tin roofs, and when it would rain, it was like somebody playing the drums. We had the most exciting electrical storms. There were big booms, and the power would go out. The storms would come in off the ocean. The robberies were timed. Just as the thunder boom resounded, the rogues would take the window out. In our bedroom, we slept with our heads against the wall. On the other side of the wall was where the burglars had actually come in the house. We didn't hear them at all. We were in embassy housing. So Dennis went to the embassy to report that we had been rogued. The burglars had gone through the whole area; they had taken money; they had taken stereo equipment. Dennis said he felt kind of strange saying they took 2 turkeys and the kitchen curtain. The robbers had tried to get out of the kitchen, but they couldn't get the door open, so they were confined to that little area. McNutt: That's funny. So, security-wise, you weren't worried while you were there. Olsen: No. We were never in fear. I mean, there was just no concern. McNutt: It was relatively stable out there? Olsen: Very, very stable. Again, you had a night guard. But you paid him, and I'm sure he paid whoever it was that was stealing so they wouldn't come and rogue you. I have a letter that a night guard wrote me. He was a very old man. The letter said, "Dear Mother, please buy me a bed so I can sleep on your couch while I guard. I might have considered his request if he had called me Missy, but "Dear Mother." McNutt: What kind of problems did you have in establishing working relationships with the African counterparts there? Olsen: Well, I wasn't working, except at the school. I really didn't have problems. By that time, I could understand pidgeon English, and usually they were a very kind and quiet people. Many times, the little boys who played soccer with a grapefruit in the vacant lot next door would come over to get a drink of water or just to say hello. Or they would pick the papaya off my tree and then want to sell it to me. But we never felt threatened at all. I'm sure things have changed-the world has changed-but then it was very nice. They made beautiful tie-dye. I used to buy tie-dyed material from the lady who lived under the bridge. Her name was Mama Sony. I would take other American women to her. I think sometimes people were reluctant to interact with local people but I was very comfortable with them because I was teaching Liberian children at school and working with Liberians. So it was very natural. At that time, there was a large international population, too. There was the German store, and there was a large Irish population, so we made many international friends. We would get invited to their houses for dinner, and so we'd have all kinds of different foods. McNutt: So, what about your husband? Within the smallpox program, how did he or the team work to get people to sign on to the program and agree to being vaccinated? Did they have to go to tribal leaders? Olsen: They didn't have the kind of health systems then that they had in some of the colonial countries. Oftentimes they would go to the different villages. And all of his staff were Liberian. He oversaw program operations, and Dr. Thompson was in charge of the medical aspect. I don't know; he'll probably describe it. But his office was incredible. It looked like it washed out to sea and came back. His office was in an interior room, and somebody had painted it a few years before, but when they painted it, if there was a bookcase, they just painted around the bookcase, so you could see where the furniture had been in the past. I remember one time he was really upset because, again, it was really humid and really hot, and he had gone to the USAID mission and asked if he could have an air-conditioner. And they said, "No, that's a Liberian building, you can't have an air conditioner, or everybody will want one." The statement that was made was, "You have the benefit of working with local people. Therefore, you should be able to cope with the local conditions." But he enjoyed working with the Liberian staff. Years later, he went to Liberia on short-term consultancies. His staff were still there and were very pleased to see him. He went up country, where he found out that his driver was now a paramount chief in one of the villages. On his way back, there was a pole thrown across the highway, which meant stop. It was placed there because John Masaquoi wanted to give him a present. He had this country shirt. He stepped aside and said to Dennis, "Tell Carolyn to wash it in Clorox; it's been under the bed." We have only fond memories. We have things that probably no longer exist. They made country money. Nimba Mountain had such rich iron ore that they just pounded the iron ore into 6- inch sticks with kind of a forked end and a round circle at the top and twisted, unrefined iron; one piece of country money was worth a penny. Years later, I met somebody whose cousin had lived in Liberia back in the Firestone days. She used to go into the bush. In the afternoon, they would tell stories, so she made a whole book of notes. After Liberia had all its problems, she went back to her notes that she had taken in the '40s, and even though she was in her 70s, she made a book on Liberian folk tales. It is entitled, You Can't Unsneeze a Sneeze. And reading those tales just brought back so many memories. Food, for instance. They have one thing that's made out of casava called dumb boy, and it is to make you feel full. And you're a dumb boy if you don't swallow it quick because if you chew on it, it swells in your mouth and you can't swallow it. McNutt: That's interesting. Olsen: And then you would eat it with just a little bit of what they called soup, which is kind of like our chili. McNutt: Wow. I love to hear these stories. You said that you did a lot of work, and you spent a lot of time with the locals as well as the expatriates. What was it like coming back to the States? How did you fit in again? Olsen: We came to Atlanta for about a month, and then Dennis was assigned to San Francisco Bay area. One of the hardest things was going back into the grocery stores, places where you had so many options. You had a whole row of dog food. We had gotten so used to having a limited amount. In Liberia, if the ship came in, everybody knew that there was fresh or at least new products. I think the part that amazes me is when you return to the states and you start to tell people about your experiences, and suddenly their eyes glaze over. Then you realize that you are now a part of a different group. If you really want to communicate about travel or about experiences, you have to find a new group of people who also have done similar things or who are well-read. I find that people who are well-read oftentimes enjoy the same interests. The thing about reading or seeing movies of these areas, be it Darfur or whatever, you don't get the heat and the smell. And the heat and the smell are just as much a part of everything as everything else. I think it gives you an appreciation in the United States of many things, but at the same time, it makes you realize that you're fortunate and you need to give something back. McNutt: What was the toughest problem you faced, and how did you handle it? Olsen: It must have been so tough, I put it out of my mind. I feel like I had no problems. Oh, I know. This is a funny problem, but it seemed traumatic at the time. They didn't have parallel parking. You pulled in. And a parking spot in front of the grocery store was always prized. We had a little green Volkswagen, and I'd just been to the grocery store. I was backing out. I looked and no cars were coming; it was clear. And I backed up and I ran into a car, a big black Mercedes. McNutt: Oh no! Olsen: And a lady came out. I could tell she was an honorable's wife. I was in the middle of the main street, but all of a sudden, I was totally surrounded by Liberians. Everybody was talking about this great wreck. The woman was distressed. The policeman was there. And I am the only white face in the crowd. All of