7 12 306 https://www.globalhealthchronicles.org/files/original/a9f3467b7db2391364bee10ac5687a6d.jpg 12d6c00d1ea77ebb7d729b86916fc2ed https://www.globalhealthchronicles.org/files/original/fe408524bbac2714bd3af07fabbfb22d.pdf e2dc6b2f07dfdc5accb0f12094f47f38 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 Leo Morris about his activities in the West Africa Smallpox Eradication Program. His wife, Jane Morris, is also present. 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 choose public health as a career? Morris: It was a bit serendipitous. My background is statistics, and I was studying statistics at the University of Florida. Usually every summer, I went home to Miami to work, usually in the hotels, to get money to go back to school the next fall. But during my junior and senior year, I thought I'd better get some experience. The Public Health Service had a traineeship program for statisticians, and 1 other person and I were selected from the University of Florida. Our assignments were just random. He got assigned to the Department of Agriculture, which turned out to be pretty boring, he tells me; and I got assigned to the Tuberculosis Program, Public Health Service, before it was transferred to CDC. After that summer, they asked if I'd consider coming back after graduation. And I might add, in those days-'59, late '50s- a statistician, even one with just a bachelor's degree, was in great demand. There just weren't many around. And I said, "Well, you know, I'd like to stay closer to Florida," and they told me about CDC. The Serfling-Sherman Polio Immunization Surveys were being conducted then, so CDC was looking for statisticians. So they recommended me to CDC, and there I was. Chillag: And so, how did you get tracked into smallpox eradication? Morris: I started out in the Polio Surveillance Unit, when we had cases of polio in the United States. I worked in that unit for 3 years in the EIS [Epidemic Intelligence Service]. Then Dr. Langmuir [Alexander Langmuir] supported me for employee development, and I left and got my Ph.D. at Michigan, where our first child was born. (The first was born in Michigan where I got an MPH in biostatistics in biostatistics, the 2nd in Atlanta, and the 3rd in Brazil,.) Then I worked with D. A. Henderson [Donald A. Henderson], mostly on viral diseases in the Surveillance Section. The Investigations Unit was devoted to bacterial diseases back in those days, with Phil Brachman. I also worked a lot in reviewing material for the MMWR [Morbidity and Mortality Weekly Report]. That was '63. I worked on a big St. Louis encephalitis outbreak that year in Houston, Texas. In '65, I worked with Larry Altman. He became the first person to go to West Africa in the measles program in West Africa on a TDY [tour of duty]. We were getting involved in some smallpox work, and I was chosen to be part of it. We had a 5-person team in '65, including Don Millar [J. Donald Millar], who later became head of the Smallpox Unit at CDC, to evaluate the vaccine produced in Brazil. Basically, we were comparing the Wyeth freeze-dried vaccine with the freeze-dried vaccine produced in Brazil. We worked in the Amazon territory of Amapa, which is now a state. We were gone about 5 weeks. When we left here, it was winter. In fact, we had a snow storm, and that day we didn't know whether we were going to get to the airport or not. And there, of course, it was summertime and 100° in Rio de Janeiro before we went up to the Amazon. That was my first trip to Brazil. I did some polio work in Chile and Puerto Rico in 1960 and 1961. I really sort of fell in love with the culture in Brazil, and the people and so forth. That was '65. Then '66 was the start of the smallpox program, so I stood up with D. A. Henderson and others in the original group that started the Smallpox Eradication Program. I was in charge of the statistical end and evaluation. In '66, we trained the first group that went to West and Central Africa. I had interviewed many of the nonphysicians who had applied. Then the Pan American Health Organization (PAHO) came to CDC. At that time, Brazil was the only country with endemic smallpox in the Americas. There were some overflow cases into neighboring countries. It was variola minor, not variola major, so it didn't get the publicity of some areas. But PAHO, which is part of WHO [World Health Organization], said they were going to put advisors into Brazil. They had a newly created Smallpox Eradication Program, and they needed a statistician, an evaluation person. They had 3 physicians, 1 from Paraguay, 1 from Peru, who was the team leader, and 1 from Colombia. So I was asked if I might want to go to Brazil. I said, "Where do I sign up?" I was very eager for that. In February of '67, we left for Brazil. And that's how I got to Brazil. I was there 3 years as advisor to the Smallpox Eradication Program after I had participated in sending the first trained group over to West Africa. Chillag: And, Mrs., Morris, how did you feel about that? Mrs. Morris: I loved it. When Leo asked me, "What do you think about going to Brazil?" I said, "When?" Morris: We both learned how to samba. Chillag: Yeah, there you go. So, you mentioned that before the actual smallpox eradication, you did the trial between the 2 vaccines, correct? Morris: In '65. Chillag: In '65. And then, after that, was there a typical day for you as a statistician working on this in Brazil? Morris: Well, we had several primary objectives. I spoke Spanish reasonably well, but I took some Portuguese courses so I could forget my Spanish because it's hard to combine the 2 languages. The director of the program in Brazil was a man named Silva. He had recently retired from being the head of malaria control in all of the Americas at PAHO in Washington and returned back to Brazil. Because of his vast experience, they talked him into taking over this new Smallpox Eradication Program. He was the only one in the office who spoke English. Now if you went up to the Ministry of Health in Brazil, a good percentage of the people spoke English. But he was the only one who spoke it in this office back then in 1967. So on my first day there, we conversed in English, about the surveillance we needed, reporting, and so forth, and then he said to me, "This is the last day I'm going to speak to you in English," and he never spoke to me in English again. So in that environment, it was easy to really improve my Portuguese. We had 3 primary objectives. First was to develop a reporting system, which they didn't have. There were 22 states at that time, and I think only 6 or 7 were reporting cases of smallpox . Sao Paulo, the biggest state, with the most cases, never reported. Starting a surveillance report based on the reporting was the 2nd goal. And the 3rd was to start thinking about evaluation. I had worked on the system that they were going to use in West Africa for evaluating the vaccination program. We wanted to extend it to Brazil, although in Brazil we could be a little more sophisticated because they had better census data to use as a sampling frame. Chillag: When you talk about evaluation of vaccination, what all does that entail? Morris: Two primary things. One would be a sample of villages or towns, sometimes big cities in Brazil, to look at 2 things: 1) asking everybody in the sample households if they had been vaccinated in the campaign; and 2) checking everybody </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/310131763%3Fsecret_token%3Ds-OergU&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 sound recording - nonmusical interviews Date A point or period of time associated with an event in the lifecycle of the resource 2006-01-13 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/158th emory:158th Subject The topic of the resource Smallpox Eradication USAID WHO CDC Surveillance Format The file format, physical medium, or dimensions of the resource 574078512 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Chillag, Kata (Interviewer); CDC; Anthropologist Morris, Leo (Interviewee); CDC; Statistician/Surveillance 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) Centers for Disease Control Title A name given to the resource MORRIS, LEO AND JANE Description An account of the resource Leo Morris describes the smallpox program in Brazil and the eradication of the disease. Jane Morris relates some of the challenges of life abroad. Leo, was already employed with CDC, and helped interview and train the initial group that went to West Africa. He served as a statistician for the Smallpox Eradication Program in Brazil, which was the only endemic area for smallpox in the Americas. Leo helped develop a smallpox reporting system and surveillance, as well as an evaluation program for the smallpox vaccination campaign. After his time in Brazil, Leo continued his work with surveys and evaluation techniques in the area of reproductive health. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/c0e9e0e50be5cbaed70d73c2e712fcda.jpg 2b5d3c2fab535c5de4db7a737df904af https://www.globalhealthchronicles.org/files/original/6c8301345e9e95c987ef3effc9d5eec3.pdf 60556767adac34a43a4ac18eb01fa7f2 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 Dr. Donald Moore on July 14, 2006, at the Centers for Disease Control and Prevention in Atlanta, Georgia, about his experience and involvement with the West African Smallpox Eradication Project. The interview is being conducted as a part of a reunion marking the 40th anniversary of the launch of the program. The interviewer's name is Diane Drew. Drew: Welcome to Atlanta, and I hope you have a good visit. Could you start by telling me where you're from, your background and education, and anything that strikes you? Moore: Okay. I was born in El Centro, California. I came to San Diego in 1942, was raised there, on the beach actually, in Pacific Beach. I did a lot of surfing, spear fishing, swimming, and water sports. I went to Mission Bay High School and attended the University of California at Berkeley, graduating in zoology. I was briefly employed by the State of California Department of Fish and Game as a research biologist and then was accepted to medical school. I completed medical school at L.A. County, at USC Medical School, and then did my internship at San Diego County, UCSD Hospital. After I completed an internship, I entered the US Public Health Service as an EIS [Epidemic Intelligence Service] Officer, but not exactly, because I was entering the smallpox and measles program. I was married then and had 2 children. We moved to Atlanta and lived in North Decatur while I was training for this position. I was advised that I would need to speak French on entering the country, and so as soon as I found out that I was likely to go to a francophone country, I started learning French, even before I had finished my internship. Drew: Could we back up for just a second, because I'm interested in how you happened to decide to go into medicine? Was there anything that particularly influenced that choice? Moore: I had been interested in clinical work early on. Sort of in the back of my mind, I was interested in medicine and surgery. Drew: It sounds like you must have found out about this program while you were an intern, if you had started to learn French. Moore: Yes. While I was at the University of California, in Berkeley, I was accepted into the dental program at UC-San Francisco and into the veterinary program at UC-Davis, and I just kept thinking that I may as well become a doctor, so I just proceeded along that path. I had an opportunity to take over a family business in electronics or stay in research biology with the Department of Fish and Game. The Department of Fish and Wildlife, the federal government, also actually offered me a job. But I decided the best thing to do would be to go to medical school, so that's what I did. Drew: So you started picking up French and then came to Atlanta at some point with a family already. Your wife and a couple of kids? Moore: Yes. I wouldn't say that I was particularly facile at learning languages, but I did know Spanish from working at L.A. County. One had to speak Spanish. So French was not that difficult to learn. As I said, we lived in North Decatur, in what seemed to be rehabilitated military housing of some sort. The training period started in July 1966. It was supposed to be 3 months long in immersion French and a lot of epidemiology and infectious disease background training. Living in North Decatur was fun. The kids picked up southern accents. Drew: How old were they then? Like little toddlers? Moore: Toddlers, yes. I guess one was 5, and one was 2. They enjoyed running around with the other kids in this project we lived in. The kids would run as a herd from house to house, so it was a wonderful place for children. We always felt safe because it was an enclosed project. And it was nice to come to Georgia and get a feel for a different area of the United States. I'd always been a Southern California sort of beach boy before, and I guess returned to it. We were scheduled to go over to Niger in the fall, around October. However, the bilateral agreements had not been signed, so we were delayed another 3 months. We arrived in December in Niger. It was very hot. When we first came, it was a strange place to adapt to, but we had read books on Africa, books on Niger, so we knew what to expect. Drew: And your wife and children went? Moore: My wife and children. My wife was totally prepared to do it, and she loved Africa too, and took good care of myself and the children. I remember that we had to wash all of our vegetables in iodinated water. We took Aralin twice a week to prevent malaria. Interestingly enough, I had been told a scare story that the female secretary for the embassy had been shipped home in a lead casket only about 10 days before because she refused to take her cloraquin. We did not want to make that mistake. Drew: That's interesting. I do remember hearing that a person wouldn't take her cloraquin, but I also heard about somebody who wound up with hepatitis. I guess there were really a lot of health risks. Moore: Oh, there were many diseases that one could contract there, a lot of them parasitic diseases. We were always concerned about that. Schistosomiasis could be contracted in the Niger River; malaria was everywhere; onchocerciasis was around, schistosomiasis was just recently controlled but still around. So there were many health dangers over there. Drew: That must have been particularly challenging with children in terms of keeping them healthy and safe. Moore: It was. But they seemed to do very well. They adapted to the French schools nicely. It was a little different because my son was used to a little more freedom. The French were very disciplined and kind of rigid in teaching. One time I recall that my son was doing something, probably misbehaving, and the teacher slapped him, and we were up in arms. Then we had to just think back and consider where we were and what the cultural aspects of being in that situation were. We complained, but we did not make a big deal out of it. One always had to be careful of cultural interactions that could result in adverse consequences. We lived in a very nice home there, as the homes go. It was on about an acre and had a fence around it and had a nice patio and deck, where we held many parties, inviting people from the embassy and the Peace Corps. The program itself got under way quite nicely, I thought. We were shipped 7 trucks, which arrived in the port, Cotonou at Dahomey, and we went down there and picked these trucks up with drivers. Drew: Were these the infamous Dodge trucks? Moore: Dodge trucks, yes, extended-cab trucks. Tony Masso [Anthony R. Masso], a very competent individual and a wonderfully gregarious and nice person, was my Operation Officer. He and I went down to this port to drive these trucks back up with other drivers. Dahomey was a very interesting place. I had read a little bit about it. But at the time, we were quite young and just over from the United States. It was a little shocking, driving up along the road, to see bare-breasted women. I think that Tony, who was younger than I, and not clinically used to seeing nude females, was pretty impressed with these beautiful women. And the roads were red clay, which got all over the trucks. Some goats ran across the road, and, unfortunately, we hit 1 or 2. But we heeded advice not to stop because in the outer villages you could be attacked if that happened. You couldn't explain why you had hit the goat. So we didn't stop. But later, the villagers were compensated for those goats, I believe, by our embassy. Drew: And this was at the very beginning? Moore: It wasn't at the very beginning because we moved into an office at the building facility called the Service des Grandes Endemies (SGE), which was also called the Trypano [phonetic]. The government of Niger furnished us with a nice office there. Niger was a French colony before it was granted independence, but the French still were involved in the infrastructure of Niger. And one of those places was the health service. Their director was French, Dr. Shamrun [phonetic]; he was very nice, very cooperative, and very intelligent. I understand that in some areas, the Medical Officers had difficulty with the French counterparts because they looked at them as competitive, but we did not at all. Dr. Shamrun [phonetic] cooperated fully, and the Minister of Health did everything he could to help us. So it wasn't difficult to organize the vaccinating teams, 7 of them. We also got a big map of Niger and all the erandisements [sp.] that we had to vaccinate. Drew: Was that like a French overlay on the local system? Because I associate that terminology with Paris. Moore: Yes. The country is organized along the French lines of geography and names. I can't quite remember the name they used for the larger sections. But, in any case, we formulated a plan of vaccination and trained the teams with a vaccinating gun, and it seemed to work out quite well. We had leaders in the teams who were quite good, and they were well motivated. And for our program, it worked well. In an organized fashion, we were able to vaccinate the entire country. Drew: Was your program coupled with measles control as well? Moore: Yes. This brings another point. One of the difficulties we had was that the measles vaccine needed to be refrigerated. We really didn't have any method to do that. We had ice chests, which we could periodically keep the measles vaccine in. And, of course, in Dahomey, that was no problem because we could have the vaccine refrigerated. But when we went out in the field, we had to keep the measles vaccine cool, which was somewhat difficult. But I do remember an incident when we traveled to Agadez. And this is always with me. It was a sad occurrence. We were vaccinating all over the country. My Operations Officer, myself, and a vaccination team went up to Agadez because we'd heard that they were having a measles epidemic there, and, sure enough, they were. But when we arrived, we asked, "Where is the chef de village?" and we were told, "Well, he's over there." And we went over there, and "over there" happened to be a cemetery for the children who had died from measles. There were, as I recall, about 30 or 40 graves, maybe more, and the people were sitting around them mourning. And, of course, we came and said, "We're the measles-smallpox vaccination team," and they said, "Well, doctor, I wish you could have been here about a month earlier." Drew: Wow! Moore: We felt badly because we had moved as quickly as we could and did everything. Of course, we vaccinated everybody for smallpox and measles. But it was sort of like closing the barn door after the horse escaped. I never forgot that. So from that time on, we tried to be as expeditious as we could getting the vaccine out to the rural parts of the country, which was difficult. Drew: I'm sure a part of that too, must have been how you would get information from rural areas about measles occurrence. Moore: Yes. We got this information usually by telephone or telegraph. A lot of peculiar things happened. Tony Masso was with me on a trip to Zinder, and then, from Zinder to N'guigmi, which was called au fin du monde, the end of the earth. It was near Lake Chad. And it was really primitive. But it was interesting. We had to fly out there in a small plane flown by the French. When we took off, the door fell off of the aircraft. And we're sitting there with open air right beside us, and they said, "No problem. We'll land and put it back on." So they landed the plane, put the door back on, and we got back in. But I noticed that my Operation Officer turned white. And I said, "It'll be okay. These guys, they know what they're doing." So then we took off, and we're flying near Lake Chad, and they kept changing course. I asked them, "Do you know where we are?" and they said, "Well, we're a little bit lost right now." And so we were lost over the Sahara Desert. But, finally, they did find the airfield and landed. Drew: And Tony was already pretty pale. He probably got paler after that. Moore: He didn't like that flight at all. I don't know whether he recalls it or not. On the return flight the French pilot permitted his student to land the plane-which was a very rough landing and the plane almost skidded off the runway. I quietly asked the French pilot how many landings his student had made; he replied, "That was the first one". But, anyway, then we went out with the teams. They had already proceeded to that area by road. Drew: This was the au fin du monde. Moore: Yes. This was N'guigmi, near Lake Chad. We were vaccinating up there and just observing how teams were working. And I remember a harmaton came up there and blew our tent down. We were camping out. Drew: What came up? . Moore: A harmaton. Drew: Is that a weather phenomenon? Moore: It's a big wind that comes in Africa. It's like a hurricane on the sand, a huge wind that comes up with a big sandstorm. It's a sandstorm, basically. And it comes up suddenly. You can see it coming for miles away because it forms a huge wall of sand in the air. Drew: And it's moving toward you? Moore: And it's moving towards you. Drew: So you know to make preparations. Moore: That's why camels have these great eyes and eyelashes, which can close and keep the sand out. So we had that to deal with this sandstorm. I remember we were making some rice, in the same camp area, and a plague of small grasshoppers or small locusts came, just clouds of them came. There was no way to keep them out of the tent or an open- air area. We lifted the lid on the rice to see if it was done, and several of these grasshoppers flew in. And that boiled rice was the only thing we had to eat. So either Tony or I said, "Well, open the lid and quickly get the grasshoppers out." But when we opened the lid, before we could get the grasshoppers out, more flew in. So then we decided, well, we'll just eat the grasshoppers. And so that's what we did. Drew: It would be a little like having water chestnuts in your rice. Moore: One time I went out to look at teams, somewhere east of Niamey. It may have been around Zambia. I traveled out there and I visited