a sudden this very tall black man comes and puts his arm around me and stands next to me. He was the husband of one of the schoolteachers at the American School. Dennis was up-country, and so I gave the woman my name and I told her we would have her car fixed. What had happened was, she had passed my parking spot, but her friend said, "Oh, there's somebody coming out," so she backed up, and so she ran into me. McNutt: She should have been looking for you. Olsen: She should have been looking for me. So I was looking for oncoming traffic, and she is backing up down the street. Bang! I was so distressed. I went home and knitted. Whenever I'm distressed, I knit, so I knitted. And when Dennis came back, I said, "You've got to talk to Honorable so-and-so because I ran into his wife's car." Well, the honorable said, "Forget it. She was distressed because she had just gotten it out of the shop from her last wreck." But, I mean, when you're suddenly surrounded, I mean, it's scary. McNutt: So you were glad that man was able to help you. Olsen: Oh, yes, yes. He said he was driving down the street and he saw this big crowd of people. When somebody sees a crowd, something must be happening. He said, "And there you are in the middle of it." McNutt: So, back to smallpox, at what point did you think that smallpox would actually be eradicated in Liberia and West Africa? Olsen: Well, I have to tell you, I've never seen a case of smallpox. As close as we came was toward the end, when they found a case of monkeypox. It was the first time they had found monkeypox transmitted to man, and the lesions looked like smallpox, but it didn't manifest in the rest of the family. And so a lot of people went up into that area. They would take a scab and send it to CDC to be verified. So it was kind of like the show-and- tell. But it was kind of an exciting time. But, like I said, I never saw a single case of smallpox. Evidently, somebody had come through and vaccinated the people years before. Or perhaps, because of their isolation, smallpox just never happened there. But there was so much migration. People from other countries moving in and moving out. McNutt: The tribes aren't divided along country lines. Olsen: No. McNutt: So, had your husband seen smallpox there? He was more up- country. Olsen: Not in Liberia. He saw it in Sierra Leone. He went there short- term. One day we were driving. Our car hadn't arrived, so we always took the taxis. And I said, "Dennis, look! I think I see smallpox!" And here was this little kid sitting there by the road. They have what they call the sandy society, and they have mud stuck all over them, and it looked like some kind of disease. But taxis were interesting. The taxi drivers spoke in pidgeon English. You could take a bus for 5 cents, or you could take a taxi for 25 cents. But you would have to flag the taxis down. Even the policemen didn't have police cars; they used taxis. You would take a taxi up-country. Our Peace Corps friends would go down to the taxi area to catch a taxi up-country. One time the taxi driver was very aggressive. His fare was inexpensive to take them all the way back up to their village. They went with him, and the person in front was not talking. About 5 miles out of Monrovia they realized the passenger in the front was dead. The taxi driver was taking him back to his village. McNutt: Oh, my God. Olsen: One night we had a group of Peace Corps people come to visit. It was late, so we were going to take them back to where they were living in Monrovia. We were going down the main street; 4 of us were in the back of a Volkswagen, and 2 big guys were up front. And all of a sudden this taxi pulls around and tries to stop us. And pretty soon this taxi goes around us again, yelling, "Stop in the name of the law!" So we pulled over, and this policeman, who was drunk, comes to our car and says, "You're under arrest! You have 2 people in the front, you have 4 in the back. That's 7; that's too many." And he said, "Follow me. I'm taking you to the police station." And we're thinking, well, should we go or should we not because we had always been instructed to go to the embassy. The one fellow in the front with Dennis was Peace Corps, and he was teaching law. He said, "I'd like to see this part of the law." So we proceeded to the police station. It was midnight. So Dennis and the arresting officer walk into the police station. They have to wake up the policeman on duty. So now the policeman and the arresting officer come out to the car, and you can tell that this policeman is really tired. He looks in the car and says, "Professor!" The policeman was one of the lawyer's students. So policeman said to the arresting officer, "Now, I know these people and they are okay, so we will let them go." It's now like 12:30 AM. Just as we're leaving, the officer who had tried to arrest us said, "Okay, I'll let you go this time, but if I see you out after midnight, there'll be no mercy." Policemen also directed traffic. If they arrested you, they would get in the car so that they could take them to the police station. But we had these little driver's licenses, little red books. The people who work there for business had told us that if we ever got stopped to just put a dollar in the license and give it back, and they'd let us go. Well, I had one friend. She was downtown, and this policeman started to give her a ticket, and she had done nothing wrong. So she proceeded to give him the riot act. He took her license and put a dollar in it and gave it to her! McNutt: How funny! Olsen: But, again, you would go to the movie and you would always have some young fellow watch your car. When you got out, you would give him a quarter or 50 cents, and your car was safe. Your car probably would have been safe anyway, but it's just the way that they made some extra money. But the movies were interesting because it was back when they had reels. Sometimes you would see the middle reel, the first reel, and then you had to try to figure out the movie. Or they would have broken it and spliced it in backwards or something. When we saw "Wait Until Dark," the opening scene showed the plane backing into the airport port from the sky. McNutt: Whoa! Is there anything from your experience or from the program that you were involved with that you would change? Olsen: Nothing I would change. It was such a wonderful opportunity. I think that it is a shame that young people don't have that opportunity now. You know, Peace Corps sometimes gives them an opportunity. But, actually, they usually work at a grassroots level, and this was more on the professional level. The thing that was kind of amazing was that most of the people in the smallpox program were probably 10-20 years younger than their counterparts. They were all in their mid-20s or early 30s, and most of the doctors and people in Liberia that Dennis worked with were probably in their 40s or 50s. On the social level, it probably took us 2 years before we started getting invited to Liberian houses. When we were in India, it was much easier. In India, we lived in what was basically an Indian house, and we would have different people come to a party at our house, which was probably not as good as what they lived in. So then when we would be in their city or New Delhi, they did not feel uncomfortable inviting us to their house. So that made it much easier to interact. But I think in Liberia, there was a status level that was involved. Even though the salaries weren't that good and the housing wasn't that good compared to stateside, they were still better than what many people had. When the power went out, we had a game we would play. Whoever had the flashlight would have the almanac and ask questions. The other entertainment, if it was light, was watching the geckos. But I think that we benefited because of the people who went before us, in 1966. So I would say the training for the group that went in '67 was good. The other thing is, Bill Foege [William H. Foege] and the Thompsons had had to leave Nigeria, because of the civil war, so they were at CDC during our