these Peace Corpsmen, and they invited me to stay in their house, and so I did. They had an outhouse. So I went to use it. It was all dark inside the outhouse because it was all enclosed, no light really. I sat down, and I heard some strange scratching on the wood planks around there. I was wondering what it was. Drew: Is this daylight? Moore: It's daylight, but the outhouse is dark. So I finished and I opened the door, and the light came in then, and I started looking around, and there were these big scorpions everywhere-on the corners, underneath where the planks were, where the toilets were. They didn't seem to bother the people using the outhouse. They just were scary. It upset me. I said, "If one of those bites you on the rear end, or stings you, it can be pretty painful." It also seemed a little bit unaccommodating, unfriendly, to the people trying to use the outhouse. So I said to the woman from the Peace Corps, "Why don't you take some spray, Raid, and spray that outhouse out there and get rid of those scorpions?" and she said, "Well, we did that, and the scorpions didn't die, they just came into our house here, so we don't do that anymore." But you live and you learn. I remember a lot of cultural things too. Usually the village chef invited us to eat. Once they were passing around this bowl of camel's milk and millet mixed together. It was a common bowl. So we were sitting there, and the bowl came around. The entire rim of the bowl was covered with flies. I was a little concerned because it was a pretty communal thing; we were drinking with about 10 Africans at a time. To drink it, you had to clear a space to put your mouth and clear out the flies to drink the camel's milk, but you couldn't refuse. So, of course, I drank it. Things like that went on-you had to make accommodations to the culture. Drew: And hope for the best. Moore: And hope for the best. Drew: How long were you in Niger? Moore: I was there 18 months. I was an active commissioned officer for 2 years, but I was there for 18 months in Niger. But in that 18 months' time, we did get the initial vaccination done. When I left, another Medical Officer came; I think Dr. Logan Root was his name. Tony Masso, my Operations Officer, a really excellent facilitator, stayed there another year or maybe a year and a half. I was very happy with the program. We had trouble sometimes with the trucks. Initially, there was a problem because our trucks were supposed to be taken care of by the Vinel Corporation, a contract corporation that took care of government vehicles running overseas. However, in Niger, we found that these people just were not the kind of people we wanted to work with because they didn't take care of the trucks and they used our parts for other vehicles. And so Tony said, "This isn't working." And he said, "I would opt to take our trucks back, keep them here in the Service des Grandes Endemies yard, and take care of them ourselves. We can take our parts back and put them in a garage." And I said, "Well, go ahead and do it." We went to the Ambassador and said, "We just have to have control over our equipment." And so he said, "Yes, go ahead," and we did. I think that, if we had not done that, the program would have had a lot more trouble. Drew: It sounds like a lot of other programs, either officially or by default, may have taken care of their own vehicles, too, because I keep hearing a common thread among a lot of folks in the program that they learned how to do maintenance. Moore: Well, some were blessed with excellent mechanics. The Operations Officer in Mali was Jay Friedman [Jay S. Friedman], who was a very competent mechanic before he came into the program. Drew: Yes, I interviewed Jay yesterday, and he was telling me that he can't deal with modern cars, but he knows old-fashioned cars, and I guess he got so he really knew how to deal with the trucks. Moore: So I think that was a real plus in the program. And we were actually blessed with having mechanics among the drivers. You know, they were very good mechanics and could take care of the trucks just fine if they had access to the parts, which we obtained. So that helped the program a lot. I remember coming back from Agadez-Tony was driving-and this horse ran in front of us. It was sundown, dusk. Tony swerved to miss the horse. I still remember the horse; it was big and brown. The truck rolled completely over, and the top of the truck got smashed and the windshield broke completely out. And we were upside-down in the truck. Drew: This was before seatbelts and everything, wasn't it? Moore: You know, I believe it was. I don't think we had seatbelts, no, because I actually sprained my neck a little bit. Actually, we had been told previously that if an animal runs across in front of you, don't swerve off the roads because there are no shoulders in Africa, and you will hit sand and you can roll a truck. But it just happened so suddenly. And, of course, he was trying to not strike this horse. Drew: Well, and I'm sure hitting a horse is a little more formidable than hitting, say, a chicken or a pig or something. Moore: So maybe that was justified, swerving at that time. But I knew one thing. I knew that if we didn't get the truck turned back over quickly, the oil would drain out, and then we wouldn't be able to drive the truck, and if driven, the engine would be ruined. So we quickly assembled the villagers there, who were happy to turn the truck back upright for us, and we drove back to Niamey without a windshield. At that time, it was cold there. It was a pretty cool trip back, but we did make it. That was the only serious accident that we had there. Lots of times we would have to send money or get money sent because the teams would be out of gas. But all in all, it was really a good time. It was fun working there because we connected, we had social interactions, with the Nigerians, the French. And there were people of other nationalities traveling through all the time, Europeans. Niamey was sort of a hub in Africa for people who were traveling from the southern part of Africa up to North Africa and on to Europe. I met many people in the Peace Corps. The Peace Corps doctor stationed there was interested in psychology-psychiatry; he was a psychiatrist, basically. And I was more of a clinician. So I took care of lot of Peace Corpsmen clinically there. Once I had to make a decision about whether this woman in the Peace Corps had appendicitis or not, and decide whether to evacuate her from the country, which would have cost about $20,000. Finally I decided she didn't, and we didn't evacuate her, and she survived. But it was pretty primitive. On the other hand, there were parties. There wasn't any television, so people had each other. So, for entertainment, they had many parties. Sometimes there'd only be a sack of peanuts and some beer. Sometimes the parties were fancier. It was relatively inexpensive to give a party there. The food wasn't that expensive, and, of course, there was plenty of inexpensive help. And the Peace Corpsmen, coming out of the bush, were always happy to come to a party and do some dancing and meet other Peace Corpsmen. Drew: Were they living in more austere circumstances? Moore: They were living in very austere circumstances. They had to because they had to identify with the people very closely in order to do their work. But it was a time of heavy idealism. They were really motivated, idealistic young people, and the Nigerians loved them. The programs were fantastic there. They had well-digging programs and all these different things that they were doing. And it was a time, of course, of Bobby Kennedy; it was John Kennedy's program, and so these were all idealistic, liberal kids, and we loved working with them too. The Nigerians that we worked with were wonderful people, too. Many of the team leaders, although not educated, were highly intelligent so it was easy to teach them these different methods of vaccination and organization of supplies and equipment and recording of data. They did pretty much everything we asked them, but sometimes it was a little cruder than we wanted. Some of the data that we collected were not exactly as accurate as we wanted. But all in all, I think that they did a wonderful job. Drew: My sense is, too, that a really key part of a person's working in that kind of program would be knowing how to compromise and when to compromise. You had to know where you had to maintain some standards and where you could be more adaptive. Moore: That's true. We had to work with the government officials pretty closely, especially the village chiefs. The chef de village is kind of like a mayor here. And I learned early on that if you were going to make a trip to their village, the chiefs needed to be notified in advance because part of the respect of the people and their role as chief was to make a visible welcoming of any important visitors. They needed to be notified so they could prepare a welcome that was appropriate for their office. Drew: So, if you were to show up without them knowing ahead of time, it would almost be viewed as an insult or disrespect. Moore: That would be viewed as gauche. And if it wasn't done, they were very nice, of course, and they wouldn't say anything. But this is something that one always had to be cognizant of, notifying them so they could make the appropriate and respectful preparations for visiting dignitaries or persons that were official. So we tried to do that. As I recall, we had the only active cases of smallpox in West Africa at that time, except in northern Nigeria, where they had a few. But ours was a major place that smallpox was still extant in Africa. So we felt that we could play an important role in eradicating smallpox in that we were vaccinating in a place where it was still active. And I've always felt good about that. Drew: Did you come back to Atlanta afterwards? Moore: I came back through Atlanta briefly. Drew: Did you do any additional tours in Africa? Moore: No. I did 2 additional tours with the Ready Reserve of the Public Health Service. One tour was for 2 weeks in Fort Indian Gap, taking care of Cuban or Haitian political refugees fleeing Papa Doc Duvalier. And I did another 2-week tour in the Yakima Valley, Washington, taking care of farm workers. But I love the Public Health Service. I have great respect for the organization. I very nearly chucked my plans to go into a surgical subspecialty and almost decided to stay in the Public Health Service, to go back and get a Ph.D. in epidemiology, and work in that area for the Public Health Service. It would have been a very interesting and viable alternative. So I have great fondness for the Public Health Service. Through the years, I've followed what they do, read about CDC in the paper or in articles, and I still go back to them for information on infectious diseases and different problems. Drew: So when you finished your tour in Niger, you came back to CDC or . . . Moore: I came back and started a residency. Drew: Here in Atlanta? Moore: At Los Angeles General Hospital. Drew: General surgery? Moore: I did the general surgery year of the neurosurgery program and started the second year, but then I decided to change to obstetrics and gynecology. In fact, when I came back, I was accepted in the program of ob-gyn at the University of Washington and neurosurgery at USC. But I started the neurosurgery program at USC and then changed to obstetrics and gynecology just because I liked it better. Drew: Neurosurgery can be pretty grim. As a nurse, I have worked for neurosurgeons; it's a different field. Moore: Well, you know, it's technical, and you have to be happy with partial results. But at L.A. County, I had done quite a bit of OB as a student, and I just liked the action and the idea of taking care of 2 persons. It's always exciting and vital. You're dealing more in the young end of life. So it was something that attracted me. But I could have done either neurosurg or general surg as well, and, alternatively, I always liked epidemiology too. At the time I made the decision, I wanted to do more clinical training. I'd always imagined myself as a clinician when I was a doctor, and so I did do that. But, as I say, retrospectively, I don't know whether it may have been better to stay with the Public Health Service and go into epidemiology. I think I could have been happy, but I may have always regretted not doing the clinical work. Drew: Don't you think there are always those kinds of junctures in life where you think, well, what if I had done this instead of that? Moore: They're difficult decisions to make, true. I'm training residents now at the Navy Hospital, in ob-gyn. We have rotating through our service some internal medicine residents from private hospitals who just want to get some experience in gyn. And if they talk to me about their careers or they're undecided about what to do, I never fail to mention the Public Health Service and epidemiology as a career, and how it isn't what you might think it is, that the science of epidemiology can be applied to so many different problems. I just try to give people who are coming through our service an idea that there's more to medicine than just being a clinician. Dave Sencer [David J. Sencer] asked us to list 3 things that we got out of the program in West Africa. I don't know about 3 things, but I can tell you one thing that I got for sure, and that is that one man, or a team of a couple of men, with the backing of a strong government, like the United States, with the Public Health Service behind them, can make a fantastic impact on a large population of people. A country can make a major world health impact. And that's something that you can't really do as a clinician working one-on-one. You can, but you do it singly, and you have to have lots of clinicians doing similar things, if you're trying to make an impact. It isn't quite the same as if you're organizing a broad program to affect world health. So I think that if somebody wants the satisfaction of doing something that will really impact people's well-being, there could be few better choices than working in epidemiology and the public health sector. Drew: Not too many careers, either, where people can really truly say that they have that firsthand experience of having a positive impact on a large number of people in terms of things like longevity and quality of life. Moore: There aren't. And this Public Health Service facility has made a great impact on the well-being of people throughout the world. I think, overall, if you look at the 2 areas of clinical medicine and public health service, it's really public health service that makes the maximal positive change, for the most people. It drifts down. You know, their recommendations and their advice on what should be done to improve health do come down to the clinician, who does it on a more limited basis. But the initiative comes really from broad programs, at least in terms of a major improvement in people's life. Drew: We're kind of at a point where we probably should think about wrapping up, so I want to be sure and give you a chance, if there's other things you'd like to talk about... Moore: Well, I was trying to think of any little incidents there. I know my daughter- Drew: Are your children French speakers? Did they pick up French? Moore: My son speaks some French. My daughter was too young. My son also speaks Indonesian, Dutch, and some Spanish. But he works a lot overseas now. Talking about getting involved with a culture, I can remember my daughter, when she was just 2 or 3 years old, going out to where the guardians sat in the morning. They would have this really sweet tea. They offered her a cup of tea, and so she copied them, sitting cross-legged right down on their rug on the sand, drinking this tea that they were giving her. And I thought, how neat that she could have that experience. There were a lot of cultural interactions like that that I really enjoyed. Drew: Those things enrich a person's life so much. Moore: They do. It was really an enriching program in terms of my life and, looking back, really an important part of my life. Drew: Well, I really appreciate everything you've had to say. Is there anything you want to add? Moore: Only that I really appreciate what everyone in this smallpox program has done to preserve the memories of it, the archives and all the things done by the people working with CDC to be sure that the program is remembered, because I think that's important. Drew: Well, it's a pretty unique program and really had a pretty amazing effect, I think, on a global level. Moore: I think so. Drew: Thank you. Thanks for your work and thanks for the interview. # # # </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310130821&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 text 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:/25593/158sc emory:158sc Subject The topic of the resource CDC Smallpox Eradication Program USAID WHO Epidemiologist Format The file format, physical medium, or dimensions of the resource 578415600 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Drew, Diane (Interviewer); CDC; Nurse Moore, Donald (Interviewee); CDC; Epidemiologist 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 MOORE, DON Description An account of the resource Dr. Donald Moore, was an epidemiologist stationed in Niger. Don speaks about moving to Niger with his wife and 2 small children, the French colonial legacy of the health infrastructure, the challenging logistics of delivering vaccinations, working with the Dodge trucks and with local customs, and muses about a hypothetical alternate career with the Public Health Service and further studies in Epidemiology. Don went on to complete his residency in obstetrics and continues to practice as a clinician. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/a661fea7dee214a20ea9e7271f5ef133.jpg 7cde4355f210715732bf6ac981f302e1 https://www.globalhealthchronicles.org/files/original/e327786249e1e9de0297f0448fc8d2fc.pdf 9319854875dbb7a21d3da048a4012eab 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 Anthony R. Masso 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 is Kata Chillag. Chillag: So, what we want to hear is any stories. We have a series of issues we'll want to cover, but it's a bit loose. So, the first is, how did you come to public health as a career? Masso: I was in the Peace Corps for several years before joining the Smallpox Eradication Program. I saw a piece in the Bulletin that CDC [Centers for Disease Control] and the World Health Organization (WHO) were about to launch a smallpox eradication- measles control program in Africa. I was interested in continuing my international experience, learning another language, and doing something good. So I decided to send in an application. I also thought it was a good thing to do in the '60s instead of going to Vietnam. After my application went in, I was interviewed by D. A. Henderson [Donald A. Henderson], the WHO Director at that time. We met in Washington, DC, in a bar, and over a couple of beers he said, "Hey, listen, you're great for the program. Come and join us," and that was it. Chillag: Where had you been in the Peace Corps? Masso: In Latin America. So it was a completely different experience to go from Panama in Latin America to Africa. Chillag : And where were you in Africa? Masso: Niger. Chillag : And so, what was your role in the smallpox program? Masso: My role was to be the operations officer along with a medical officer, Don Moore [Donald J. Moore]. Together, we formed the team of about 16 West African health workers, all male. The West African health workers, the nurses, were men; no women. It was a Muslim country. I'm sure that's the reason. And with about 25 trucks, our job was to go throughout the entire country and make sure everyone got vaccinated and to contain any outbreak that we saw. Chillag : What were your expectations of the work? Masso: Well, there was no real expectation other than knowing that it was hard work and that the conditions would not be good. I had lived in the United States, a privileged citizen with all the modern conveniences. And even as a Peace Corps volunteer, although there were no real conveniences, Panama had a lush environment, with greenery and the ocean. To go to a desert country, Niger, the size of Texas and California combined, with a hundred miles of paved road in the entire country and virtually all desert and mountain, and to see people live at the edge of existence was quite a different experience completely. There was no way to prepare for that. Our training was mostly to learn French and to study epidemiology, but it didn't prepare us for the life in that country. Chillag : And what were you most prepared for? You mentioned the sort of people living at the edge of existence. Masso: Well, we were prepared to do the work. We knew what we were there for, so from a technical point of view, we knew how to operate the equipment, how to maintain the vaccines, how to map out each town we were going to for vaccination. I remember one of my first impressions was seeing people living as they did 2,000 years ago, during the time of the Bible. You saw people literally with no more than one little clay pot and a little fire and a few seeds. and certainly no meat or anything-there are no conveniences at all-moving from place to place on the back of a donkey. I mean, it was exactly the way the world was 2,000 years ago. And many parts of that country are like that today. So there's very, very little progress. The country is exceptionally poor, large and vast, no real resources, no real agriculture. There's almost no rainfall. I remember many times I'd say to myself, people shouldn't be living in places like this. Not very hospitable. But our job was to contain the disease and wipe it out over a period of a couple of years, which we did, of course. Chillag : What were your specific living conditions? Masso: Our personal living conditions were good because we were attached to the American Embassy, and they gave us a small ranch- style house with a couple of bedrooms and a kitchen. We had air- conditioning, we had nice furniture, which was brought in just for the smallpox program. We had a car for our family as well as a truck that we would use for our work. We had servants, a houseboy. That was the norm. So the living conditions weren't bad at all. We were all young, and we didn't care that much to have super luxury. Chillag : And you traveled around the country. Masso: We traveled around the entire country. We worked so hard. We would try to schedule the trips to go to look at certain villages to see if smallpox was still rampant. Don and I would try to schedule a trip on a Thursday or toward the end of the week so we could travel and do the work outside the capital city on the weekend, on Saturday and Sunday, then come back during the beginning of the week to do anything we needed to do back at the health ministry. It was an arduous type activity because we'd be out for sometimes days at a time, and on big long trips, sometimes a couple of weeks at a time away from home, with no communications, no cell phones, no faxes, no telephones. When we were gone, we were