training and gave us first-hand experiences of what it was like. And different people would tell you things to take to your post. We were very spoiled as far as having American foods. People who came to visit from Mauritania or Guinea would think they'd died and gone to heaven because they could have dill pickles and ice cream and all these things that you couldn't get in other countries. McNutt: So, how did participating with this project change your life? Olsen: I would say that, being an environmental engineer, it gave me more of a global view of the world, and also a real appreciation for water , especially the needs of people for clean drinking water. Unless you have lived in a situation where you really have to plan what you're going to drink, you don't have that same appreciation for water. And remember we lived in Africa before bottled water. Nobody carried bottled water around, and you didn't go to the store and buy a case of bottled water. So you had to make sure that your water and your food were clean and good. That was a challenge. McNutt: And did this first experience contribute to later work experience? You talked about India. Olsen: Yes, India, and in my profession. I was a utility manager, and I was on the board of American Water Works and Water for People. Then I was the president of the nonprofit Water for People. For the last group, I would talk to people, trying to raise money for water projects. And being a woman in a professional field, Africa was, to some degree, a matriarchal type society, but in India you realize how downtrodden women are. But in any society, it's the women who end up carrying the water. McNutt: And the little ones. Olsen: The little ones, yes. And so it just gave me a real appreciation, for different cultures. And to know that almost everywhere you go, there are people who are wiser than you. McNutt: So is there anything else that you want to add? Any words of wisdom for the next generation of public health workers? I mean, you've had so many nuggets already. Any last statements? Olsen: I think that it is very good that we were able to see the world and see the problems of the world. I think also that people need to realize that there are problems here that are also very trying, and we need to be aware of that. People really need to know about health issues. Maybe we don't have the tropical diseases, but we have the overweight and the diabetes and the other things that affect that same socioeconomic group here. Water and wastewater are my areas of special interest. Global warming and cultural changes are going to see the development public health problems that we don't even envision yet. McNutt: Thank you for your time. Olsen: Thank you. McNutt: What a wonderful discussion. # # # </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310135748%3Fsecret_token%3Ds-Hx2bg&amp;color=ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false" frameborder="no" scrolling="no" width="100%" height="166"></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 sound recording - nonmusical interviews Date A point or period of time associated with an event in the lifecycle of the resource 2006-07-14 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/158ws emory:158ws Subject The topic of the resource CDC Smallpox Eradication Life as expatriate wife USAID WHO Format The file format, physical medium, or dimensions of the resource 753573744 bytes audio/x-aiff Creator An entity primarily responsible for making the resource McNutt, Kathryn (Interviewer); Rollins School of Public Health; Graduate Student Olsen, Carolyn (Interviewee); CDC; Wife of Operations Officer Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of West and Central Africa Smallpox workers (2006 : Atlanta, Georgia) Title A name given to the resource OLSEN, CAROLYN Description An account of the resource Carolyn Olsen recalls life as an expatriate in Monrovia, Liberia in the period of 1966-1970 while her husband, Dennis Olsen, served as Operations Officer. Carolyn talks of taking a job as a teacher in Monrovia, expatriate social activities, and daily life living in Monrovia. Carolyn also briefly compares life with the smallpox program in Liberia to their later posting in India. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/b07847907b2c8762b6d63c2a4536e899.JPG 91f148317e5d406c7b2ea2a8433f68df https://www.globalhealthchronicles.org/files/original/1152aa1d46ef31f9bc016b68e3a2f616.pdf 1b2d762a6f4793cf6640a5fcd223fd75 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> fThis is an interview with David Newberry on July 13, 2006, at the Centers for Disease Control and Prevention in Atlanta, Georgia, about his role in the project to eradicate smallpox in West Africa in the 1960s. The interviewer is Melissa McSwegin Diallo. Diallo: You started out working at CDC in venereal disease. Could you talk a little bit about how your education before that and your upbringing led into a career in health? Newberry: I have a Native American ancestry mixed with an upbringing by very humble parents who really prompted us to seek education. I was a high school dropout, joined the US Army, went to Korea assigned to the 3rd Infantry Division. After completing Basic Training, Ardyce Timmons and I were married January 29, 1953. I served 3 years in the army. Upon returning to Kansas, I tried various jobs but with little education and a GED Certificate, it was clear that there was no way I would be able to provide for my growing family. I went to the local university and applied for entrance armed with my GED. They tested me, and the Registrar reluctantly agreed to let me enter as a probationary student. I carried a double major (Pre-Med and Secondary Education) with a double minor (History and Chemistry) in my undergraduate work. With a growing family I needed to work full- time in a local 750-bed hospital laboratory, as a nonregistered medical technologist. We had 6 children, and that always made seeking higher education difficult. We suffered the death of a 6- month-old child, who was being watched by a babysitter who let a fan blow a plastic sheet over her face. I was accepted as a student at the Kirkwood Missouri Osteopathic School of Medicine. We did not have the necessary $600 needed to reserve my place in the class. I was employed by the Midwest Medical Research Foundation as a research assistant. We were working on mitochondria and some of the early, basic research on liver transplants. We were using dogs as study subjects for liver transplants. I assisted in surgical procedures, postoperative care of the animals, and enjoyed the work but I really missed the person-to-person contact of working in the hospital environment. So when CDC advertised for Public Health Advisors (PHAs) to serve as basic epidemiologists in identifying sources and spread of sexually transmitted venereal diseases, I was hooked. While serving in the military, one of my NCO assignments was to give lectures on venereal diseases. So I applied for the CDC job, and since I was a 15-point veteran, CDC really had to hire me. My application and personal status did not meet the usual CDC recruiting profile or employee pattern. Personnel (the organizational term used then) offered me and my family one assignment choice: New York City as a cooperative employee with CDC on a probationary basis assigned to the NYC VD [Venereal Diseases] Program. We had 5 kids, no money, had never been to a really big city, and were totally ignorant of CDC's work climate, and so we immediately took the assignment. My CDC clinic supervisor was a truly gifted professional who was committed to disease prevention and control. I was directly supervised by Joe Benkowski, who was the Senior Epidemiologist at Brooklyn's Fort Green Facility, which was located on Flatbush Avenue Extension. It was one of Brooklyn's Social Hygiene Clinics. The morbidity there was a huge volume of syphilis cases (all stages), gonorrhea, and other diseases spread by sexual contact. I probably interviewed about 2,000 homosexuals, serving as a Cooperative CDC assignee and later as the Senior