really gone. Chillag : And you were there with your wife too. Masso: I was there with my wife. She was pregnant when we arrived. We had 2 children born to us while we were in Africa, which was a little bit unusual, although not too unusual. There were several people who had children there. And it was because we were young and we had both been in the Peace Corps that we were able to endure the conditions. But even others who hadn't had a prior international experience did fine. Being young and well motivated, I think I always rolled with the punches. Chillag : You had to work, I'm sure, with lots of local partners. What was that like? Masso: Well, the work with local partners was mostly frustrating because what you expect in a counterpart in a country like that is different from what reality is. Their motivation, especially at the higher echelons, was how to do the minimal amount of work and take a lot of credit, and they just didn't have the drive that we did. We were very focused on what we had to get done. Now, on the local level, with the people who worked "under us," who were the health nurses, it was completely different. I mean, we'd get up at a 4:30 AM, 5 o'clock in the morning and we were off. We would travel all day long, 12 or 14 hours, to get to a location. We'd work all night setting up camp. These people, the vaccination teams, would go out in the worst of conditions to perform the vaccinations. So they would work very hard and very long with meager pay and meager food available to them. But at the Ministry of Health, where the bureaucrats were, it was completely the opposite. They just saw this as a free ticket for them. Chillag : Was there general receptivity at a government level to the program as a whole? Masso: Yes, there was. These countries really are developing or Third World countries, and they knew that the United States was coming in with lots of equipment, lots of money, talented Americans, to "give them something" that they wanted and needed to improve their health. But it was also free, and so they were very receptive to opening their doors and getting the equipment and the opportunity to do something in public health. We encountered no resistance to our work at all from any government leaders or local chieftains. We were there to do good, and they knew it. Chillag : Were there any particular cultural differences that were very striking to you or very challenging to you in living there? Masso: Well, I remember having learned in the history of medicine that the little lighted, red-and-blue swirly cone with a white background that you still see today outside of barber shops, symbolized blood. Because the old barbers were blood letters, even in Europe and in this country, 150 years ago. When a person was really sick, they would let out blood. I had thought this was a practice that you only read about in history. When we got there, sure enough, there were practitioners right outside our office-a modern office with maps on the wall and vaccines that came from the States and the latest in hydraulic vaccination equipment. There would be people out there paying some practitioner to cut their backs or their arms and put suction devices on them to pull blood out. They thought if they were being bled, it would cure them of a headache or a stomachache or whatever it was. So that was a weird practice. There are a lot of Muslim practices that were unusual: the feast of Ramadan, where they'd fast every day for 40 days and not eat until sundown; slaughtering of animals in a ritualistic Islamic way; preparing sheep, kind of skewered, spread-eagled, which is called mishlee [phonetic], roasting the sheep. So we saw plenty of unusual practices. But after a while, they just became part of life. We didn't see them as strange; we saw them as part of their culture. And I think that's the way it's supposed to be. Chillag : What do you think was the biggest challenge about the work? Masso: I think the biggest challenge for us was the logistics. It was unbelievably difficult. We were forced to use American Dodge trucks, which was unfortunate because we should have been using Land Rovers. The trucks broke down frequently; axles would break. It got so bad that we'd have axles air-freighted in from Detroit to Niger at a humongous cost just because we had to use American equipment. And Niger was not like the coastal countries, like Ghana or Nigeria, where you drove on paved roads. We were in mountainous dirt-road locations, with these trucks that just wouldn't keep up. So the logistics of that, plus moving the vaccine around, keeping measles vaccine refrigerated where there was no refrigeration, was a big problem. And getting around the country, I mean, the size of Texas and California combined, with a small team and doing all of that in a couple-year period was very challenging. But, nonetheless, we got it done. Chillag : Yes. What were the biggest rewards? Masso: Well, the reward was very simple. I didn't realize that, in a couple of years, we would actually be able to see that there was no more smallpox in the whole country, and that was phenomenally rewarding. I can remember being out under the desert skies with a team of African male health workers, and we looked up at the stars. That was about the time, by the way, when we first went to the moon, the late '60s; '69 was the first moon landing. And I remember saying, "Look at those stars and look at the moon." The American space program was going up there. And here we are, and we're going to do something just as important. We're going to wipe a disease off the face of the earth. And we're not alone, you know; like that big sky, those stars are not alone; we're not alone. We are in each of 20 West African countries doing the same thing, and if we all do our job, we'll see it removed from Africa as a disease. That was tremendously rewarding to be able to say that to those people, to believe it, and then to leave when it was all done. Chillag : Has that affected the choices you've made afterwards, your career and your personal life? Masso: Well, certainly. I think what it's done to me as a person was to realize that there's no hardship you cannot endure. There's no obstacle that you can't surmount. There could be nothing tougher. You can be successful at something if you put your mind to it, if you work hard at it, and if you've got the tools to do it. CDC gave us tremendous tools to work with. And I don't mean just physical tools. We had the backing and support that were required to do it. And like the space program or like any other major achievement in history, we were able to get it done, and that leaves you with the sense that you can do almost anything if you have the right approach and the right support. Chillag : I didn't ask anyone else this, but I'm just interested. Did you have any issues coming back to the United States in terms of reintegrating here? Masso: When I came back, I went to Syracuse, New York, where there was 157 inches of snow that first winter. And, of course, when you leave a country which is 120°F in the shade, not unusual in the Sahara, and you come to New York, you get the climate difference. But the bigger difference wasn't that. It was that after 3-1/2 years of living like this in Africa, getting back into modern society doesn't seem real. The United States was now not real. Africa was real. Speaking French and speaking dialects were real. The superficiality of normal American suburban life, which is what we came back to, seemed like a movie, and Africa, then, was the real place, where at first it had seemed just the opposite. So the biggest cultural change was readjusting, which, of course, we were able to do after 6 months or a year or so. Chillag : Do you think there's anything else that it's important for people to know about the endeavor? Masso: I think that the most important thing for people to know is that it's unusual for the USAID [US Agency for International Development] program, or for any type of American foreign aid, to be looked at as being very successful. But I think CDC leadership in Atlanta and the people they were recruiting were uniquely able to demonstrate to the world that you could say we have a goal of eradicating a disease, and spend a modest amount of money doing it, and be tremendously successful in accomplishing it. I think that's a once-in-a-lifetime activity. The legacy is certainly something that we should all be proud of. People who listen to these tapes or people who see what's been done should realize that it was accomplished by normal people under abnormal conditions, but with exceptional leadership and dedication on the part of everyone. Chillag : Well, thank you very much. Masso: Thank you very much, Kata. # # # </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310130241&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:/25593/158r7 emory:158r7 Subject The topic of the resource CDC Smallpox Eradication USAID WHO Operations Officer Format The file format, physical medium, or dimensions of the resource 175409808 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Chillag, Kata (Interviewer); CDC; Anthropologist Masso, Tony (Interviewee); CDC; Operations Officer Contributor An entity responsible for making contributions to the resource Centers for Disease Control Title A name given to the resource MASSO, TONY Description An account of the resource Tony Masso, Operations Officer was assigned to Niger. Tony relates his impressions of Niger, working in the field and with Ministry of Health officials, cultural differences, and the greatest challenges and rewards of his time spent in Niger. Tony notes, "People who listen to these tapes or people who see what's been done should realize that it was accomplished by normal people under abnormal conditions, but with exceptional leadership and dedication on the part of everyone." Language A language of the resource English https://www.globalhealthchronicles.org/files/original/39ed46c91bdb1476732b08e5f2e4c3e6.JPG 32687499f0714d9ee0066f9c36569ca1 https://www.globalhealthchronicles.org/files/original/e0f226bf37f678c446589add4fd0fc1e.pdf 0f1d2df5de2ded7fa0b2ae8b01ef0733 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 Jeannie Lythcott on July 17, 2006, at the Centers for Disease Control and Prevention in Atlanta, Georgia, about her experience and involvement with the West African Smallpox Eradication Project. The interview is being conducted as a part of a reunion marking the 40th anniversary of the launch of the program. The interviewer is David Sencer. Sencer: Jeannie, do you want to tell me a little bit about your early years? Where were you born, what were your parents like? Lythcott: I was born in Leeds, in Yorkshire, England, and I was born in Leeds because my mom had to go to the hospital. I was the only 1 of her 5 children who had to be delivered in a hospital. We grew up in a little village called Rye Hill, partway between Leeds and Sheffield, a coal-mining town. My dad was the only child of coal miners, and he won a scholarship to go to the local grammar school, but his parents wouldn't pay the fee-what would be maybe a dollar, now-to go to that school. And so he was down in the mine at 14. He took himself to night school. He was drafted in World War II. He got in the Royal Signals Corps, and when he got home, he went to college on a program for servicemen. He became a science teacher and grew to become the headmaster of the only school in which he taught. So education for Dad was absolutely prime. Mom had gone to the local high school, and so they were both incredibly bright folks, and with 5 children. I was born in 1939, at the beginning of World War II, and some of my earliest memories are about gas masks and being evacuated. You know, bombs were dropped on Leeds. I grew up speaking Yorkshire, and our teachers spent a good 12 years trying to have us approximate the Queen 's English. This is how Yorkshire sounds. I'm going to give you a Yorkshire toast: [toast in Yorkshire, which Dr. Sencer can't understand] About 6% of students went to university in those days. I applied for and was accepted to Majesty University. Because our family was so poor, I got a scholarship from the government as a result of the 1944 Education Act. The government paid every penny for me-bus fare from home, food, everything-to go to university. If that had not been the case, I couldn't have gone. I taught in England for a couple of years and then decided that I wanted to go around the world, knowing somehow that my experience of education was limited by the British system. So my thought was that I would teach in former British colonies, where some things would be recognizable. And at that time, David, I was going to end up this grand tour of the globe in America, that being the far end of the spectrum. And after that, I was going to go home and become headmistress of a school for girls. I began in Ghana. I arrived in August of 1962. George Lythcott and his 4 teenage children, ages 12 to16, had arrived in Accra with an American team the month before I got there. He was there as Deputy Director of a medical research team to help Ghana build a national health institute manned by Ghanaian scientists and molded after NIH [National Institutes of Health]. We lived very close to each other. I met the family on September 9, about a month after I arrived, and we became very, very close very quickly. It's amazing. George had to go back to the United States in October or November of that year. Three of the children, Ruthie, George, and Mike, were in boarding school in Achimota, so they would be taken care of while he was gone. The youngest one, Steven, was going to a day school, an American international school. So I went to see George the night before he was to leave for 9 weeks to go back to the United States. His household goods hadn't yet arrived from America. We were relative strangers, you understand. I sat there in his house helping him to pack his bag, and he kept giving me money. He gave me 3 blank, signed checks just in case anything happened to his children. I mean, his trust in me from the start, it was amazing when I think about it. And so we worked side by side. I was there to teach physics, chemistry, biology, and mathematics to girls who were given a scholarship. They were bypassing secondary school and being prepared for a degree nursing program, which was unusual in 1962. So that's what I was doing there, and continued to do, until December 1965. Kwame Nkrumah [the first Prime Minister of Ghana] had fallen into disfavor with the American government, and as a result of some of the things that had happened, the United States decided to pull out most of George's team. There were 22 scientists of different disciplines there. The United States decided to pull most of them out as a political statement, but the Ghanaian scientist with whom they'd been working made a plea to the American Ambassador at the time to say, "Can't we keep a scientist-to-scientist relationship?" And so George stayed with 1 technician. But I had upset the Ghanese government, so my contract was not renewed in 1965. Sencer: How did you upset them? Lythcott: In the summer of '65, those who taught in this pre-nursing program said that, for the first time, they were willing to leave as a group (they were very close friends) to go on vacation because they felt that they could leave the college in my hands. We were on vacation, and they felt that they could leave the administrative details to me and they would come back at the beginning of school. Around this time, we had administered an entrance exam to over 2,000 girls from all over Ghana. We had announced in the newspaper when the exam would be given and when we would announce the results. And those results were to be given on a specific date, maybe September 28 or something. While the women were gone, the Minister of Education in the government called up the college and wanted to know whether his niece had been accepted for the pre-nursing program. And so my reply was that the exams had been scored, but we hadn't done the final analysis, and as we had reported in the paper, all of the results would be available at the same time to the public on September 28. I had the good sense to write that in a letter to the director of the college. But he didn't like what I'd done; he just didn't like it. But I stood my ground. So I wasn't expelled from the country, but my contract wasn't renewed. I'm not sure of the details of how this happened, but I ended up working for NIH in Ghana for 6 months on the Burkett's tumor project. I was responsible for getting the tissue samples, getting the osmium tetroxide, and we did 2 other lab manifuplations and then. I hand-carried the samples in dry ice to a plane at midnight to get to Washington, D.C. So that was my last 6 months in Ghana. And then, in November or December of '65, George met D. A. [Donald A. Henderson] in New York somewhere, and they'd talked about the smallpox program. So, in January and February, I think, he was roaming around the 20 countries to be in the eradication effort, getting the agreements signed. We got married in Ghana on January 17, 1966, in an incredible ceremony. So there I was. George headed off to get these agreements signed. We came back to Atlanta in that summer to help get the team oriented to Africa.. So those are my beginnings. Let me tell you 1 other thing. It relates to where I am now. When I was at the University of Manchester, I had applied, on the basis of recommendation from my professor, for a Ph.D. program in Saskatoon, Saskatchewan. There was an interesting morphological problem. There was a weed in the prairies; when you pulled up a plant, if you left any little piece of root, each root had the possibility of making a whole new plant. So the weed was noxious from that point of view. They wanted somebody to study that plant from a morphological perspective. So I got the scholarship. It paid for everything, but I couldn't afford to get there. The professor said he made every effort to try to get me there and found a scholarship from the Dreyfus Company, $1,600, $1,700, something like that. It was a scholarship for post-university work at any college or university in our dominions or colonies, but it stipulated that it was for a male student. And they said they were so happy if somebody would try to change it, but it would take them 5 years. So I went into teaching. Sencer: You got married instead. Lythcott: Yes. I met George. That derailed my whole plan. Yes. Sencer: You came here in '66 for the training course? Lythcott: Yes, yes. Sencer: Was this your first experience in the States? Lythcott: No. My first time in the United States was 1968. We'd been married in '66, and I was still a British citizen. We found out that when an American official was part of the diplomatic corps, marries an alien overseas, and is returning to post overseas, that the residency requirement for US citizenship is waived, which makes good sense. Also, you can be naturalized in any court that's meeting. So in 1968, I took all of the steps to come in on an immigration visa. I had studied up the kazoo. We found out that the federal court was meeting in Washington, D.C. I was in New York, pregnant, so I went up for the day to Washington, D.C. to take this exam. I took the oath, in a very moving ceremony. It came time for the exam. Well, I had studied. This judge sat there, and he said, "How many arms of government?" "What do we call this form of government?" Then the next question was, "So tell me what you know about the Executive Branch." And in all seriousness, I said to him, "You mean everything I know?" And he looked at me, over the top of his glasses, and he said, "Well, why don't you just start, and I'll tell you when to stop." Well, I started, and I had this down. It was like unpacking the files from memory, you know, and so on and so on I went. He didn't ask me another single question. It was amazing. Sencer: So, in the smallpox program when you went back after '66, George had traveled around getting the agreements signed. Lythcott: Right. Sencer: And then what happened? Lythcott: Most of the agreements were signed, but not all, when we came back for the training program here in 1966. Nigeria was still the very difficult one. And if I recall, 50% of the population was in Nigeria, and I don't know if 50% of the smallpox cases were there also, but without Nigeria, this program made no good sense. Back then, CDC had a program in Atlanta for the families while the guys were going through their training. There were some cultural events for children. So George went off for a week to Nigeria to get the agreement signed. But when he got there, all of these hostilities between the north and the east had just erupted, and nobody, but nobody, was interested in thinking about a smallpox eradication-measles control program. So it is my understanding that he did everything that he could. And people would check in with him. It wasn't easy to make long-distance calls back in those days. You could hear the ocean, I think, in the background. You had to book your call 3 hours ahead of time. And so, when we knew a call had been booked, I would actually be in the hallway, waiting. D. A. and Billy and various people would be there, and I'd just wait in the hall outside for messages. George was an incredibly social person; he had people skills up the kazoo. It's funny, because at the same time, he was also very much of a homebody and a loner. He would say often things like, "I don't care about anything else, just as long as I've got you and my baby at home." But when he was out there, he had people skills up the kazoo. And people found themselves talking to him easily. He adored women, and women adored him. From his days in Ghana, he knew about the underworld, you know, those CIA [Central Intelligence Agency] spies, and so on. Actually, the CIA tried to recruit George, and George came home and told me about all of it. But he told some of the things that they knew about him and about me, and I said, "I don't think you need to be a part of that." So he gave it up, although it would have meant a whole lot of money, which would have been helpful with 4 children. But he was used to that, sort of thinking, where messages can be passed back and forth that can ameliorate situations before they erupt. He was used to that sort of level of conversation. So George was at a cocktail party in Lagos He'd been there about 6 or 7 weeks. And nobody knew much about the new young leader of Nigeria, General Yakubu Gowan. As president of the federation, he was in the middle of Yoruba country, but he was from the Jos Plateau. So he didn't have his own people, his own tribe, around him. So it must have been very tenuous for him in the beginning. And so it was hard for George to find connections with him because there weren't many in that milieu. So George was at this party, chitchatting with the wife of one of the Yoruba diplomats there whom he'd come to know. And George said to this lady-it was very serendipitous-"He's such a handsome young man. And he's not married, I hope. This is the army," some conversation like this. And the woman leaned over and she said, "Oh, no, he has a