Epidemiologist at Fort Green. During our 3 years in Brooklyn, we interviewed thousands of primary, secondary, and tertiary syphilis patients. I really enjoyed that assignment. It was a little tough on the family, but the kids really adjusted. They attended St. Joseph's Catholic school around the corner from our apartment on Underhill Avenue between Bergen and Dean Streets. We sort of integrated that poor Brooklyn neighborhood in reverse, which had transited from a turn of the century Italian neighbor to a mostly black one. CDC only paid a little over $4,000 a year then. The Newberry family could have actually taken in more income by going on city welfare for 5 kids in New York City and being eligible for NY Medicaid than working for CDC. But, anyhow, we had a lot of fun, a lot of laughs, met some great people, worked with some wonderful epidemiologists, and I learned a lot from those folks. There is a lot for a family to enjoy in New York City. We could walk to the Brooklyn Museum, Prospect Park, and take a train to the Hayden Planetarium in Manhattan. One night, about 3 years into the assignment, the liquor store just below our apartment was robbed and a gunfight broke out between the thieves and police while our children watched from the fire escape. It was time to move on. I applied for a job with the CDC Tuberculosis Control Program and was selected for an assignment in Memphis, Tennessee. So the Newberry family moved to Memphis, Shelby County, Tennessee. My CDC predecessor was the Acting Tuberculosis Director for Memphis and Shelby County. I became the Acting TB Division Director there, supervising some 35 county employees. Our clinical activities were provided by the West Tennessee Tuberculosis Hospital located across the street from the health department. Within 18 months, we were recruited by Billy Griggs [Billy G. Griggs] for the CDC/USAID [US Agency for International Development] Smallpox Eradication and Measles Control Program. So we prepared mentally and physically to move to Ghana in West Africa. Diallo: So what would you say motivated you to get into smallpox? Newberry: Oh, I think probably the idea of eradicating any disease really appealed to me, and from what I'd learned while studying epidemiology, this prospect was a huge turn-on with me. The CDC staff talked about it; "Hey, let's eradicate this smallpox disease. Let's get rid of it forever." That really resonated with me, and I thought. "Hey, we will go to any lengths to do that." Also, my culture, and my family's culture, has always been that you should make the world a better place because you're in it, and that you should do everything you can to help others. And, of course, I'm Catholic, too. The nuns beat service into in my head. The guilt for not doing a perfect job I was able to develop on my own! Diallo: Okay. So then you applied to the program, you got accepted. Newberry: Right. Diallo: And you got your assignment in Ghana. Correct? Newberry: Right. Billy Griggs recruited me, and again the Newberry family sort of broke the mold in terms of the usual kind of folks who went to Africa as CDC assignees. We had a huge family. And the guy that I was replacing, Jim Lewis [James O. Lewis], had no children. So he actually leased the former Japanese Ambassador's residence, with 6 bedrooms and bathrooms all over the place. The backyard had a little Japanese garden with a pool in the back, and it to us it was awesome. Accra was just starting the Lincoln Community School, which conducted classes through the eighth grade. CDC/USAID helped subsidize tuition so we able to pay for school for the kids. By the end of our CDC tour, I ended up being chairman of the school board. That was an adventure in itself. The complexity of eradicating smallpox was accomplished by the wonderful Medical Field Unit (MFU) of the Ministry of Health. Being chairman of the school board led me into experiences and lessons in politics, power struggles, and money that banded several strange coalition groups together to apply pressure on the school board chairman! Diallo: So, you had a family with 5 children, you knew you were going to ship them all off to Africa. How did you prepare, and how did the CDC training help you prepare? Newberry: Well, at CDC, we had an excellent orientation, but basically it was kind of a fear school. We were being prepared for all sorts of health and disease risks and adventures. I tried to not to freak all my family out. When you talk to your wife and children about Loa loa, a filoriasis of the eyes, and the timbu fly, which causes cutaneous infestation with furuncular lesions in sub-Saharan, it scares the pants off everyone! Later I did experience a cutaneous infestation, and it did freak me out a bit. But these were nothing compared to some of the horrendous diseases and illnesses that were out there. But then my work in a 750-bed hospital situation helped so I wasn't too intimidated by those kinds of health threats, and ignorance is bliss! Also I had served in Korea so I know what it's like being overseas. So I wasn't very intimidated myself, but for the family I was really fearful. Our children are the greatest-the kids looked upon it as an adventure. I mean, these kids are great. They're amazing. And my wife's an amazing lady. She never did like it over there, and she still doesn't treasure the experience, but she did it and did a really did a good job. As soon as we arrived in Ghana we took a field trip to meet the Medical Field Units of the MOH and all the field staff. There were 315 field staff, with names like Quadgo, Kwame, and Cockaleeka. By the way, Cockaleeka is the Twi word for cockroach. One of our field staff insisted that he was to be Cockaleeka because that way wherever we went, he would already be there. So that's what he wanted to call himself, a cockroach. During that first field trip I met all 315 people the first 2 weeks in Ghana. I couldn't even pronounce one name correctly. We went into this one village, and suddenly here is a red-haired American, and he says, "Hi, I'm Bob Carter. I'm working on an agriculture program," or some such program for USAID. We shook hands, and I didn't see him again for 2 years. Two years later, I saw him in downtown Accra, and I said, "Hey, Bob Carter, how are you doing?" He couldn't imagine how I could possibly remember his name but the secret was simple: after meeting 315 people with unpronounceable names, meeting Bob Carter will always be in my memory bank. Diallo: That was the easy one. Newberry: That was the easy one. Anyhow, in order to implement the Smallpox Eradication and Measles Control Program, we traveled a lot. I put in about 240,000 miles on our Dodge twin-cab pickup. All this travel was in Ghana; it was all in the country itself. I went to every major village, market, and cultural place of geographic importance. I took the children on some of the trips, and they amazed the Africans. They would touch the skin and hair of the children and ask questions like, "How can you tell the boys from the girls because none have pierced ears"? I had then, and will always carry, the highest respect for my African colleagues for what they do, where they do it and the hardships they experience doing it. We at CDC, World Health Organization (WHO), and others may put our arms out of joint patting ourselves on the back for the eradication of smallpox, but the real people, the real heroes, the real staff, the real soldiers who eradicated that smallpox as a disease were those who lived in the countries who did the nitty-gritty work. These folks got to the communities; they got to the households and administered the vaccine while conducting wonderful surveillance systems in place. And I have nothing but absolute respect and awe for what they did, and where they did it, and how they did it. Diallo: Could you talk a little bit more about that, about establishing working relationships with your African counterparts? Newberry: The Director of the program was Dr. Frank Grant-God bless his soul, he died not too long ago-and he was one of the most amazing men that you've ever