girlfriend." And so it was through that contact that George then arranged an introduction with. the girlfriend [I believe mistress would be a more apt term. djs] And so George told the young woman about the smallpox program, what it would mean to children in all the 20 countries, and that if Nigeria didn't sign, there would be no program. He gave her that understanding, and she went to the President the next day, and there it was the signed agreement.. Yeah. Sencer: As you say, he had people skills. Lythcott: Oh, he did, he did. Sencer: Did you do much traveling with George, or were you a homebody? Lythcott: I did some, but not much. Once the civil war erupted, we were told by the American government that they were not requiring dependents to leave but that if we left, we couldn't come back. So I actually did very little traveling. I went to Abidjan, to that meeting. And then little Julie was born in November of 1967. Sencer: Where was she born? Lythcott: In Lagos, Nigeria. Sencer: Which hospital? Lythcott: It was a Nigerian hospital on the mainland. She was delivered by midwives at the hospital. George brought my mother from England to visit us, so she came for about 3 weeks, the first and only time she ever flew in an airplane. So, of necessity, we were home. Sencer: You want to tell us some of George's printable exploits? Lythcott: One that I didn't tell the other night was about Colonel Labusquiere leader of OCEAC [Organization de Coordination pur la Lutte contre Endemies d'Afrique Central]; he was a formidable character. As I remember it, he wasn't at all persuaded that the Americans had any role in the OCEAC countries; he thought that the French were doing just fine, thank you very much. In the case of smallpox, I think he was absolutely right, but measles control was something he would gladly give up. But as George used to describe him, the Colonel was just puffed up with national pride. Any notions that Americans were going to be coming to help them were just impossible. So we were in Lagos, and we got a call that Colonel Labusquiere, his wife, and his mother, who was traveling with them from France to visit them in Cameroon (I think that's where they lived), were going to have to lay over in Lagos, Nigeria, because there was something wrong. They couldn't fly all the way. I don't know what it was. But they were arriving in Lagos, and of course they would stay with us. And I was in a panic now. What are we going to do? So we've got Labusquiere, this formidable character. As far as I knew, he spoke very little English. And his mother was coming too. Sencer: Right. Lythcott: So I put the word out among the wives of those who worked in the regional office-Bonnie Flanders [Bonnie Jean Flanders], Ilze [Ilze Henderson], and Dotty Hicks [Dorothy Hicks] and so on-that if anybody, anywhere, had any French literature-magazines, books, anything-that I could at least put in their rooms, to let me know. One of them came up with a magazine, and I got the guestrooms ready. And you know how they did things in 1966. So I put the magazine down on the bedside table for the mother, and just flipped it open to a page, and placed it next to a little vase of flowers. It turns out the page depicted a vineyard, and this was their property. So completely serendipitous! There it was. The next morning, the mother said, "How did you know?" So they come, we're struggling through, in French. You know, the astonishing thing about George was that he didn't speak other languages, at least not at this point. He would have a few words here and there, but that was a tribute to his people skills as well. It was all eye contact and body language. Anyway, we're struggling through dinner. I think Ilze and Rafe [Ralph H. Henderson] came. I was struggling with my French. I hadn't used it in a long, long time, but it seemed to be okay. And we were getting through. It was a kind of a nice occasion. So the next morning, at breakfast, we got up. I mentioned that I hoped that they had spent a pleasant night, and so on. And all of a sudden the colonel begins speaking in English that is much better than my French. That old son-of-a-gun. Sencer: Yeah. Lythcott: And so he said that it had been a wonderful visit, and he said the first thing that he needed to do was to toast George because in one 24-hour period, this man had caused his mother and his wife to fall in love.. And that's when the conversation about the vineyards came up. He thanked us for the evening and how they appreciated us trying to put this together. And George always thought that was a turning point in that relationship. You have all of the other stories about the passports and things, I'm sure. Sencer: Well, we don't have them in your words. Actually, I don't think those were recorded the other night, about filling in his passport. Lythcott: George was traveling with Jay Friedman [Jay S. Friedman]. I think they were trying to go into Abidjan. George realized, as he's going up to passport control, that this [unclear]. "I still have these passports. Maybe I should send those to CDC. That would be fun, wouldn't it?" with all the extra pages stuck in, and so on and so on. And so he looked and found that his visa had expired the day before. What was he going to do? Somebody else goes through, and then George comes along. The passport officer was a young woman. So George said to her, in his own inimitable style, "Hello, honey. How are you doing? May I borrow your pen?" And so she said, "Here's one." So she took out a pen, gave it to George, and on the desk right in front of her, he drew around the outside edge of the visa and changed the date. So the date was, I don't know, tomorrow. So if it said the 17th, he changed it to the 19th or something, right there. And he gave her his passport, returned her pen, and she said, "Fine, thank you very much. Have a good day, big boy." Another time I think he just ripped out the old page of his passport with the old visas that were attached and put it in his passport. And then there was the time, it was Julie's first birthday, so November 28, 1968, George had been at a conference with a whole lot of other people in Congo Brazzaville. I'm not sure why, but George didn't get on the plane to come to Lagos as we had thought. But he had let me know that he had invited 3 Russian physicians to Thanksgiving at our house. This was a big deal because George cooked the turkey. George could cook like you wouldn't believe. He put it on a spit on the grill outside. And I was allowed nowhere near this machine. So I expecting George home, and he didn't come, and about 10 o'clock in the morning, the 3 Russian physicians arrived. And I'm panicking a little bit. I have the turkey all dressed, it's all ready to go, but I haven't heard from George. It's Julie's first birthday. I knew he was going to be there if he could. And nobody seemed to know what had happened to him. Finally, about noon, totally unexpectedly, George breezed in through the front door, dropped his suitcase and his coat, and went right into the kitchen and said, "Is the turkey ready?" and I said, "Yes." And so I followed behind him, and he said, "Did the Russians come?" I said, "Yes, they're outside by the pool." And he said, "Oh, by the way, your brother said to say hello." My brothers are both in England. It made no sense to me. But later, as I got the story, he had persuaded the people in Congo Brazzaville that he absolutely had to get to Lagos, Nigeria, he just had to. And so they entered into this whole problem-solving with him. You know, that was the art, that he got people to problem-solve with him. So they said, "Well, we can't get you to Lagos, but we can get you to Rome, and maybe you can get home from Rome." Know this. This was all on the ticket from Congo Brazzaville to Lagos, so there was no extra charge or anything involved here. And so he got to Rome, and the same spiel, and he tells a story and, of course, he's been talking to the stewardesses on the plane. It's like he's got the whole world looking out for him. They sent him to London in time to get the flight-BOAC, I think it was-from London to Nigeria. While he was in London, he called my brother. Oh, man. Sencer: What were some of your high points in Africa, besides having Julie? Lythcott: Well, that was definitely the high point. I think the only big conference that I knew about was the one that we had in '69 in Lagos. It must have been in the spring. Most of the photographs that I sent are from that conference. I remember 2 things about that conference. One is that George was bound and determined to have a diplomatic coup, which was that all of these contiguous countries would finally agree that a smallpox outbreak could be attended to by the smallpox vaccination team that was closest to the site, regardless of which side of the border the team was on. And this was huge. So that from Nigeria, you could go into Niger, and vice versa, for the purpose of containing smallpox. And they reached that agreement at that meeting. So that was a high point for George. The other thing was that George had arranged-he was so proud of this-for a sophisticated method of simultaneous translation. Translators were sent in from Geneva, and they were set up in little booths. But, of course, it was dependent on the electricity working, and West Africa being West Africa at the time, electricity working was not something that you could count on. So George had requested that the translators be able to move into consecutive translation as well. Well, that's what happened. The electricity went out. And I have this fabulous memory of these translations, which were really improvisational performances. When the translator was translating from the French into English, the shoulders would go back and be squared, the neck would be buttoned up, elbows tucked in, and the correct accent. And then the same guy, when translating from English to French, would tousle his hair, undo his shirt, and he'd be scratching and all kinds of things. It was an absolutely wonderful performance. I sought them out afterwards at the cocktail party, and they said what a joy it was for them to go back to this old skill that they used to have but didn't get to use anymore. Sencer: Was one of them mustached? Lythcott: Definitely. The other was a young woman who was on one of those photographs. I remembered her name: Eleanor Trench I think one of them may have been in that photograph. Sencer: The mustached one was one of the WHO's [World Health Organization] translators, and he was just magnificent, just magnificent. Lythcott: It must have been him. Sencer: As you said, he would fall right into whichever language he was working in. He was great. Why do you think things worked so well in Africa, or worked as well as they did? Lythcott: You know, that's a complicated question. But I was thinking about Bill Foege's presentation, the final one at the seminar the other day. Bill's thought was that nobody really believed that they could pull it off. There may have been an exception because I know George believed it. He came back from meeting with D. A., and he didn't say, "We're going to try to eradicate smallpox." He said, "We're going to eradicate smallpox," you know-and control measles. The question for him was not whether it could be done. It was just, how in the world are we going to get it done? So he believed it. I don't know who did the interviewing, but given the issues of racism and lack of cultural sensitivity in our nation at that time, the selection of those young folks was amazing. But it also may have been their youth. Because they were very young, you know. When you're 23, 24, 28 years old and if you're smart, you do believe you can do anything. I thought I could run any school in the world better than anybody else who was doing it at that time. Sencer: You probably could. Lythcott: Yeah. So it's that chutzpah of youth. But I think the fact that there was a very small American presence in each country was a fabulous decision. I think if there'd been 10 CDCers per country, they would have coalesced into a tight little team, whereas being only 1 or 2, they trained their counterparts and worked with them; that was critical to this process. But because there was usually only 1 in every country and the medical officer covered several countries, there was a sense that you were not entirely isolated. And that's why George traveled 70% of the time. I calculated it. He was gone from Lagos 70% of the time. He needed to do that. He needed to have them know that somebody was on the ground caring about things. And, you know, he did a lot of caring for families. . So I think it was that. So there was the animus of can-do. I think the other thing was that there was probably a little of that rambunctious devilry in all of these young people- sort of an obstinacy that, if you hit a wall, it wasn't going to get you down. It was just something to get over. I think there was that. Clearly, for the team from the United States, that link, also incredibly tenuous-you know, how long it took to make an overnight call; you sent telegrams, and relied on a way of communicating that seems so old when we compare it to today's world-but that link, tenuous as it was, was also incredibly strong. I don't think for a minute that George ever thought that there was anyone back in the United States that would say no, would say we can't do it. It was that can-do spirit again. And you have to give credit truly to the country nationals also. It wouldn't have worked if they hadn't wanted it to work. There were more ways than we could ever invent in our culture for not getting it done in West Africa. Do you remember when Rafe and somebody went to the subcontinent to try to help WHO get that off the ground? I think they were there for about 3 weeks for an initial conversation with the Ministry of Health. So for 3 weeks, they'd met with the Minister of Health. He had been very courteous, very engaging. They'd had wonderful conversations. But there wasn't anything happening, nothing! And it was about time for them to come home. They had reached a level of maximum frustration, so they requested a meeting with him. And he said, "Welcome, and good journey home" and so on. And they said, "Before we go, we need to tell you how frustrating this is. We thought we might be able to go home and report that something had been done." And he said- and this is the line, the actual quote-"What would you do if a friend, as a gift, gave you an elephant? We can't cope with that big thing!" So the country nationals, they could have found ways to not get it done, to not enter into the problem-solving. And you have to believe that it was because they knew what a gift it was to keep children well. Sencer: I'm now giving editorial comment. So many of the people that went from the United States had worked in state health departments, where they saw their job not to be the leader, but to get behind the leader and gently push: Let's get this done; let's get this done. And I think a lot of that was part of the success in Africa, that they recognized the primacy of the native leaders. Lythcott: Yes. Sencer: And recognized that there were ways to get them to move. Lythcott: Mm-hmm, yeah. Sencer: I notice you're wearing a bracelet. Lythcott: Yes. Sencer: Tell me about it. Lythcott: I will. One of the extraordinary things about that time, which is evident for all of us who came this weekend, is that it was a short time in our lives. I'm 67 years old. The smallpox program was 3 years; Ghana, before that, lasted 4 years. Seven years is a very small part of a lifetime, but it was life-changing. We all learned things. We all learned a way of being there. We weren't there as art collectors; we weren't there out of curiosity. We were there as national, you know, the old National Geographic notion of, will there be curiosities? Jim Lewis [James O. Lewis] was telling a story on Saturday night about how the truck he was in had driven into this pond or this mud in the road, and the driver had assured them that they would get out. They were knee-deep in mud. People just turned up on bicycles and helped them get this truck out of the mud and refused payment and seemed offended to having even been offered it. And Jim said that since then, he always stops to help on the roadside. So, my point being that we all have remembrances of that. So, I've put on umpteen numbers of pounds, so I can't wear my African clothing anymore. I just have 1 dress that I can wear. But I wear it often. When I put it on, it puts me back in that part of the world. So the other day I was co-teaching a course with a professor friend of mine at Stanford. He was delayed considerably. When he got there, he said he'd had trouble with his car on the way. I said, "Now I'm going to use an Africanism at Stanford." He had trouble with his car. And my immediate response was, "Oh, sorry." And he said, "Don't be sorry. It's not your fault." And I said, "It's the West African sorry," sorry that the world did this to you. Another memory, when Georgia died. In Nigeria, if they came to your office and you weren't there, there was this phrase, "I came and I met your absence." It's the notion that there's a presence of your absence as well as the absence of your presence. And they're not the same. Sencer: You mentioned life-changing.. How did it change your life? Lythcott: It taught me that I needed to revise my sense of my own country. I needed to give up this notion of glorious British history and acknowledge that some of British history was an inglorious thing. Nobody had taught me in England about our role in the slave trade, or that there even was one. I specialized in the sciences. I gave up studying history at Henry VII to specialize in the sciences. But I don't think that they taught that in British schools anyway. How the raj came to be is an incredibly important issue. I had to reshape how I walked on planet Earth. So I think that that made me, as a human being, open to the difficulty of understanding cross-cultures and being with cross-cultures. One of the things that we talk about in academia is this notion of white privilege and how hard it is when you are in the position of privilege, which is almost always tacit. You just don't know yourself well enough to be think across cultures. So I think it did that for me. And the experience taught me the role of sharing, of not holding onto objects too hard, of the extended family, of what you have you have to share, and that kind of thing. And so, in lots of ways, George and I became who we were as a result of being in Africa. So I just wanted to say that now, Julie, our daughter, and her husband and her 2 children, and I pooled our resources and we bought a house together in Palo Alto. We never could have done it on our own resources. So we're living together under the same roof, a situation fraught with potential dangers, you know, the old mother-daughter thing, your mother-in-law. And we said at the outset that we knew it was going to be difficult and that we wouldn't hide it under the table. We'd make sure that we put it on top. It's been such an incredible journey for Julie and I. Julie is all set to write a book about it. One of the incredible things about George was that he never stopped living. He changed his mind on some really big things as an older person, as a 60-odd-year-old, as a 72-year- old. It's quite astonishing, you know. But I think once you've been in a situation where your whole world, the things that you're sure about, have to be totally examined, you can see yourself whole and confident and competent, having gone through that change. Sencer: Yes. What's Julie doing now? Lythcott: Julie is dean of freshmen at Stanford, and just newly promoted to associate vice-provost. She just completed her 4th year, and they absolutely adore her. Every year they've changed her role and brought her more into the centrality of what's happening at the university. This year, one of the things she initiated was that the incoming freshmen would read 3 books, or they could choose 1 of 3. Stanford will have the authors there, during orientation, so that there will be a conversation between the authors and the freshmen. They chose books on Afghanistan, Haiti, and a collection of short stories about mothers and daughters. Sencer: Carrying On the Tradition. Lythcott: Carrying On the Tradition. That's exactly right. She has George's oratorical skills, and she has George's charisma. You know, I saw George walk into a typical West African cocktail party (that's how people there spent their evenings), into a gathering of 80 people, and the room changed when he walked in. He had that power. Julie has that power too. Sencer: I'll tell you a story about George. We were in Mali and going out to the Dogon country. This was at the time of the 25th millionth vaccination. And we stopped at a little rest house way out in the middle of nowhere. At that time, Mali was very Chinese dominated. We walked in to the rest house. George was in a big orange jumpsuit. There were 3 Chinese in there, and they came over to him thinking him to be Malian, and George said, "Howdy, brothers!" And those Chinese turned tail and left, realizing he was an American. Lythcott: Oh, man! Yeah. George was with the first team that went into China after Nixon went. And then he went a second time. The second time, he was walking on the Great Wall of China, and he heard someone call out behind him, "George Lythcott?" Can't help Can I just tell you how D.A. looked after us in Atlanta? Sencer: Please. Lythcott: We were living in a motel, and D. A. was persuaded that trouble was brewing in the motel. We were breaking the segregation laws in several states at that time. I know that. And so he moved us for the duration to the apartment of at Unitarian minister. And then, while we were still here, George had to go to Washington for some reason, I'm not sure why. We were newly married that year, and I had hardly seen George. You know, he'd been roaming around West and Central Africa since we got married. Three days after we got married, he left. And then he was gone for 9 weeks in the summer. So George said, "I want you to come with me." The idea was that we would go on the overnight train from Atlanta to Washington, getting into the Washington on the sleeper train at 6:30 in the morning. But D. A. was very worried about us, as was George. So they got the plan together, which was that both George and D. A-and I don't know how tall D. A. is, about 6'; George was 6'2½"-with their raincoats on, unbuttoned, would get to the railroad station, with me, and then we would walk fast. I'm 5'½" tall. Their raincoats would flap open, and I would be hidden behind these raincoat flaps, and they would hustle me on the train. And that's what they did. And all was well. And then the last thing involved the chairman of the department in Oklahoma. He had come from Mississippi and had been told at his interview, "We have a black American on the faculty. How do you feel about it?"And the man had said, "Oh, just fine, just fine." And then a week or 2 after he became department chair, he called George in and said, "You need to know that I can't have anyone on my faculty whom I can't invite home to dinner." Later, that same guy applied for a position to Johns Hopkins. All we knew was George got a brown paper envelope. In it was a letter of application from this guy, and D. A.'s response on a little office memo. D. A. just wrote on it, "Turn of the screw." So D. A. looked after us in really important ways. Sencer: Yes. Well, thank you for talking. Lythcott: Oh, you're welcome. Sencer: And we'll sign off now at 10:25. Thank you very much. Lythcott: 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/310129775%3Fsecret_token%3Ds-3IgEq&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 2006-07-16 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/158q3 emory:158q3 Subject The topic of the resource Smallpox Eradication USAID WHO CDC Format The file format, physical medium, or dimensions of the resource 585786768 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Sencer, David (Interviewer); CDC; Former Director of CDC Lythcott, Jeannie (Interviewee); CDC; Wife of Regional Director 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 LYTHCOTT, JEAN Description An account of the resource Jeannie Lythcott, widow of George Lythcott, who was the Director of the West African Regional Office of the Smallpox Eradication Program in Lagos Nigeria from 1966-69. Jeannie, originally from England, tells how she came to work in Ghana and met and married George. She narrates some of her husband's escapades working for the Smallpox Eradication Program and how it changed her life. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/3e027e382c5eed16196c06d8cc7535a9.jpg f7d78b88df4e468df04a13d6b5b8f263 https://www.globalhealthchronicles.org/files/original/9a83f5a9b21cf972ec1dc75d92eeb079.pdf c22f3d531c3cfceeb1968d7187a26c39 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 Ann Lourie 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 Deborah Gould. Gould: Would you describe your early life, where you were born and had your education through high school? Lourie: I was born on Long Island, Flushing, New York, and I lived there until I was 10. My father died when I was 10, and my mother remarried, and we lived in Connecticut for a while. I went to a boarding school for 3 years, from the 7th to the 9th grade Finally, we moved back to Scarsdale and White Plains, New York. I went to high school at Scarsdale High School, and I went to college. Gould: How did you and your husband become involved in the smallpox eradication effort? Lourie: Well, we got married in 1960 and we had 3 children soon after, 2 years apart and 18 months apart. My husband was in the Public Health Service after he finished his internship, and then he went back and got a Master's in Public Health at Johns Hopkins. Our children were 5, 3, and 2. We discussed that we would like to do something really exciting before our children got to school age. Being interested in public health, he just heard about the program with CDC at that time, and we both thought it would be a terrific idea to do this. Gould: I understand you lived in Chad. Is that correct? Lourie: Yes. Gould: Describe what it was like living in Chad with 3 small children. Lourie: Well, it wasn't that bad really. When we first got there, we were in an apartment on the 1st floor, and it was hard because it was very small and very cramped. And the main front door had a space about 2 inches between the floor and the bottom of the door, so in the evening all these frogs would come in under that door, and they'd be jumping all over the room. That was really my first unpleasent experience. But anyway, after a month or so, we got moved into other quarters. There were 2 houses in a compound, 1 with Russell Charter and his wife, and a very nice 1-floor rental house for us. It had a living room, dining room, 2 bedrooms, and a bath. We had a swimming pool between the 2 houses, so that was nice because I taught my kids how to swim. So, physically, it was not that bad. Gould: What about dealing with some of the cultural differences? The markets are so unlike the States, where we've got a Publix or a Kroger grocery store on every corner. Lourie: Well, we had a market. We lived in the capital, which was then called Fort Lamy and is now something else with an N, N'Djamena, I believe. As far as I remember, there were no paved roads. The town was just 1 or 2 streets with little stores on both sides, and the marketplaces. One wonderful thing was that I had a cook and a houseboy who helped, so I didn't have to do laundry or cook. I did go shopping.for food. Occasionally, the cook would go shopping too. Culturally, we had a hard time at first. I started teaching English classes occasionally to adults, and so I needed someone to take care of my children. We had 1 houseboy, but I didn't want to give him that responsibility. So we hired this young girl to be a babysitter and take care of the children while I was gone, and she was there a few days. The kids always had their bath after dinner, and they were all bathed in the same tub. My 2-year-old was still in diapers at the time. So I went in to the bathroom for something. They were all in the tub. And she had taken the diaper and she was rinsing it out in the bathtub, . So, needless to say, she was fired, and I went on to the next. She couldn't help it. . She just didn't know any better. But anyway, we got another houseboy named Bartolomey, really very cute, short, smart little guy, and he wound up helping the other man and also taking care of the kids, and we had him the whole time we were there. Gould: You said the children were 5, 3, and 2? Lourie: When we got there, yes. Gould: And you were there for how long? Lourie: Two years. Gould: What about schooling for the 5-year-old? Lourie: He went to the 1st grade in the French school in town. I taught the Calvert system at home, in English, for the 1st grade, so that when we went back to the States, he could go into the 2nd grade. So he had both the French school and the Calvert system at home. The other 2 children weren't old enough, so they didn't go to school or any other kind of pre-kindergarten or kindergarten. Gould: Did they learn the language? Lourie: Yes. They all could speak basic French, but two of them didn't remember it when we came back. The oldest, who was 7 when we left, can speak fluent French to this day. Gould: That's wonderful. A good skill to have. Lourie: Yes. Gould: What was the toughest problem or problems that you faced? Lourie: I didn't really have any tough problems. Basically, I was living with servants whom I'd never had before in my life. You did had to be very careful what you did with your food, that you washed everything well, that you peeled everything, that you didn't drink water. But there were no real problems. We did go swimming and waterskiing in the Chari River. Now, when I talk about it, people say "You did that? You didn't get schistosomiasis?" And I say, "No." "When we went there, Dr. Pierre Ziegler was there, who was the French counterpart whom Bernie [Bernard Lourie] was working with. He told us that since the water was swift moving, it would be alright.I was talking to Rafe Henderson [Ralph H. Henderson] last night, and he said that he was always in the water and loved the water, and he said, "Oh, it's just fine, and we did this all the time." And that's what we did on the weekends. That was our entertainment. We would go waterskiing and picnicking and swimming in the Chari River with the hippos. Gould: Oh, my goodness! I hear they were pretty vicious. Lourie: Yes, they can be dangerous. We were lucky, we really were. I don't know what was wrong with me at the time. I didn't realize they could be dangerous. But physically, I didn't really have any hardships at home because I had a nice, comfortable house, and I took care of the kids and I was busy doing things with them and teaching them things. I would go out occasionally or play bridge with the gals about once a month. I was very happy. I had a wonderful time; my kids had a wonderful time. There were other American families. Russell and Sharon Charter were the only American families there from our CDC group. There were some ancillary workers, and we did socialize with them occasionally. And then there was Dr. Ziegler and his wife, who were French. We socialized with them a lot on weekends. Gould: So, during this time, was your husband out in the field most of the time? Lourie: Yes. He went out every day with a truck. Sometimes he would be gone for a couple of days. I can't remember any more how long exactly. It could have even been a week that they would go out for. So he would come and go. I only wish that I could have gone, too. Gould: Yes. Lourie: That was my wish. I thought, "Oh, if I didn't have any children, I could go and be with him every day." When he was in town daily, the day ended early. It ended about 2 o'clock. They'd come home, and we'd have our large meal in the afternoon, and that would be it. They would work from early morning, when he was in town, until around 2 in the afternoon. Gould: How early in the morning? Lourie: Quite early, maybe 6 or 7 AM. Gould: Was that a French system? Lourie: I don't know. It was a French colony at the time, and that was just the schedule. Gould: Can you recall any unique experiences or occurrences that you had when you were there that you would like to tell us about? Lourie: Well, besides the frogs, 1 funny thing occurred when we were still in the apartment. We had one houseboy, and while I was gone he had taken our white sneakers and covered them with Elmer's glue and then set them out in the sun to dry because he thought that was polish. They were stiff as a board. That was a funny experience. And then another thing. . .We normally never let the children swim with anyone.but ourselves. But we wanted to be sure that if we left them and they happened to go near the pool, that Bartholomey would know how to swim and what to do. So we asked him, "Can you swim? Do you know how to swim?" He said, "Oh, yes, yes, I can swim." So we took him to the pool. We said, "Okay, show us how you can swim." So he jumped in the pool and he almost drowned because he had no idea how to swim. I guess he was afraid he might lose his job- or he just didn't want to say that he couldn't swim. Just before we left to go back home, we went to a game park with wild animals. I had never been out at all to see the animals. So we had the 3 kids, and I think we were in a little Volkswagen in this park, and it was just the driver and our family. Six of us. We got stuck in the mud sometime during the afternoon, and we couldn't get out. So we were there all night, sleeping in the car. My middle son had an earache, and he was crying most of the night. The next morning, everything had dried up and we were able to get out. We went back to the main place and we said, "Why didn't you send someone out to look for us?" They didn't even know we were out there. Noone at all knew we were gone. So that was a little disconcerting. Gould: Did you encounter any animals during the night? Lourie: No, we didn't. I didn't even get out of the car. We were just huddled in there. Gould: They might have been curious and come up to it to find out what was in the car. That's amazing. It sounds like a wonderful adventure and opportunity. How did participating in the program, and being there, change your life? Lourie: I don't know really how it changed my life. I had traveled before I went to Africa. I'd been to Europe and I'd been to India, so it wasn't a complete culture shock .. But I found the Africans to be extremely warm, extremely friendly. There weren't that many higher-ups in town, and I didn't really socialize with higher-up Africans. But all the people that we had working for us and just had daily contact with, were just extremely nice, extremely open. I thought about the whole experience for a long time after we came back, and I thought it was wonderful for my children because they not only learned French, but they didn't have any prejudices at all when we came home-because in the '60s still- Gould: I hear you. Lourie: And so it was, I think, a good experience for them. And I remember it as being a wonderful time. Gould: What difference do you think it would have made if the spouses and children had not gone to Africa but had stayed home in the United States? Lourie: I think that would have been extremely hard, to be separated for 2 years. I don't think we would have gone if the program had said that I'd have to stay home. . That would have been too hard. Gould: Do you think that would have had an impact on the program at all? Lourie: I don't know. It would be hard to say. Probably. There certainly would have been many more singles. Gould: For that length of time, right. How did you prepare to go over? I mean, you were living in the United States, you had a home, you had a life here. Lourie: Well, we didn't have a home. We never owned a house 'til we came back from Africa. We were always renting. We rented a house in Baltimore, and then we came down here for the orientation. So we didn't have that many possessions, really, before we went over. We had a dog, though, a beagle, and we had to leave him behind. We weren't going to take a dog over to Africa. So that was hard for the children to separate from the dog. We'd had him about 2 or 3 years. Other than that, we didn't prepare, really. We took clothes, and that was it. We hoped we were going to have an adventure. Gould: Wow. It sounds like you did. If you could do this all over again, is there anything that you would change? Lourie: No. I'm sure all the other countries were different. Each country that everybody went to was an entirely different experience. But, no, there wasn't anything that I would change, just that I would have loved to have gone out on the trucks and done what they were doing if I had had no children.. Gould: You mentioned that you were teaching English. Lourie: Yes. Gould: Could you tell me a little bit more about that? Lourie: I can't really remember it that well.. I was trying to remember the other day. There were 2 adults, fairly educated adults, probably schooled in African schooling and they spoke French. They held positions in town, and they just wanted to learn English. I think I taught them in the late afternoon and the evenings, and I did this for a couple of months. But I can't really remember the details of the class. Gould: Had you previously taught? Lourie: No, no. I worked for 4 years before we were married, in bacteriology, but I had never taught before. Gould: So you learned another field while you were there. Lourie: Mm-hmm. Gould: Is there anything else that you would like to add or any particular stories that you would like to tell us about? Lourie: I really can't think of anything in particular, just that it was a wonderful experience. My husband had a marvelous time. And we had fun, too. The family had fun. And as I said, a major attraction was going out on that river every weekend. My 5-year- old learned how to waterski. The other 2 didn't, but he did. And they all swam; they could all swim from the age of 2. Gould: Was that your last time in Africa? Lourie: Yes. I did not go back. Gould: Or your children? Lourie: No, my children haven't gone back to Africa. Gould: Thank you for this interview. You have made a contribution. # # # </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310128227%3Fsecret_token%3Ds-Wvs5V&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 2006-13-07 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/158pz emory:158pz 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 228263952 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Gould, Deborah (Interviewer); CDC; Health Educator Lourie, Ann (Interviewee); CDC; Wife of Epidemiologist 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 LOURIE, ANN Description An account of the resource Ann Lourie, wife of Bernard Lourie, who served as an Epidemiologist in Chad. Ann speaks of adjusting to life in Chad, living abroad with 3 young children, and relates family adventures. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/2a15d7e56f699e0d9b656b933a9097f0.jpg d41e52482a63d40c8c63da4569f3d4fd https://www.globalhealthchronicles.org/files/original/f3d5b6add61103d571965d7687a2e094.pdf 7d4d3dc3766a295220a5cf78aebd3bc1 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 Mark LaPointe about his experience and involvement with 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, as a part of the 40th reunion of the West African Smallpox Eradication Project, to mark the launch of the project. The interviewer is Diane Drew. Drew: Mark, I wonder if you could start by sort of telling me a little bit about your background, your education, where you grew up. LaPointe: I grew up in Maine. I majored in English at Assumption College in Worcester, Massachusetts. After graduating, I went into the Peace Corps in Guinea, West Africa, where I learned a little bit about Africa and got fluent in French, very fluent. I went something like 4 months without speaking English. Then I taught French and English in a high school in Mechanic Falls, Maine- French to the college-prep kids and English to the shop kids. I think they gave me the job because I was big. Drew: And you could keep them under control. LaPointe: I could keep them under control. Just for the record, I'm 6'1" and about 220, and I guess they had a teacher before who they terrorized, even tied him up. Drew: And that goes back a few years. That was like high school is nowadays. LaPointe: They were nice kids. But anyway, during that Christmas vacation, I went down to see some friends in Washington. I saw Stan Shaya [phonetic], who was the Peace Corps doc when I was in Guinea and went on to become the medical director of the Peace Corps, and he asked me about teaching. I said I liked it but that I didn't know if I wanted to do it for a career. I said, "If anything interesting comes up, let me know." And, literally, I was teaching school, and I got a call from a woman named Faye Hendrix at CDC who asked me if I would be interested in the smallpox program. Evidently, Billy Griggs [Billy G. Griggs] was in Washington, talked to Stan Shier, and told him they were wanting to recruit for the smallpox program in-house, but they wanted a few folks who had been in Africa just to sort of fill it out. So there were about 4 or 5 of us who were ex-Peace Corps volunteers. And so, literally, I was teaching a class, and I got a call. In those days, a long-distance call was a big deal. So they said, "Hey, do you want to do the smallpox program?" And I said, "Sure." I was, what, 24 at the time. So I drove down 1 day to Concord, New Hampshire, and interviewed with Leo Morris. He offered me a job. And Diane and I got married on June 25 and drove to Atlanta for training. She always teases me that I'm a cheapskate and that I earned 16 cents a mile on my honeymoon. Drew: Somebody that I talked with yesterday, either Jay Friedman or Betty Roy was in the Peace Corps, too. LaPointe: Both Jay and Jean [Jeannel A. Roy] were in the Peace Corps. Jean was in Cameroon and Jay was in Sierra Leone. Also Tony Masso [Anthony R. Masso]. Those were the ex-Peace Corps volunteers that CDC brought in. I think it was good because sometimes people had questions about this, that, and the other thing because at that time, people didn't travel that much, especially to that part of the world., and they could come to us. So, anyways, this is the 40th anniversary of the smallpox program in West Africa, and Diane and I had our 40th anniversary 10 days ago. People talked about the smallpox program, but it was actually the smallpox eradication-measles control program. That was very important because a lot of the countries, especially the francophone countries, had what they called the Service des Grandes Endemies (SGE), which were mobile health teams that were run by French military doctors who were assigned to Africa. And pre-vaccines, if you looked at data for measles, there was a very pronounced peak and valley every 2 or 3 years and a high mortality rate. And these Service des Grandes Endemies tried to control smallpox, but they didn't believe in eradication. And so in the francophone countries, you didn't have the problem with smallpox that you did in some other countries. A measles field study had been conducted in then Upper Volta, now Burkina Faso, in the early '60s. And the results were very, very positive. So the African francophone community really wanted measles vaccine. There was actually a measles control program, which was the predecessor of the smallpox program, but it wasn't very well managed and it had all sorts of problems. LaPointe: The Minister of Health of Upper Volta came to Washington, and he said that his country wanted the measles program. And because the situation was such a disaster, a lot of CDC people-I think Mike Lane [J. Michael Lane] was one of them-went to West Africa and reviewed the measles control program. They concluded that it was not a medical problem, but an operational, logistics problem. And so that's where they got the idea of guys like us (I became an operations officer) going over. Drew: It seems to have been really critical to the overall program. LaPointe: Yes. As time went on, although they realized that physicians were good, they also realized the value of good managers and operations officers. But anyway, when AID [US Agency for International Development] came to CDC and said, "Can you run the measles control program?" CDC said that it wanted to do smallpox eradication too. That's an oversimplification, of course. Drew: Sure. LaPointe: And so, that was that marriage. And I know in the anglophone countries, especially places like Sierra Leone and Nigeria, they really wanted the smallpox eradication program, and so they took the measles control with it. But anyways, I think we talk about smallpox eradication . . . Drew: And kind of forget the other . . . LaPointe: Yes. And many Africans were more concerned about measles than smallpox. Drew: Because they were losing a lot of children to that. LaPointe: Oh, yes. We would hear stories of measles just decimating the pediatric population of a village. And you'd hear stories about a woman who had several children under 5, and measles would come along and all of a sudden she had none. So I just feel, for the record, that it's important to state that for many countries measles control was more important than smallpox control. Some of the French military physicians would ask me, "What's this eradication stuff? We've been controlling smallpox for years." There was always the debate whether smallpox control was adequate. Plus eradication is such an absolute. And so physicians in the French military community would say, "Well, it gets down to nothing. There's a little flare-up, we send some people out and vaccinate, and it calms down again." Drew: So they were skeptical about eradication? LaPointe: Well, you know, they thought eradication might be too difficult. But I think that was one of the beauties of the West African program: they showed that if you can pull off the eradication program in West Africa, with all the problems there, there was a case to be made that it could be done globally. Drew: So some