met. His father was a minister, and Frank was a true gentleman, an excellent epidemiologist, and a wonderful, patient human being. Frank was educated partly in the U.K. and partly in Accra, Ghana. I can't say it well enough: he was just a wonderful human being and a highly intelligent person. He was a well-trained Medical Officer and one of the hardest working professional persons I've had the pleasure of knowing. I traveled to some of the most remote locations in Ghana. I was housed in old huts seldom used because professionals rarely actually went to these locations and worked. I never traveled to any desolate corner or stayed in any hut that didn't bear evidence that Dr. Frank Grant had been there sometime before me! I quit smoking cigarettes in his home, in 1971, because his wife, Mary Grant, who was also a physician, said to me, "Why do you smoke? Have you read the US Surgeon General's advisory on smoking?" "Yeah," I answered, "I read it back in '57, right after Luther Terry published it as part of his findings. I found it very convincing." Mary Grant said, "Well, why are you still smoking?" and I said, "You're right. I won't." So I quit. February 9, 1971, I smoked my last cigarette. I hasten to add that my children made sure that every piece of tobacco disappeared from the house. Later I did take up the pipe but gave it up when I overheard the children trying to justify Dad doing it because it was less of a health risk. Frank Grant was one of the fairest people that I have ever been blessed to work with, in part because of what has already been stated. In addition to those comments, I feel the need to add additional attributes he possessed. Frank Grant was honest to a fault and loved his family and his country. In return he had the love of his staff and his family and the people of Ghana. There was no question about his devotion to Ghana and the health of Ghana; it was incredible. You could not be around him and not be inspired and touched by him. And the intellectual process that he exercised was inclusive and resonated with individual "ownership." He loved the MFU staff, and even we expatriates; he always maintained our equality in a relationship. I didn't know more than him, and he didn't know more than me. I respected his authority and never questioned it. We learned together and walked a path together. And later, Mary became advisor to the head of state on health matters, Jerry Rollins. And so I continued to have a lot of input over the years because of that relationship with the Grant family and with those wonderful people. The Brits trained the MFU staff, which was an organization that the Brits put together because the infrastructure hadn't existed. The capacity to provide outreach health services was extremely limited. So the Brits brought this program for training in treatment and outreach infrastructure together to serve the rural people by training national medical auxiliaries in treatment and public health. They were sent out to the people in what they called MFU teams. These teams actually rotated out to every part of Ghana. Health Inspectors were also trained, and the MFU was charged with a simple task of mapping the entire country. The way they trained those folks was amazing. They had medical auxiliaries. Now Ghana has 2 medical schools, but then they were just setting up the one in Accra. And so they trained these medical auxiliaries; they had a 4-year program and a 2- year program. And the sophistication of the training and the clinical practice of a 4-year graduate of that paramedical school was awesome. So they were our team members. They were the ones who really went in the trenches to eradicate smallpox. We developed surveillance systems. My predecessor, Jim Lewis, and the Medical Officer were exceptionally good people. They were great to follow. Their talents and the legacy they left were real easy to pick up, and we just carried it to the next stage. And everywhere I went, the Medical Officers were good. There were some expatriates from India and other places that were probably a little more interested and focused on the money they were making, but I made lifelong friends with most of the African people who I worked with. I go back to Ghana, even now, and I still occasionally see a person or 2 who I know real well. Diallo: You mentioned a little bit about that British legacy they left behind as far as infrastructure and so on. Would you talk a little bit more about that? Newberry: Yes. The Brits trained medical and paramedical, and set up a system that was really quite comprehensive. You could probably criticize colonialism, but that aspect you could not because they provided and developed a service and accessibility to health services that didn't exist before they were there. They actually had the good conscience and did develop those systems and those structures. They built the hospitals, and they formed the labs. It was complementary to what the missionaries did. I mean, you'd find a Baptist hospital in one place and you'd find a Catholic hospital run by the white fathers in another place, and they were all coordinated with the government hospitals, the missionary hospitals, as well. So they worked together and shared resources occasionally when there was a need. Father Kelly, was one of the first White Father missionaries who first came to Ghana in 1918. They arrived when Ghana had only "Long Boat " off loading from ships as no harbors were built yet. These amazing priests pulled all of their possessions off a ship in Accra (then the Gold Coast). Then loaded them on "long Boats", and then landed on the beach at Labadi at the foot of Accra City. These missionaries then hired porters and carried all their belongings, up-country 500 miles, on their heads. Father Kelly found the poorest tribe living in/under the most wretched conditions imaginable in the northeast of Ghana. He made a whole new life for the people that he grew to love. Where does one get that kind of dedication? When I became acquainted with him after he had developed a written language for 'his' tribe and built any number of maternity hospitals. Father Kelly had a particular love for women and their childbirth sufferings. Whenever you went to see Father Kelly, you had to work basic construction with him as you talked. He wouldn't take a fridge for vaccine storage because he was afraid he'd be "tempted" to use it for himself. We were able to set up a mechanism whereby we could store vaccines and he couldn't be "tempted". So they set the structure up. And the British trained folks who were incredible. When you said, "We'll leave at 6:30 AM for village A, B, C, and D," at 6:30 they were there. Diallo: That's amazing. Newberry: And they knew they were going to stay all day. And no one was late. I mean, that's the legacy. They were very precise, very dependable, very comfortable to work with. I mean, they were so dedicated and committed. Diallo: Wow. That's good, that's really good. Can you talk a little bit about some of the problems of living in the villages and adapting to life in a new country? Newberry: Well, I'm left-handed, and you go up north and you can't hand anything to anybody left-handed. And you're not supposed to eat with your left hand, and so it's sort of like sitting on your hand and trying to work with your right hand. Understanding the culture and the taboos I think is really important. Of course, I was raised in sort of a primitive society as well, so I think I had an advantage over some of my colleagues. I learned over time what protocol really demanded. If I went to a village and it was very poor, hospitality has to be extended to you. But you know that if you ate, you're eating somebody else's food because somebody had to give up their food for you to eat. So I found out that no one could eat until I took 3 bites, and, of course, you ate with your hand. And I found out that if I took 5 bites total, then I didn't have to take any more food. My obligation is finished. So I take 3 bites, everybody can eat; I take 2 more, and I'm finished. So I think little practices like that