of the lessons learned, then, during that period probably applied in subsequent countries. LaPointe: I think the biggest lesson was that, although mass vaccinations were good, CDC questioned whether you really needed them for an eradication program, especially with a disease like smallpox that, over time, especially in West Africa, proved not be as infectious as people thought it was. Originally they thought it was going to be an urban disease, and actually it was a rural disease. That's another thing: they talked about search and containment strategy, but many of these countries had what they called firefighting teams. If there were an outbreak someplace, people would go out and vaccinate. So it was sort of a containment strategy. It was haphazard, ad hoc. But the notion that you would run mass vaccinations and just do the whole country, and if there were an outbreak in an area where you weren't vaccinating, it was left unattended-that's not true at all. You got some vaccine and went out and did what you could. Drew: So, even when there were mass vaccinations, even then there were containment strategies? LaPointe: Yes. They had these strategies. If there were an outbreak someplace, you just wouldn't sit there and say, "No, we're doing mass vaccinations. We're not going to go out with that." So I think that what Foege [William H. Foege] did is that he institutionalized that, sort of codified it for the campaigns in the subcontinent. Am I straying? Drew: No, no. Please don't worry about that. I feel that you and the others I've talked with are the ones who have the stories, the experience, and from my conversations with Dr. Sencer [David J. Sencer], I think the interest is in trying to gather the heart of your experience. So maybe tell me about where you were and what the living conditions were like. LaPointe: Well, we came down to Atlanta, and we had our training from July through November. And as projects agreements were assigned in countries, then you'd get the go-ahead to leave. Diane and I went back to Maine in mid-November and just waited for the word to go. We were assigned to Gabon and got there in late November of '68. Drew: So, you celebrated your first Christmas together in Gabon? LaPointe: Yeah, we did. And Gabon was an interesting country because it was very rich and underpopulated. At that time, the official census was something like 450,000. It's a country that has always had a problem with its demography because the birth rates weren't very high. Some people attributed it to a lot of untreated gonorrhea. Drew: I'm not that knowledgeable about Gabon. LaPointe: It's on the equator, very wealthy. It had a little bit of oil. It was one of the smaller members of OPEC [Organization of the Petroleum Exporting Countries], which was just started when we were there. Gabon had uranium, manganese, a big iron-ore deposit, and wood (because it was heavily forested), and it was very much controlled by the French. My counterparts were mostly French. My direct counterpart was a Frenchman about my age, Alan Gourdon [phonetic], and we got along pretty well. We had a good time together. The head of the Grandes Endemies, that mobile unit, was Jean Montinazo [phonetic], and the dean of the medical community was General Gee Sholiak [phonetic]. These people, even to this day, have stayed in contact; I saw them last about 3 or 4 years ago when I was in France. The Grandes Endemie was very, very prominent. Gabon was very interested in measles control because it hadn't had a case of smallpox since '63, and it was '66 when we were there. But the SGE bought into the notion of mass campaigns because the vaccines for smallpox that they used really weren't that good. The experience was good for me because I worked with the French. I think I got to understand them and I got very involved in the community. If Diane or I made a mistake in French, the neighbors would tease us and correct us. And so we got to be pretty close friends while we were there. that are still entrenched with, the parents, the kids, and the grandchildren have visited in the States, and we've visited them. Drew: Which is a great side benefit. LaPointe: Yes, it was. But they were very fixed in their ways. I think a lot of the things that CDC was promoting-epidemiology, surveillance and reporting, using data as a tool to control disease-were used for their records, more for their archives than to really help control disease. So there were these continual little-I can't say they were squabbles, but debates-about how you're going to do this stuff or improve surveillance. Drew: Kind of maybe not being altogether on board with CDC's way. LaPointe: Well, no. At that time I think the CDC was the new kid on the block, and people really didn't know much about it. That was CDC's first overseas project. By contrast, the French ran institutions, like the OCEAC [Organization de Coordination pour la Lutte contre Endemies d'Afrique Central], which is the medical community in Central Africa, that did training (it was based in Yaounde, the capital of Cameroon, and people would go there for their training and almost eschew training elsewhere). And the French had the same thing up in the OCCGE [Organization de Coordination et de Cooperation pour la Lutte contre Grandes Endemies] countries and Bobo-Dioulassou. I worked in the smallpox program, and I also had several other African assignments right up until 3 years ago, so you can see things over a period of 40 years. And what's interesting is that these organizations are now pretty much passé. At the time the role of the paramount trainers and policymakers in that part of the world had fallen on hard times because the French don't support them as much, Now, people realize that WHO training, CDC training, and training in the tropical institutes in Holland and in Belgium are all very worthwhile. So I was working in Gabon in sort of the heyday of the French dominance in that part of the world. So, I think in terms of getting the teams trained and building a warehouse and a cold room and things like that, I was busy. But I thought the real action was in West Africa. Drew: So in some ways, your assignment was a little more low-key than some of the others? LaPointe: Well, it wasn't a high priority, I guess, because of the small population of the country, for 1 thing. And the infrastructure of some of places-the roads were abysmal, especially in the rainy season. I remember taking something like 36 hours to go 40 miles. Drew: Amazing. LaPointe: And we had to dodge trucks and this and that. People chided us about not having a winch on our vehicles to pull us out of the mud/ Once, we had had to rebuild a bridge because our truck went through it. We took the jack and got a 2×4 or something like that from the bridge. I jacked it up and found a hard spot, in about 5 feet of water, and jacked it up. We took turns doing that. It was miserable. I was young then; I could do that. American ingenuity born of necessity, But those are the sorts of adventures we had in Gabon. It's such a different place. It was newly independent-I think it got independence in '63. And there wasn't much of an infrastructure. Now, once they have some money from OPEC and started building their own . I haven't been back there. It's sort of like a forgotten country on the continent because it has such a small population. I have a friend who was the ambassador there. We were talking about the demography of Gabon, and he was saying that, even today, they have the population up over a million, but nobody can count the people. They must be counted 3 times. And I remember when I was there, the population count all of a sudden went, with the stroke of a pen, from 450,000 up to something like 600,000. And the ambassador, a wonderful man named David Bane, called me and he said, "What do you think?" and I said, "According to all of our figures, there's been no change." And my theory was, is, that they would count people twice. They would count them in the village and then, as they moved into town, they'd count them in the town. But there's no way in the world that they had that increase. The president who took power when I was there is still in power. He must be the longest-serving head of an African state. Drew: What's his name? LaPointe: Well, when I was there, his name was Albert-Bernard Bongo. He became a Muslim about 20, 25 years ago, and now his name is Omar Bongo. When I first got there, the president was Léon M'ba, and he was sick. He was in Paris, and the cabinet used to fly to Paris about once a month and have signatures and this and that. It was sort of a tempest in a teapot. There were several people vying to be vice-president, knowing that Léon M'ba was going to die. Léon M'ba died in the summer of '68, and Bongo, somehow, was appointed president. The country, as I've said, was dominated by the French, and there was a fellow named Jacques Fokka [phonetic], and he used to come in. He was some sort of a political henchman of de Gaulle and the people who ran the ministry. The French community had great trepidation because he could fire people. So I think he and some other people decided that Bongo was their man, and so he's been in power ever since Drew: That's amazing. LaPointe: Yes. He's been around about 38 years, and he's still a relatively young guy. Drew: He must have been very young. LaPointe: Oh, yes. He was in his early 30s or mid-30s. So, after that, we headed up to Mali. Our older daughter was born while we were in Gabon. Diane is talking about that in her interview. She had Mary in a missionary hospital in Cameroon. LaPointe: So we went up to Mali, and that was different work. I had been the only CDC person in Gabon. Up in Mali, I was working with Pat Imperato, the CDC epidemiologist in Mali, that was different, just the opposite. Gabon was firmly in control of the French, whereas Mali had socialist notions, Marxist notions. A lot of the people we worked for were confirmed socialists and Marxists because those were the people who supported African independence. They bought into the philosophy that the riches of Europe come from exploiting Africa. Drew: In Mali, were you dealing with migrant people with cattle and stuff like that? LaPointe: Yes. In Mali, Pat did a study called the Tranjo Mas. In Mali there was a whole series of movements, depending on the season. During the rains, the cattle herd stayed stationary because they had adequate pasture, plus people liked to stay home during the rainy season because it rained a lot. The nomads liked to go way north during the rainy season to get away from the mosquitoes; and so the Tuaregs would go way up almost to the Algerian border. The hill cattlemen would stay in south-central Mali. The fishermen would stay in their village. And the Sauri [phonetic] stayed up around the Niger River. As the waters dried up, the northern nomads would come south to follow the grass. And then the southern herds of the [unclear] would come. And right in the middle of the [unclear] delta or the Niger was something called Lake Dabo. And I remember Pat and I went up there, and he felt it was like a National Geographic special because all these folks would come together to Lake Dabo. They all had their little turf. You would meet people, try to vaccinate them, and find out if they had any smallpox. That's how we did surveillance. Drew: And you were also doing measles vaccination? LaPointe: Yes, and then other things. Mali had a big yellow fever outbreak, and so we were doing yellow fever vaccinations. We had Russian oral polio vaccine, Sabin, and they were like little bits of candy. We used to go crazy because the vaccinators thought they were candy and would start eating them. We were funded for measles and smallpox, but yet when a crisis would come along, we were a viable operation. We had as many as 30 teams. Drew: So you had the manpower and the structure and so forth to be flexible? LaPointe: Yes. One of the great lessons, I think, in public health, is that most of our vaccinators were not trained, except by us. I mean, they called themselves nurses, but they weren't. They were people we recruited. Some of them were illiterate. But they formed teams and they did a great job. I don't think they've gotten enough credit. We talk about some of the people who went on to become very prominent in public health, but a lot of that work was done by teams of people, men mostly, with primary school education, if that. We're getting away from Lake Dabo. I just want to finish up on it because it's a fascinating story. All these folks would come together. Then, when the rains came, they would just disperse and go back to their cycles. And so we had to move quickly. After 2 or 3 rains in the delta, the Niger became just a morass; it was bottomland clay. If you didn't get out, your vehicle might just stay there, and that whole area, during the rains, would become an inland lake. Drew: So you could wind up being trapped if you didn't pay attention? LaPointe: That's right. There were places, during the dry season, where you could drive across the Niger if you found a ford. But then, as the rains fell heavily in places like Sierra Leone and Guinea, the headwaters of the Niger, the river would be a half a mile wide at the height of the rainy season. They had steamboats that would only navigate the river for 6 months a year. But we rode a boat because we had the idea that we could drop off vaccine at these small, isolated villages, and we wanted to see how it was done. It's sort of impractical, but it was great fun. So in places like Mali, you really had to be attuned to the rainy season because the whole dynamic of the country could change. When I got to Mali in '68, we survived a coup, the military overthrow of Modibo Keita, who was a socialist. That was a little hairy because on the ride down to the bakery to get some bread, I saw soldiers all over the place and machine guns and stuff. Drew: Did you know ahead of time what was going on? LaPointe: No, I didn't, and I said, "What are all these soldiers doing here?" Duh. We had just arrived. I left Gabon and went up to Mali, and then Diane came after, when Mary was just about a year old. We settled into a little transient apartment, from which I could walk to work. And the nurse came by and said, "There's been a coup," and I went and told Pat, "There's been a coup." We had to stay in the house for about 3 days. I remember we were going to go take a walk, and it wasn't too far away. Some small-arms fire opened up, a machine gun, tat- tat-tat-tat-tat-tat. So that changed a lot because the socialists-their party was called the Union Sudanese-were very hostile to Americans. They were against the war in Vietnam because it was against one of their socialist brothers After the coup, the military took over, and things became easier for us. The Minister of Heath was a guy named Benny Chenny Fofona [phonetic], who was a good friend of Pat's. They had done some fieldwork together. And he was very good. Well, the other guy was okay, but he was under political restraints. Drew: Sure. LaPointe: So I think, in Mali, when the military took over, there was sort of a honeymoon. That was a time in Africa when there were lots of coups. I think people in the smallpox program went through half a dozen in places like Nigeria, Dahomey, Togo, and Mali. And so that changed, and, of course, after a while the military abused their power and became crooks. I don't know if anyone's talked about the last outbreak of smallpox in Mali, which was in 1968, October-November. We had gotten reports that there was smallpox in an area over near the Upper Volta border. We looked at the maps and we talked to people, and the only way that we could get in there was to go through Upper Volta, through a town called Watagere [phonetic], and come in the back. That was a big expedition. It was like a Frank Buck movie. We had people carrying Ped-O-Jets on their heads. We must have recruited about 20 people or so. And we walked up to. We met Tom Leonard (CDC operations officer) over in Watagere [phonetic] with his counterpart. And Dave Asteen [phonetic] was there. I think he was in Burkina Faso or Upper Volta. And we all went up there, to this little canyon that had something like 5 generations of smallpox. And that was interesting because everyone thought that smallpox spread lightning fast in West Africa. Mike Lane had done a survey of the outbreak in nomads and found out that they had 3 or 4 generations of smallpox. And we saw that, too. People with scabs. That's one of the things you would look at, their faces, because after the scabs, they'd have pock marks. But if the scars were of recent origin, they'd still be pink. So we did these surveys. We just walked around looking at people's faces, and if the scabs had recently fallen off, their faces were so pink, that was at least a 30 percent attack rate. I remember we walked up there, spent the morning, vaccinated everybody, and did all the things that we were supposed to do, and that was the last outbreak in Mali. We had scares after that, outbreaks of chickenpox and this and that, but that was the last smallpox outbreak. After that, we still did the mass campaigns because we hadn't finished up in the desert area. Looking back on it, it was great fun. But the Dodge trucks used to break these front axles. I used to be amazed at our mechanics. They could set them up with spare axle housings. Somehow they're out in the middle of nowhere in 115° to 120°F heat, and they would take off the axle and sort of put the snap where the housing was, and they'd reassemble it. Drew: Didn't it take a certain amount of brute strength too? LaPointe: Well, it would take a lot of patience, some strength, and then some ingenuity. Again, we talked about the vaccinators being good, but some of these drivers were exceptional because they always brought the vehicles back. And they could repair them. I mean, I would go up and watch them and, looking back on it, I have the greatest admiration for the work that they did. Drew: These were Africans? LaPointe: Yes, Malians. And the same in Gabon. Some of these drivers were amazing. You know, these muddy conditions. I have a picture in my mind of a driver-his name is unknown to history-but we were coming down a slope, and the car fishtailed, and we were going toward a relatively small village. And it was in the rainy season, and in Gabon, the rainy season was just gumbo. It was terrible. And this driver, somehow he downshifted, fishtailed, and just straightened us out just as we hit the village. If he hadn't done that, there would have been a serious accident. Those were the days before seatbelts and air bags and all that stuff. These guys were great drivers. And they used to compliment me on my driving because, up in Maine, I knew how to drive in snow, and if you can drive in snow, you can drive in mud. So I knew how to downshift and go with the flow. Most of the time I didn't like to drive there, but just in case there's an accident or something, for practice I'd do it every now and then, and they'd always comment. So I could admire how well they drove in mud, because if they were in Maine, they would have been able to do the same thing on snow. But I don't think that these folks get the credit that they deserve. Drew: So there's really kind of this whole foundation of getting the job done. LaPointe: Yes. We stood on their shoulders, you know. Drew: Were they primarily informally trained? LaPointe: Oh, yes. These apprentices would be assigned to a driver, and it was exploitation because things that, teach my kids to drive was an afternoon, and then sort of a white-knuckle drive. But they would learn rudimentary mechanics and they could fix things. In that part of the world, they added water to a lot of the fuel; they were constantly tinkering. And these guys did a marvelous job. Drew: How old were they, about, on average? Young adults? LaPointe: My age. I was in Mali in 2003 and spent a couple of afternoons with some of my old drivers. Drew: That must have been kind of neat. LaPointe: It was wonderful, wonderful. Drew: Were they French speakers? LaPointe: They knew greetings and phrases.. Drew: But they were fluent in French? LaPointe: They could say simple phrases like, "Where's the chief's house?" or "I want to eat," or "I need some water." But that would get me to someone. The problem in that part of the world is that, in Gabon, for instance, they must have 40 dialects among half a million people. I remember driving along with my driver, who was a Fang. He would be fine translating in that area, which is up at the Cameroon border. But we'd go down to southern Gabon and someone would speak in a dialect, and I'd say, "What's he saying?" and he'd say, "I don't know, I don't know." The situation was like with a romance language. You know, like if you understand Spanish and French, you can sort of follow a little bit Portuguese or Italian? But with the local dialect, absolutely zero, not even the same language. The same in Mali. You had [unclear] in the central part, and you'd have 15 languages. And so to master one might be great. Then you go to another part of the country . . . I remember when I was in Senegal the last time, I was talking to some Senegalese in French about why they should have a national language, saying, "Well, you'd be like Belgium," because the Walloons and the Flemish are always fighting about language superiority. It's very political. You know, language is political, even in this country now. Drew: Oh, yes. LaPointe: And the thing is if they did that, I was telling him that Senegal would have to be like a Scandinavian country. When Scandinavians learn English, it's not fun and games. They take it seriously because it's their lifeline to the rest of the world. You meet Scandinavians who speak very good English; they start in grammar school. So, anyway, I said, "Well, if you guys want French as a national language, first of all you'd have to appease all the other non-French speaking. then you've got to be serious about a language. So French is, maybe people don't like it. They're always figuring out official language and the language of instruction. Drew: Because that's the association with colonialism? LaPointe: Well, you know, they speak French well and they love it, but when push comes to shove, it's still foreign to their African culture. But they also realize that they have to have that because how else can someone, say, from Mali speak to someone from the Congo? They need a common language. And so it's French. And they realize that, because if you chose a native language, which one would you choose? And so the subject is fraught with politics. When we went back to see the driver, we always spoke in French. I mean, I would fool around and say, "What's the word for this?" and "What's the word for that?" He was a Bambara speaker. And we would play around with it. But when push came to shove, if you really wanted to talk, it would have to be in French, so that was the language you stuck with. It was nice going back to Mali. I saw my counterpart, who was sort of administrative counterpart if you needed travel orders or some formality or process type thing. He and I were about the same age. I saw him, and he's