you had to be tuned in to what was going on. You really had to look for these cultural nuances in order to be more effective. I think a lot of us in the West, we tend to look at Africans as primitive. Let me tell you, I sat in villages when a chief was presiding over a court. And it was the most remarkably precise, fair, and balanced proceeding I've ever witnessed. I could quote you several cases. I'm just telling you, believe it, it's a fact. And it was kind of a funny thing because there are mores attached to ordinary human conditions and problems that we don't even think about. For instance, we were in this village, and a chief was hearing an important case about someone violating fishing rights on a river. The water, food, and all the rest of this is very important, and owners' rights are very important. And so he was hearing witnesses. And then a madman, a Mahakachee, came in and approached the group. And no one paid attention to him until he crossed some invisible line-and I didn't know what it was-but when he crossed that line, everything stopped. And he came around, and he saw my skin and he touched it. I was used to that, so I didn't react at all. And then somebody had given him some food, so he was carrying that food because they couldn't let anybody starve. After all, this is a brother. He's not a social pariah just because he's mad. And so he wandered around and then, again, he crossed over this sort of invisible line, and the witness immediately started testifying and the whole proceeding picked up again. It was so remarkable to me. We tend to look down on folks who don't have the same culture and the same processes that we have, but it was absolutely remarkable, that experience. Diallo: How did your family like Africa? Newberry: Oh, the kids loved it. And I'd give them a task. I'd say, "Okay, the task is that I'm giving each of you 50 cents, and you have to buy your own food for the whole week." And everybody did it-everybody except my oldest son; he liked Coca-Cola or soft drinks too much, so he went over his limit because he bought soft drinks. Diallo: How old were they all then? Newberry: Well, the youngest, Phillip, was just getting ready for second grade. And then, the oldest was one third of the eighth-grade class. (We had 3 eighth-grade students at Lincoln Community High School then.) So our children ranged from first to eighth grade. And they loved it. They'd go to the field with me, and all the Africans loved it. I actually put my children to work when we'd go out to help mobilize a community. People would come to see the kids, and then we'd immunize the people when they came out, that sort of thing. And I actually put my oldest son in the field working with a team during summer vacation. Diallo: I bet they have great memories of that. Newberry: They did love Ghana. And then, we went back later for guinea worm eradication, and my youngest daughter sent her son with us so he could have that experience. So I took my grandson to Ghana later. Diallo: Wow, that's neat, that's really neat. How did participating in smallpox change your life and the course of your career? Newberry: I think it would be easier to phrase that question the other way, Melissa: how didn't it? Diallo: Okay. Newberry: It changed my life in every way that it could: professionally, personally, ethically, from a moral standpoint. I can't think of any part of my life that hasn't been touched by my initial African experience. And have I had some sad experiences? Yes. We experienced the death of people that we know and love both in our own family and outside. But the Africans, the people we lost in Africa, I think were real special, each in their own unique way. Their appreciation for life and death was just amazing. I once asked Frank Grant how Africans accept death. And he said, "Well, let me tell you. We have so many proverbs that cover everything that are our way of life, and our trust in God, is really much like that of the American Indian." And he told this story. "A man was in the forest one day, and he saw 2 snakes. One snake was consuming the other, and he took a stick and broke up the fight and stopped it. That night there was a knock on his hut, and he opened the door, and there's a man. He said, 'I am death, and I was being consumed today in this form of a snake that you saw. So, because you saved me, I will grant you any wish that you want.' The guy says, 'Well, I want to be warned before I'm going to die so I can live the way I want, but I can die the way I should.' So he went through life with no regard for other people. He was selfish and sought pleasure. And then one night, there's a knock on the door, and he opened it, and there's death, and he says, 'I've come to get you.' And the man says, 'Wait a minute. Our agreement was, because I'd saved your life, you were going to warn me.' And death said, 'I warned you with the death of your brothers, with the deaths of your mother and your father and your friends. Now I've come to get you.'" And that's such a poignant way to look at death, and every aspect of life itself. But I think the things that are more important to me were the hospitality and the acceptance that the Africans have. Some Westerners will say, "Well, basically they give you hospitality and greeting because they're going to get something back." That's not true; that's not true. They do it from the genuine openness of their heart. They'll give you their last bite of food. And is it because of protocol? No, it's not because of protocol. It's because that's the way they are. That is their standard. That is their upbringing.. And they taught me how little I know. The first African phrase I learned was to-ba-see-bro-nee, which means, "Take your time, white man." So they taught me there's a pace and a rhythm to life. They taught me what little I know, and the fact is that I need to know more. They taught me a sensitivity for culture and language. I did learn to speak Hausa subsequently in Nigeria. They taught me what family is all about. And I don't mean your immediate family, but global family. They taught me that when one person suffers, everyone accepts you can suffer. They taught me justice in terms of the courts and in terms of being tolerant about people; that you can't draw lines. Because somebody's bad doesn't mean that you ignore them. Some of the customs are so quaint, like if a husband and wife have a disagreement, they can hire an arbitrator. An arbitrator has a little stool, and they come to the house and they sit down on the stool, and while they're seated on that stool, they are arbitrators, they are marriage counselors, and they hear both sides of the disagreement. On sort of a macabre note, in one instance there was a couple who had the arbitrator in, and the wife became so angry at what the arbitrator said that she grabbed the stool and hit her and killed her with it. Diallo: Oh! Newberry: I mean, like I said, it's sort of a macabre thing. But the society and the culture are so rich in Africa that I think we Westerners have missed a lot of it even by being there, even by working with them, even by living with them, and in some instances even by learning the language. Because you can be bilingual, but you can't be bicultural. And certainly the richness of culture also changed my life. I also think road safety and common sense is a major factor. When I used to teach students, I'd say, "You're learning all these things about preserving your health and about avoiding disease organisms," and so on. "Will you get out of a car, will you stop a vehicle, if you're a passenger, and get out?" "Well, why?" "Well, if someone's driving unsafe or at a great speed, your life is in greater danger then than it is from these little organisms. Stop the vehicle and get the heck out." I know I'm rambling, but I'm just trying to look at your question in a holistic way. My oldest daughter married a second-generation missionary in Cameroon, and they went back and lived there, so their household language is Falani. They speak Falani at the household, and they're back here now. Diallo: Oh, and they still speak Falani? Newberry: Yes, they still speak Falani. So in all the ways that you can be affected by living and residing and learning about another culture, Africa had its impact on us. Diallo: What would you say was the biggest problem or challenge that you faced when you look back, specifically at smallpox and how the eradication program went? Newberry: That's a really good question. I think the biggest challenge was developing surveillance and response because we went out with the idea that we immunize people, protect against smallpox, and we would eliminate disease. But the strange thing was that we immunized 25 million, had a big celebration, and we still had smallpox. We gave out 50 million doses, we have even a bigger celebration, and we still have smallpox. Foege [William H. Foege] had figured out that we had to deal with the disease itself, so we needed to get our surveillance system moving, identify those exposed, and protect those individuals. And my colleagues and I, I don't think any of us could ever remember anyone who had been immunized, either early or late, even after onset of the disease, who had died. The biggest challenge, I think, was getting surveillance- and-response systems organized so that they really functioned where smallpox was being spread. I didn't get my surveillance reports, and so that's one thing we really kind of plugged into, getting surveillance workers. If you don't have surveillance, you can't respond. So I used the police telegraph because we didn't have any communication up to Gushiagu, which was well over 500 miles away on the Togo side of Ghana. And I hadn't received reports from the guys for about 6 months, and we were kind of concerned because that was an area where smallpox could occur, and we'd occasionally have smallpox on the other side of the border. So I sent up a Telex saying, "Give us your report." Well, I got back a report within a very short period that said they had 50 cases of smallpox. So I sent 2 teams, 2 vehicles in, and we trudged up there, and one bridge was out. We had to drive across the stream, and all this stuff. We got there about 4 o'clock in the afternoon, to this village called Gushiagu, and I said, "Okay, let's get in the field." Well, there was a lot of palaver, talk, talk, talk, talk. And I'm all anxious to go, and they're going talk, talk, talk, talk. And then, 'Let's go, let's go!" Talk, talk, talk. Finally they said, "We don't know how to tell you this, but when you sent the Telex requesting a surveillance report, he decided just to go and put anything down, so he thought, well, smallpox, about 50 cases would be a reasonable number. So we responded. And, of course, they were totally blown away by having 2 full vehicles with teams driving up there to help them with this outbreak. Diallo: They didn't think you'd come. Newberry: They didn't have a clue we would come. I think we didn't understand the traditional African culture, and we didn't appreciate it or use it very much. Everything looked to us like it had to be done a certain way. You couldn't hire your cousin or your brother because of nepotism; we tried to keep people honest according to our standards. And then we often had trouble with understanding their basic needs, how the African worked. So, like our payout teams would go out, and they always got a kickback. And so when we found out about that, it drove us crazy trying to stop it. But the real enemy was smallpox, and so it was real hard not to focus on smallpox. It was difficult not to get entangled in the personal and cultural and traditional kind of situation and instead really focus on the fact that everybody realized that the real enemy was smallpox. Let's keep that in our focus, our sights, and that's what we're going to fight. Diallo: In retrospect, since hindsight is 20/20, if you were the one who had been running the program overall, is there anything that you would have changed? Newberry: Yes. I think probably the Griggs and Jim Hicks [James W. Hicks] and Bill Foege, Mike Lane [J. Michael Lane], and Don Millar [J. Donald Millar], they all did a great job, there's no question about it. I think probably what I would have done differently, I would have assigned people long-term at strategic state-level assignments in-country. We did a little bit of that in Nigeria. Most recently, when eradicating polio from Nigeria, WHO, UNICEF [United Nations Children's Fund], and all these other high-flying groups would send somebody out for 2 or 3 weeks as an expert, tell you you're doing it wrong. During smallpox days, we didn't do that. We had key CDC personnel assigned to the epi units in northern states of Nigeria. And I lived up there, and that's how I learned the language. And what we did, is we used a holistic approach. We went to the emirs. Each emir has his own chancellor for health, his own government, his own courts, his own religious leaders, and so we went up as an extra pair of hands. And I always made a point to go, Melissa. You tell me where the toughest place to go to and get to is, and that's where I would go. I wouldn't care how tough it would be because that was the challenge. If I'm going to be there, then I want to show everybody that there's no place I won't go, there's nothing I won't do to get rid of this disease. So 6 years ago I wrote a plan for polio eradication, based on the institutional memory that I have from smallpox, and I gave it to some folks, and they said, "Oh, it's too expensive. We can't do that." And now we still have problems with polio in Nigeria. So that's what I would have done. I would have put more people in strategic places, living with, learning, and being a part of the local government, working with traditional leaders, whatever the structure is there, rather than to come fly in and then fly out again. That's probably the only change I would make, if it's a remarkably good, well-planned, and well-executed program with some superior people at all levels. Diallo: So, with everything that you learned from the smallpox campaign, you came back to the States and went on to work with guinea worm and polio. Were there any particular lessons that you learned from smallpox that you were then able to apply to those other 2 diseases? Newberry: Oh, many, many. I couldn't even begin to describe to you how valuable having that experience in smallpox was and being able to look at the logistics of the epidemiology, the use of information and data, that we applied in these other diseases. But for guinea worm, the major problem is trying to modify human behavior. With smallpox, that wasn't really the issue because if the chief says you'll be immunized and your family will be immunized, it happened. Well, in guinea worm, what I learned from my lessons with that, was that we got a little too fancy because all you need to eradicate guinea worm is a piece of cotton cloth, 120 batt, which is produced in every country in Africa. All the people have to do is pour their water through that before they drink it. Right? Simple. No. Diallo: Right. Newberry: You give me a glass of water and I pour it through my handkerchief before I drink it; it can't be done. So I did in a little experiment. I did training way up in the north, in Ghana. Well, you know the Housa tradition, their welcome is to ask, "How are you?" "How was your rest?" "How's your wife?" and "How are your children?" and so on like that. And so as part of my training, I used to add to "How are you?" "How was your rest?" "How's your wife?" "How are your children?" "Have you filtered your water today?" And I didn't tell anybody that we had done this; it was an experiment. And about a month, 6 weeks later, I sent a guy up just to see how the post-training reaction was, and he came back and he was blown away. He said, "They asked me how my wife was, how my children were, and they asked if I had filtered my water today." So, again, that's just one application that I found very useful. I think the other application I learned from smallpox is to look at the use of data. It's so important. With polio, we have an incredible ability to locate cases, and just collect specimens, determine whether this is polio or whether it's acute flaccid paralysis, and we can use that information because it tells where transmission of the virus is not being interrupted, and that's where we go. Again, the enemy is the poliovirus. We're going to eradicate it. We're going to kill that enemy. So I learned that through my smallpox experience. And I think one of the things that really, really distressed me then, and continues to distress me, was that we didn't leave a legacy. In every country that we went to work in for smallpox eradication, if they had a little, we took everything out. We didn't leave anything but an interest in immunization. And with the guinea worm program, we don't leave anything, maybe a few wells that'll last for a week or 10 days or whatever. You know, a year later, nobody uses it. So there's no legacy. But now, with polio, we've improved the global capacity and technical expertise of laboratories by 1,000%. It's unbelievable, the legacy we'll leave with those laboratories. The use of data then feeds into that because epidemiology is about learning the facts, it's about getting your lab confirmation so that you know what to do, when to do it, and where to do it. We also learned that, as far as the legacy, it should be complimentary. For instance, in India, we hold health fairs, so we're de-worming kids as well as addressing adult needs. We're looking at anemia, and we have these little health camps when we do immunization programs. And, again, it's kind of a holistic thing. I'd like to see this continue. So I think the idea of leaving a legacy is one of the things that we've been able to apply. Diallo: Oh, that's great; that's a good example. I know you're at CARE now and have worked with different organizations since this particular program with CDC. How do you see the differences in administration and so on? Newberry: Well, you know, Dave Sencer was a remarkable chief. I couldn't say enough good things about Dave Sencer. So if I were to look at some of the inherent difficulties with other organizations that I have and continue to work with, it's really a lack of leadership. Let me rephrase that. It's the difference in dynamic leadership. And we took some shortcuts at CDC. Our focus was on the eradication effort, and we didn't put a time line on it. When you put a time line-and in India we had a time line- then people look at missing it as a failure. It's not a failure. You missed a time line. So don't put a time line, like, you know, the time line from when the last person develops polio and passes the virus through his or her system. So I think that's probably one of the most important things that we can look at, the leadership we had, the support we had. I never made a request of headquarters that wasn't fulfilled immediately. I almost got jailed in Nigeria for stealing a boat because we had to immunize all the people living on the banks of the Volta Lake, and we didn't have a boat. So leadership and strong support, knowing that what we ask for that we could get. The organization, I think, with logistic focus, was tremendous and outstanding. I didn't see a lot of ego and turf problems; in fact, a lot of the normal barriers that are evident in a common effort, I didn't experience. Diallo: Dr. Sencer said I should ask you about negotiating your cook from Ghana to Nigeria. Is there a story behind that? Newberry: Well, we had the Ibos, and getting the Ibos in Nigeria to work for us in Ghana was a tremendous challenge. The Ghanaians thought people coming from Nigeria were taking jobs, and they were to a certain extent. But it took considerable intervention and effort going out to the highest levels of government to get that the Nigerian Ibos to come to Ghana with us. Then, when I went to Nigeria on a follow-up assignment, to close out the smallpox regional office, I took a Ghanaian, my driver-mechanic. I recruited him from Ghana, and I also had to go to the highest levels of government to get him approved. Diallo: You must have had good faith in your staff to go to those efforts. Newberry: I'd say it was allegiance, it was trust. We became like a family. Diallo: Well, that's good. Well, that's all the questions I have for you. But if there's anything else that you would like to add to go into posterity . . . Newberry: Well, we could talk all day about anecdotes. Like one time I had a Housa working for me who had been married 39 times. Diallo: Wow! Newberry: Thirty-nine times. And I would say, "Wow, this is really remarkable." I said, "How, answer me one thing. Have you married the same woman more than once?" And he said, "Oh, yeah." He was married to one woman, he said, 4 times, but not very many. There were about 3 or 4 women he'd been married to more than once. But this one woman, he was married to her about 4 times, and he couldn't live with her, couldn't live without her, couldn't live with her, couldn't live without her. Finally he learned to live without her. Many of the people we kept our relationship with long after. When I went back to Ghana for the guinea worm program, I recruited some of the same staff and the same superintendent, and they probably tell more anecdotes about me than I do about them. But, no. I think the lessons are humility on our part as we work in a program. I think the major task is teamwork and the recognition of who does the real work. It's the house-to-house work. It's getting in the communities, working with the community. And, unfortunately, CDC and most multilateral agencies are not connected at the household level. Take polio. That's one of the big problems. They're not connected at the household level. They come in with the experts at the upper, rarified air of the stratosphere, and that's not where it happens. It's got to be at the household level. And then you have to recognize that the enemy is the organism you're fighting; it's not people. When people tell me they're working in Nigeria and they're going to try to keep the Nigerians honest, well that's not our job. I mean, I love Nigeria; I really loved Nigeria. But I don't try to make them honest; I don't try to interfere with their culture, their tradition, and their practices. I always figured that you were successful in Nigeria when you only lose about 25% of your assets to theft and pilferage. Diallo: Wow, that's funny. Newberry: So, anyhow, Melissa, thank you so much. Diallo: Thank you very much. # # # </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310134984%3Fsecret_token%3Ds-fX2yR&amp;color=ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false" frameborder="no" scrolling="no" width="100%" height="166"></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 sound recording - nonmusical interviews Date A point or period of time associated with an event in the lifecycle of the resource 2006-07-13 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/158vn emory:158vn Subject The topic of the resource CDC Smallpox Eradication USAID WHO Operations Officer Format The file format, physical medium, or dimensions of the resource 502921104 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Diallo, Melissa McSwegin (Interviewer); Rollins School of Public Health; Graduate Student Newberry, David (Interviewee); CDC; Operations Officer Contributor An entity responsible for making contributions to the resource Reunion of West and Central Africa Smallpox workers (2006 : Atlanta, Georgia) Title A name given to the resource NEWBERRY, DAVID Description An account of the resource David Newberry was an Operations Officer assigned to Ghana. Dave speaks of moving his family of 7 to Ghana, his Ghananian colleagues, cultural experiences, and how it impacted his own life and the lives of his children. Dave identifies surveillance and response systems as the biggest challenge during his time in Ghana. Dave went on to work in guinea worm and polio eradication and offers comments on how leadership and support were crucial to the success of the smallpox eradication effort. Language A language of the resource English