retired.. Drew: And he is a Malian? LaPointe: Yes. His name's Sisoko [phonetic]. In his retirement he formed a service to solve small problems for civil servants. He doesn't get paid for it. But it was fun because I went in and he was talking, and he just lit up, jumped over his desk, and gave me a big hug. There must have been about 25 Malians there, and they go, "Who the hell is this guy?" Then he told them who I was and what I had done. And so it was good going back. We talked about the old days. Drew: Did Diane go with you, too? LaPointe: No. I was working. The last time I was in Africa, I managed a 10,000- household survey for UNICEF and managed, activities in Mali, Senegal, Ghana, and Benin. I went to Mali 3 times. So I made time to go around and see as many people as I could, and the word got out that I was around. It's nice seeing people again, going back, oh, I guess, 38 years. Drew: Did you and Diane have other children? LaPointe: Yeah, we had Michelle. Drew: And this was while you were still in Africa? LaPointe: Yes. Diane went back to Portland, Maine, where she had family, because Mali really didn't have the facilities. Mary had been born in Ebola. In Cameroon, there was a Presbyterian hospital. When the physicians went on furlough, they usually went to do a residency someplace, so they were all board-certified. We were young and maybe a little foolish, but things went well. I drove up from Leeperville [phonetic}. We drove across the border. It was about another 100 miles to where she was. And everything went well. But Mali just had no facilities that were as good as the ones in Cameroon. So the option was to go up to Europe or the States, and we opted to go to the States, and it was best. So off they went. Anyways, they're doing well. Drew: If you'd been in charge of the program, are there things that you would have done differently? LaPointe: I think the biggest thing that they did is that they left us alone. Don Millar [J. Donald Millar] was very good that way. If you showed some initiative, and even though you broke every rule in the book, he'd say, "You're a naughty boy, but God love you!" Once I was way out on the tip of Gambia in a small village. We were driving out for the smallpox program, and our vehicle didn't really have any air-conditioning; it would all be dusty and red. And one of the Malians said, you know, "In the smallpox program, we're not white or black; we're red." And so this time we went up there in an air-conditioned vehicle and people had their laptops and their phones. There seems to be this phenomenon where people land someplace and [unclear] airplnes, it seems that everyone has a cell phone and wants to call someone up here. . Drew: It always makes me laugh how quickly they adapt to the new technologies. LaPointe: As soon as they say you can use your cell phone, it's . . . Drew: Everybody and their brother. LaPointe: It seems like most people do that, and it's the same phenomenon. We were with some UNICEF people, and they rented an air-conditioned van. There must have been 15 of us. And these guys were calling their offices and had their laptops and all this and that, and yet it was a practice run. And we went out to the village, and the village hadn't changed that much. I was thinking that when we were there for the smallpox program, the last thing in the world we'd think of when we were visiting a village was to call Atlanta. Now they have cell phones, and many people call their local offices, regional office. Drew: Checking their voice mail. LaPointe: Yes, all that stuff. And I remember they did some sample interviews. We were looking at the forms and walking around in the village. There was absolutely no-or very little-change in 40 years. But then I picked up a form and really looked at it, and it noted that a 23-year-old woman had had 6 pregnancies and half the kids had died. She had no education. So, I just grabbed a sample of every woman who was 23 or 24-I forget the exact age- and all had pretty much the same type of history. And I was thinking, we have the technology, and yet nothing's changed at the local level. It's disappointing in a way. And I can never figure out why. If people want to change, they leave the village. Change doesn't come to the village. A person has to leave the village to change. And so the villages' populations, I suppose, really don't grow that much because people want to leave. But I think somehow the modern technology might lead to micromanagement. I mean, why do you have to call your boss and say, "I'm here at the village and I'm shuffling around." I really think it's a distraction. Or your boss tells you stuff to do. Among other things, if you don't want people telling you what to do, you don't call them up and ask them for advice, and especially a superior. Drew: And if you don't want to be told no, you don't ask. LaPointe: That's right. And I think with the smallpox program, the program was CDC's first overseas project, and we were all young. People didn't really defer to headquarters. I think sometimes when people who have been out in the field come back to headquarters, they have their own values and start to impose them on people. I supervised people overseas. I think one of my biggest chores was to keep my mouth shut and not say, "Well, that's not quite the way I'd want to do it." And I just think that the smallpox team was a good team. I consider Billy Griggs a friend and a business associate. But he understood his role. He really didn't interfere with the daily stuff. But he knew how CDC worked and how CDC should be supported in the field. He never went to the field. I think there's a tendency now for people to travel too much. Some travel is good. But I think Billy was a key to that success. I don't think he liked to travel. Once, I asked him, "How can you not travel?" And he said, "Well, I know CDC, and if people need something, I can get it at CDC." And that was a very valuable thing. I don't think people have given it the credit that it deserves. If you needed something, they'd find it. And with Millar, if there was any doubt about the central office or the field, he always supported the field because these guys knew what they were doing. Now a lot of things have become very institutionalized, and I think there's too much process. I went to a 30-day evaluation conference, again in 2003 when I was doing that stint for UNICEF. Everyone was talking about input. There was no output type of thing. And I think an eradication program, process is good, but the bottom line is eradication; your feet are really to the fire. I mean, it's an absolute term. You have the disease. I suppose it's like pregnancy. You either are or you're not. But I noticed when I've gone out and talked with the same people, they spend a lot of time on emails. I remember once I went to Guinea for something in the '90s, and there was this kid who went along. He did something at CDC. He came up to me, and I said, "Well, here's where I'm going to be if you ever want to link up, just show up." And he said, "I love to do it, I'd love to do that." And I was there 10 days, going to the ministry and clinics and talking to people, taking notes and doing my evaluations. I saw this guy a couple of days before I left, and I said, "I never saw you. What happened?" He said, "I can't get out of the office." He said, "Everyday, a window opens up in the heavens and dumps a whole screen full of stuff, emails from Washington, the AID office. I have to answer them." And he said, "I get all caught up, and the next day at 3 o'clock, I get another dump." I asked him, "How often do you get out of the office?" He said, "Never." See, in the smallpox program, people were never burdened with that stuff. You had your reports and you sent them in. Drew: Well, one of the things that I find happens is almost like a Pavlovian response. An email shows up, and we're often geared toward, "Oh, I must respond to it right now." LaPointe: And then, nowadays, with phones. When we were in Mali, I think we got 1 or 2 phone calls. Big deal. In those days, you'd have to go down to the "Ministry of Telephones," etay tay [phonetic], as they called it. Post Telegraphic and Telephone, something like that. And you'd say, "Well, we want to call Atlanta at 3 o'clock tomorrow," or whatever. And then we'd go down there and somehow the call would go through Paris, and we'd get our call through. And we could hardly understand it half the time. Why bother? Now, with the phone systems working so well, people call headquarters everyday just to say, "Checking in." When I was going overseas. I always liked to go to the schools and see what was going on because my wife was a teacher and teaching is sort of our family profession. My grandmother was a teacher; my dad was a teacher; my wife is a teacher; and Michelle, the one who was born in Mali, is teaching, doing research at Stanford as a postdoc. I always liked to see the class size and this and that. We'd see class sizes of 60-70, and hear kids come in speaking an African dialect, trying to learn something in French, or English in the anglophone countries. I also like to talk to people in the offices, especially at UNICEF, ask them, "How often do you get out in the field?" And they say they can't. They take emails and telephone calls. Drew: Somehow that just seems wrong. LaPointe: It does. I remember when I did some work for the Carter Center in Guinea. I went out to Niger, and the place I was in had a lot of Guinea worm, at one time perhaps more Guinea worm than any other place in West Africa. They had put up a little sort of rest house office so that the director could go out there. He had young kids. And he told me, "I go out in the field. I bring my wife and kids and work for a couple weeks." I saw him about 6 months later, and I asked, "Are you spending enough time in the field?" He said, "I can't get out of the office. I have calls, I have emails, I have meetings," and this and that. And I said, "Well, how about the field?" And he said, "Well, I just can't get out there." Well, the thing is, is that you can, but you have to tell your people and say, "I'm sorry, we're not going to reply to emails," and this and that, and you go out to the field for 2 weeks. In the smallpox program, you were expected to spend 50% of your time out in the field. Now, we were younger then, but even so, those roads, I swear to God, it was like someone beat the hell out of me because of the rocks and the bouncing around. The smallpox program was really field oriented. I just wonder if you had the same program today, with modern technology, would you spend all your time answering emails and phone calls and not go out in the field? Drew: You wouldn't be as productive ultimately. LaPointe: Yes. Looking back on it, Atlanta pretty much left you alone, and they supported you. And CDC at that time, I think, was more flexible. Drew: They were a little less bureaucratic. LaPointe: Well, I think technology leads to bureaucratization. It's just, if you have the ability to communicate, you communicate. You see people yakking away on their cell phone, and you think, before cell phones, what did these people do? So, I don't know, technology is a mix, a double-edged sword. Drew: I think it is. One of the phenomena that I find fascinating is how frequently you'll see people who are not present in their present space. In other words, they're constantly emailing, calling. They're interacting with something that is far away and they're not, in a sense, fully present. I can't tell you the number of meetings that I've been in where you'll have everybody and their brother with their Blackberry on the table. LaPointe: My son-in-law works for Microsoft, and he said the same thing. In Gabon, General Sholiak [phonetic], who now is [unclear], and I got along very well. I think he had kids my age, and everyone else would be bracing and saluting because he was the general and they're all captains. And I'd say, "Hey, General, how are you doing? You look tired. You sleep okay?" But he liked me. I remember him telling me he went to Gabon for the first time in 1937, and he said he got off in Porjantee [phonetic], which is on the [unclear], took a Dogon canoe, went up to this hospital, and stayed there for 10 months. And sometimes he'd get a pack of mail. So he was almost lamenting telephones and e-mail. I don't know what the solution is. Computers are wonderful, but they're a terrible distraction. You know, the Africans say that-I'll translate it from the French- Drew: No, say it in French. LaPointe: In French, they say, le feast. It's a French expression that means that success is the son of everyone in the village, and failure is his mother's son. And so the smallpox was a success, so everyone bought into it. When I did the first draft of the smallpox history, I remember that everyone who was remotely associated with the smallpox program, took some credit. "Well, I did this," you know, or "I recruited this" or "We did that." Before I close, one cautionary tale. In the mid-'90s, I was in Cote d'Ivoire. They were having an AIDS meeting, and I was staying at a hotel with someone who was going to a dinner for the AIDS workers. And Kevin DeCock who is now, I think, the head of WHO, HIV/AIDS, he was saying that it would be wonderful if we could eradicate the disease, that then we could be like the smallpox people, who had these orgies of self-congratulations. And so I said I had been in smallpox." He said, "I didn't realize it was smallpox." I said, "We're everywhere." So success does generate things like that. If the program had been an abject failure, it would have been sort of swept into the outback someplace. We're lucky. You know, areas where we worked in Mali, I don't know how the hell we did this, but I took Diane. We went way up in the desert. Now you can't go up there. Drew: In terms of safety? LaPointe: Safety. The Tuaregs were on the warpath. They were pacified or brutalized, I don't know what the word is. But the area that I went up to in 1970, which is way up Keydal [phonetic], had a shootout out about a month ago between the Tuaregs and the army, with casualties. Sierra Leone, Guinea, Liberia are pretty much semi-failed states. Could we work there now? It's very iffy to be in the desert areas of Niger. When I was in Chad working for Guinea worm eradication, sometimes we were out with armed guards, guys with AK47s. Drew: And that's so qualitatively different-on so many different levels from what you're describing about your relationship with your drivers and nurses. LaPointe: You know, I went to a meeting once during the smallpox days, and my counterpart opened up his briefcase, and he had a gun in there, a pistol or something. And I said, "Geez, I didn't realize you were packing." And he said, "You were the only guy in that room without a gun." And he said, "I'll get you one." And I remember once we were in southern Chad and we went out to a village, and the district officer wanted to go. It was like an old Western. I mean, he reaches in and he gets a gun and sticks it in his belt, and takes a rifle out of the closet. Other people got shotguns, and off we went. I don't think we could have done that. We were lucky. It was an era where, if you looked at the history of Africa, it had the infrastructure of the colonial age, which, in many instances, has disappeared or hasn't been maintained. You had a lot of political people who were socialist. That's a bad word in this country. But they did have a conscience about health, and they supported it. If my memory serves me correctly, they dedicated something like 10% or 12% of the national budget to health. Well, the economies are stagnant now, and populations have doubled. I remember reading something about 40 years ago about the demographic history of India. I remember talking to Pat about it. I said, "You know, when you have population growth in this part of the world, these populations are going to be more than double in 40 years," and they have. But now Africa has stagnant economies, and so the per capita income for social services has gone from what I described down to 35 cents. Now, many of these countries can pay people, and that's about it. Everything else is dependent on foreigners or other things. And so we were lucky in a sense, is that we had- Drew: It was like you were in a perfect sort of a window. LaPointe: And then we had CDC just starting out and they didn't know how to boss people around. They let us alone. Everyone was young. You realized you had to spend a lot of time in the field. You had infrastructure that was still workable. Drew: Yes. LaPointe: And political stability in a sense. You could go almost anywhere in the country without safety concerns. But recently, when I went to Chad, the ambassador gave me hell. He said, "What are you doing down there?" I said, "Well, that's where Guinea worm is." "That's dangerous. You're not supposed to be going there." I said, "Well, what am I going to do?" And so we were lucky. As Napoleon said, he liked lucky generals, and we were lucky generals Drew: Mark, thank you so much. I really enjoyed this interview # # # </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310127651&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:/25593/158nt emory:158nt Subject The topic of the resource CDC Smallpox Eradication USAID WHO Operations Officer Endemic Disease Service Format The file format, physical medium, or dimensions of the resource 774640608 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Drew, Diane (Interviewer); CDC; Nurse LaPointe, Mark (Interviewee); CDC; Operations Officer Title A name given to the resource LAPOINTE, MARK Description An account of the resource Mark LaPointe served as an Operations Officer in Gabon and Mali. Mark highlights the measles aspect of the smallpox eradiction/measles control program, working with French medical structure such as Endemic Disease Service and other French institutions, seasonality, nomads, and a coup in Mali. Mark reflects on management strategies, lack of change at the village level after 40 years, today's burden of technology while working in the field, and comments on the changed political situation of many countries where the smallpox program once worked. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/448cff1fc20ab4239fee37331af8f8f3.jpg 755c2614d2744074a2b53d2c06302bb6 https://www.globalhealthchronicles.org/files/original/89b57463696a8505f3a85d0ca251c78f.pdf 1589db6e5ccc0fc03924b2795568d4f0 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 Diane LaPointe about her 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, as a part of the 40th reunion of the West African Smallpox Eradication Project, to mark the launch of the project. The interviewer is. NOVA: Would you take a few moments and just describe your early life-where you were born and your education? LaPointe: I was born in Portland, Maine, and I attended Cathedral High School, which is a Catholic girls' high school in Portland, Maine. LaPointe: I also went to college in Maine, at St. Joseph's College in Lake Sebago. After I graduated, I did 1 year of volunteer work in Camden, Arkansas, as a teacher for the extension lay volunteers and then returned to Portland. My husband, Mark, was in the Peace Corps for 2 years before that, and he also returned to Maine. We each did a year of teaching in Maine, and after that year, we were married and then came to CDC [Centers for Disease Control] right after our honeymoon. NOVA: How did Mark get involved in the Smallpox Eradication Program? LaPointe: He was teaching at Mechanic Falls High School in Mechanic Falls, Maine, and received a call from someone who was hiring for this program at CDC. I believe they were looking for people who had African experience and were able to speak French, and so his name was suggested by the director of the Peace Corps. Mark was hired over the phone. My, how things have changed, to be able to get hired over the phone. NOVA: Absolutely. So, tell me a little bit about what it was like. You're living in Africa, you're an expatriate, and it's a different country, a different culture. Talk a little bit about that. LaPointe: Well, I'd like to, if you don't mind, start with our coming here. NOVA: Okay. LaPointe: We married in June of 1966 and took our honeymoon. Mark had bought a little Volkswagen bug secondhand; it got 12 cents a mile. On the way down to Atlanta, our car broke down in North Carolina. So we put all of our belongings in a storage place in North Carolina-our belongings were in that Volkswagen bug-and took a bus down here. We left the car there to be repaired and came and stayed at a hotel in Atlanta. Mark would come over here to CDC to do his training, and I'd get on the local bus with the newspaper and sit behind the bus driver, looking for an apartment and telling him that we were going to be at CDC. He would tell me where to get off and point in certain directions. So we got a place on Briarcliff and started the smallpox training program here, which to me was one of the wonderful experiences that we've had, meeting all these people. We had intense French training, the [unclear] program, where you just saw the pictures and heard the people speak. You never saw a written word. That's how we were trained. A group came from France, and we did all the training here and met all the people who were going to be going to West Africa. We formed a real feeling of camaraderie with all of these people. NOVA: How long was the training? LaPointe: I believe it lasted throughout that summer and into the early fall. We spent all day with the French-speaking trainers, and sometimes in the evening, so we were really not supposed to be speaking English at all. It was very intense. It was wonderful. NOVA: So, how soon after the training did you move to Africa? LaPointe: We went back to Maine and got together some household items and we flew out probably in October or November of that same year to Libreville, Gabon, in West Africa. And I do remember an experience there right at the beginning. Mark would go off to the embassy and work with his colleagues there, with the AID [U.S. Agency for International Development] people. We didn't have a place to live yet, so we were at the local hotel. And this was my first attempt at using my French. So we would get up in the morning. Mark would go off to work, and I would go to the restaurant and ask for an orange juice in French, jus d'orange [sp.]. And I'd never get orange juice; I'd get grapefruit juice. So after a couple of days of that, Mark came back from work, and I was in tears. I said, "I can't speak, I can't even say orange juice in French. What am I going to do?" And so he went to breakfast with me the next morning and he asked for orange juice, and they brought him grapefruit juice. But he had the foresight to ask, "Why didn't you give me orange juice?" and it was because they didn't have any. So that kind of alleviated my concern about speaking French. NOVA: That's funny, that's funny. LaPointe: We had an apartment right on the ocean. I mean, for 2 young people, newly married, we had this wonderful apartment, completely furnished by the government, overlooking the water. It was very, very nice. I was pregnant at the time. I had become pregnant right away. So we began thinking about where I was going to have our first child. Speaking with the doctor there in Libreville, who was a Peace Corps volunteer doctor, we had thought about going to Lambaréné, which is Albert Schweitzer's hospital, but we were discouraged from doing that. They said they didn't feel there were adequate facilities in case of an emergency. So it was decided that I would go up to the Cameroons. We knew Arlan and Edith Rosenbloom, who were there. So I went up there in my 8th month. I flew up and spent my time with them and then went out to a hospital in Ebolowa, which was run by an American missionary group. I was flown there. It was a very small plane, a 2-seater in addition to the pilot. Beside me was an elderly Frenchman. Because this was out in the bush, they buzzed the hospital to tell them somebody was coming. And I guess I had a look on my face that looked as if I was going to pass out. The little Frenchman next to me said that he had candy with him and he tried to feed it to me so I wouldn't pass out. When the plane landed in a field, a nurse from the hospital came, with a cot, and I was picked up and taken to the hospital. I spent I'd say a week or 10 days there. There was another American woman there, too, who was from the Cameroons. We became friends, and we hung out with the nurses and the doctors and played Mah Jongg. Mark drove up from Gabon. It took him a while to get there, I guess, and he thought the baby would have been born by the time he got there. But when he arrived, she had not yet been born. So we took a walk around the campus of the hospital that day, and that evening our daughter Mary was born. NOVA: I hope your daughter appreciates the trouble you went through to get to a hospital to deliver. LaPointe: I think so. NOVA: What was it like raising your children there? LaPointe: Actually, it was very easy. We had help, which was something very new to me. We had a woman who would come every day and do our laundry and clean our house. I really took care of Mary pretty much myself, but that woman was there to help me. It was beautiful in Gabon. There were beaches there. So we spent a lot of time going to the beach and taking walks. Gabon was very French. It was a former French colony, and there was still a large French presence there. So I didn't get the feel that I got later, when we went to Mali, of that African experience of the marketplace, because it was all French shops. We developed a wonderful relationship with a French family that lived upstairs from us. The woman took me under her wing. She'd take me shopping. And her 2 daughters loved my baby. So we did a lot together as family. The thing I remember most is that all of those relationships you made took the place of family-although they certainly couldn't replace them. But they helped with that feeling of loss of family. They became your family. NOVA: How long were you there? LaPointe: We were in Gabon probably about 2 years, and then we were assigned to Mali, to Bamako. NOVA: And there was a big difference between the 2 places? LaPointe: Absolutely, yes. Gabon was, as I said, very French, and located on the water. Mali was inland, on the Niger. But the culture was so rich that I didn't miss the ocean-I had thought I would. But I got so engrossed in the culture of the people. That was a real experience. That was really going to Africa for me. The people were wonderful. Our second daughter was born. I went back to the States to have her. We had the Rh-negative/-positive situation, so I went back to Maine and then came back with Michelle. In Mali, we lived in a little compound. There were maybe 5 houses, all young American couples, people with the embassy who lived in our area there. And, again, we had help. We had a woman who would come in. She liked to take the children and go off. I didn't really like that because I wanted to spend my time with them. But she felt that was her job. But I enjoyed going to the market; I learned a bit of the language, the Bamber [phonetic] language. I liked to go and bargain with the women at the market. We had to be careful about boiling our water, and filtering it, as well as washing and soaking all our vegetables. And if you hung your clothes out to dry, flies would leave their eggs on your clothes. They could get into your skin, so everything had to be ironed. But I just had a wonderful experience because I was very young. NOVA: What was your toughest problem that you faced while you were there? LaPointe: Sometimes Mark would be gone for long periods of time. He couldn't stay in the capital all the time; he had to go out and do his business out in the villages. Those separations were probably the most difficult times. Another incident I remember is that when we were in Mali, I traveled with Mark once up into the desert. We left our children with some good friends. I can't remember the exact town we went to, but this was in the period right after there had been a coup in Mali, and the president was imprisoned in this town. There were guards around the prison. I wasn't aware that you couldn't take pictures. So I was out taking pictures, completely unaware of not being able to do that. Later, at our hotel, we got a tap on the door, and the local gendarme came and confiscated the camera and put us under arrest. We had to stay there at the hotel. Mark spoke to the head of the health department who he was visiting there, and I believe that man must have interceded for us and finally got the camera back. I think they took the film. But that was pretty frightening. So that's something that has stuck in my memory. NOVA: Nerve-racking. LaPointe: Very much so. NOVA: And I'm sure you were worried about your children. LaPointe: Right, exactly. NOVA: Earlier, you talked about, shopping and going to the market in Gabon. What did you do in your spare time when you were in Mali? LaPointe: Much of your day was spent shopping and bargaining. I love to sew, so I enjoyed going to the market and buying African material. I used to make a lot of dresses and skirts and things with the African fabric. I became friends with Peggy Yates, the wife of John Yates, a political officer. They had 3 children, so we did a lot together. They had a little pool, and we didn't, and so a lot of our day was spent over there visiting with them. Or we would get in the cars and go off somewhere, find someplace to take the children. And then on weekends, groups of us, with our husbands, would get together and go out and try to do as much as we could around the area. One particular incident I remember is when we all went off with the kids on a Sunday to a place near the river. It had recently rained, and the cars got stuck in some African lady's field, and she was not very happy about it. John Yates was able to hail some African guy with a Mobylette. So he went into town and got somebody to come out with a truck and chains. We all sat out in the field on blankets and waited until they rescued us. But I think most of our day was spent shopping. I like to cook, so learning how to cook some of the local foods and just raising children and enjoying the friendship of the other people that we met filled my days. NOVA: How do you think participating in the project changed your life? LaPointe: Completely. Even to this day, we have a lot of interaction with Africans. We went back to Africa again (not with the smallpox program), and the children went to French schools. That changed their lives. It opened their eyes to a whole different side of the world, the poverty, how much we have as Americans, an appreciation for what we have. Our daughter Michelle learned to speak French. She was younger and she just picked it up; she was so fluent in it. So when she went off to college, she majored in the romance languages, and that led to things for her. I've done work since we've been back. I taught. I'm a retired teacher. But when I retired, I volunteered with teaching English as a second language for African women, and, as I said, we have a lot of African friends to this day. At our church, Corpus Christi, there's a large African community, and we've been very involved in things relating to Africa. The experience really changed our life completely. I don't know if we'd still be in Maine, if I'd still be teaching there. I don't know. I can't even think like that. NOVA: What difference would it have made if families, say the spouse and children, could not have joined the CDC employees or the medical officers, the folks that were there doing the work? What kind of difference do you think it would have made if the families would have had to have stayed back home in the United States? LaPointe: I can't imagine. I think it would have been very difficult. First of all, you wouldn't be able to relate to anything your husband was going through. To be there together, you were in it together. It would have been a great loss for me, and I think it would have been very difficult on our family. I know we have had separations like that, and it's very difficult on families, the tensions when you get together, and the wife becomes the boss of the house, that kind of thing. I don't think I would have understood what he had been going through when he'd come back and talk about it. I just don't think it would have worked. I'm really happy to have been part of that. It was a whole new life for us. NOVA: Is there anything that you would have changed if you had to do this all over again? LaPointe: I can't think of anything, really. We really enjoyed it. We've made lifelong friends, some of them with CDC. A lot of these people [at the reunion] we have not seen since back then. But we have 1 friend in particular, Jay Friedman [Jay S. Friedman], who lives here, who we've been friends with him since we started here. That's 40 years. The Roys are another couple that we know. And some of the friends we made while we were living in Africa, the people at the embassies who had children, we're still friends with a lot of them. Our children became friends with their children, and they still stay in touch with each other. So we've developed this network of friends that will just keep going on. NOVA: Wonderful. Is there anything else that you'd like to add? LaPointe: Just that I'm very happy that we did this. I know it's just made a big difference in my life, and, of course, Mark's. We came back here to CDC, and that was his career. I'm looking forward to seeing a lot of the people who I haven't seen in so long today. I'm so glad to have had the opportunity. # # # </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310127340&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/. Title A name given to the resource LAPOINTE, DIANE Subject The topic of the resource CDC Smallpox Eradication Program USAID WHO Life as expatriate wife Description An account of the resource Diane LaPointe was the wife of Mark LaPointe, who served as an Operations Officer in Gabon. Diane relates stories of life during training in Atlanta, flying to Cameroon to give birth to their first child while based in Gabon, moving onto Bamako in Mali, shopping and cooking local food, and how the experience positively impacted her life. Creator An entity primarily responsible for making the resource Harrar, Linda (Interviewer); NOVA; Writer LaPointe, Diane (Interviewee); CDC; Wife of Operations Officer Date A point or period of time associated with an event in the lifecycle of the resource 2006-07-14 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) Format The file format, physical medium, or dimensions of the resource 261096378 bytes audio/x-aiff Language A language of the resource English Type The nature or genre of the resource sound recording - nonmusical interviews Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/158mp emory:158mp https://www.globalhealthchronicles.org/files/original/3d8f9959ed1caa24dd35a0f53c1de03b.JPG dadcdab1227b920a9105b656fe9c6c36 https://www.globalhealthchronicles.org/files/original/5128da3b3614d2e157f6a0e19d143385.pdf 0fb616a6958502f13832fcec31a0c944 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 Dr. Christopher D'Amanda about his experiences in the West African Smallpox Eradication Project. The interview is being conducted at the Centers for Disease Control and Prevention in Atlanta, Georgia, on July 13, 2006. This is a part of the activities for the 40th reunion of the West Africa Smallpox Eradication Project. The interviewer is Victoria Harden. Harden: Dr. D'Amanda, you were born on July 14, Bastille Day, in 1934. I would like you to describe briefly your childhood, pre-college education, influential family and friends, if you would be so kind. D'Amanda: May I begin by saying I prefer, if it's all right with the project, to just call me Chris, or Christopher. Harden: That is fine. D'Amanda: Yes, July 14 was the day that my mother described as her day of liberation, so it wasn't only the Bastille that was taken care of. And that was in Rochester, New York. I was in school there, at a co-ed country day school, until the 7th grade, when my parents decided I should go to Exeter. So I went to Phillips Exeter Academy for 4 years. And then, in those years it was very easy-in fact, the Exeter senior classes were told this-that if you wanted to go to any college in the country, even if you were not in the top 75%, you could go to any college without applying to more than one. So Exeter seemed to be a precursor, in my mind, to Harvard. Then I went to Harvard for 4 years, where I majored in English. Harden: I'm fascinated by how somebody majoring in English literature then decided to go to medical school, so can you slow down and tell me here? D'Amanda: Well, the sequence really began in my father's family, where we would repair every Sunday for supper or luncheon cooked by his mother, and her 5 children, one of whom was my father. Her other son was a doctor. And her daughters had married doctors. So I grew up in a family of physicians, even though my father was a lawyer. And my older brother had already claimed, as the older (as I've learned later in my role as a family therapist), he'd already claimed law as his future. So I declared for medicine, following in some ways Papa's injunction that D'Amandas never worked for anybody. They were their own bosses. Little did I know that that was a little bit illusory. We all have bosses, one way or another, even in medicine. But anyway, we all have bosses. Harden: Indeed. D'Amanda: So as far as I was concerned, I was destined to be a physician. My choosing English, and all the humanities I could at Harvard, was in full recognition that once I got to medical school I'd have no time-or at least, I didn't know that I would have time- to read history, enjoy music. I started playing the piano when I was at Harvard. I took 6 courses every semester, even though we were only required to take 4, just because I wanted to get my fill of everything I could. And then, after that, after Harvard, I went to medical school at the State University of New York in Buffalo. Harden: And would you comment on any influential teachers at Harvard or in medical school that helped direct you towards thoughts of public health? D'Amanda: Well, we'll get to why I got here, but it was totally serendipitous, if you will, or fortuitous. Both of them were very positive moments, but not by design. When I first arrived at the medical school, my dean told me that I needed to work very differently at the University of Buffalo School of Medicine than I had at Harvard, in the sense that, it was very clear, looking at my transcript, that I could get As when I wanted to, but if I wasn't interested in a class, I would get a C. And he said, "Here, you have to do all the work we tell you to do because we want everybody to excel, and we want everybody to pass the medical boards." So a large part of their teaching was designed toward doing. The testing, anyway, was designed to replicate a large part of the medical boards which consisted of multiple-choice questions, which I've never enjoyed, and still don't. I prefer essays, and thinking a little bit, rather than having a thought done for me. In any event, that was the medical school experience. There were some wonderful professors there, particularly one in. in pathology,. Cornell Terplin [ph.]. Back at Harvard. Oh, I guess the tutor at Elliott House, where I lived, was a seminal person in my experience there, in retrospect, as he told me that Harvard was a molecular society. Now, I didn't quite know what that meant, but then he explained. Everybody at Harvard is, at least in those days and probably still (I just came from my 50th reunion there, a couple of months ago) is so busy doing their own world. They're like atoms, spinning in their own spaces, and they bump up against each other from time to time. But don't expect enduring friendships or things to grow out of the Harvard experience, was his way of defining it. And that wasn't particularly true for me because I did find friends there, but actually, in retrospect, the friends whom I still have are the friends that I made at Exeter, 3 or 4 years before I got to Harvard. The experience for me at Harvard was probably, at least in my mind, better capsulated by the excitement, the intellectual stimulation, and the fact that I was taking a graduate course in my first year because I could do it. I mean, I was allowed to do it, put it that way. It was just endlessly enthralling. But it was also sufficiently intellectual that by the time I got to my senior year I knew damn well I had to leave because it just didn't seem like a real world to me. I had an instinct that there was something else besides Harvard out there, but there was no way to enjoy it at Harvard. I have always been the second child, the explorer, the traveler (which is also part of family therapy: tradition of birth order). Anyway, I left very gladly. I left Cambridge and I left Boston, and went back to upstate New York. Harden: When you finished medical school, in 1966, obviously the Vietnam War was going on, and the military always needs physicians. But you joined the Public Health Service and came to CDC. Now, you said it was a serendipitous experience. You want to walk me through this? D'Amanda: I stayed in Buffalo to do my internship in medicine, and then chose to do a full medical residency with 2 years, and then stayed on a third year as chief resident. And during those years, I had a hand in teaching and being aware of research activities, journal articles, and so on. I envisaged myself becoming a full-time academic researcher in some ivory tower someplace. However, the draft still loomed. So I had a good friend who knew about the Centers for Disease Control, and I was interested in statistics as a way of sort of separating the wheat from the chaff in so much of the stuff that was being published in journals. Too much of it was anecdotal and not enough well-designed so that you could produce some kind of conclusion that might bear benefit in the practice of medicine. In any event, I came down to CDC to see if I could enroll in the EIS [Epidemic Intelligence Service] program. But when I got here, I was older than most of the people who were being recruited, having finished not only my internship, but my residency. A lot of the other doctors, my peers in the program, had just finished an internship. Secondly, I was bilingual in French and... from earlier travels I'd done in Europe, and training I'd had as a schoolboy in Rochester. So somehow that word got to D.A. [Donald A. Henderson], and D.A. came over and basically hijacked me out of EIS, and put me in the smallpox program. And I thought, what a wonderful opportunity. Here it is, I'm going to get to Africa, where I've never been, much as I had traveled before in other parts of the world. I was going to get to really perfect my French because it was clearly destined that I was going to a francophone country. And thirdly, I was not serving in the military, except in this wonderful sort of almost Gilbert and Sullivan way. My title was Lieutenant Commander, JG. But clearly I never had a uniform, never learned to salute. But because the Public Health Service had started with the Navy, taking care of the sailors who were getting sick on their early transatlantic voyages, the Public Health has always used naval military designations. So that was the serendipity. That was chance. Harden: So this is 1966, and you were taken out of the full EIS program, but they were training... D'Amanda: Oh, yeah, we still did the biostatistics course, we did all the other things. But then, one of the things that amazed me, we had a special program that went on for some time, learning how to take apart a Dodge truck and put it together again. Not part of the usual epidemiologic training, I'm sure. And I learned to do that. I'm not a mechanical genius, by any means, but in one of the letters I wrote at the time, I was describing that we all had to learn how to take the Ped-O-Jet apart and put that together. That was a piece of cake compared to a large motor vehicle. But it was stuff that I learned to do, and in fact was able to train people to do before my operations officer got to Ouagadougou in Africa. And it certainly helped me in when we had une panne, which means to have an accident, a breakdown. Harden: But you did have an operations officer supporting you? You didn't have to do both roles by yourself? D'Amanda: No. That was the design. It's one of the designs I'd hoped would follow me when I came back to work in America 4 years later: the balance between an administrative person and a physician, a medical person. But it doesn't work outside of this environment. Harden: Why is that? D'Amanda: I think it's because the administrators are too hungry. They don't want to share the glory. Put it this way: When I went to work in Philadelphia, after I'd come back here, I had talked to the director of the program that I was being hired into as the Chief Medical Officer for Drug and Alcohol Services in Philadelphia. And I described this. He had been a Peace Corps director. And he assured me that, yes, we would be a team, and so on and so forth. Well, that wasn't the way it worked out. He clearly wanted to be the major person, and it was a major administrative job, just like smallpox was. But there were clearly a lot of clinical, medical issues to be addressed, in terms of providing service. Philadelphia at that time was the 4th largest city in the country. We had 14 different treatment programs; we had 10 methadone programs. I mean, addiction is a medical disability or a medical problem. In any event, I made do by inventing things for myself. That's how I got to do a lot research for the people in Washington. But this model that exists here is very special. And I don't know whether you saw it at the NIH [National Institutes of Health], but it's a wonderful give-and-take because clearly the administrator has his or her areas of expertise and implementation and experience, just as a good doctor does. Harden: No, I did not see it at NIH, and that's why I have found it so interesting, the 2 working together . . . D'Amanda: None of us can know as much as we need to know. No single person. Harden: Yes. D'Amanda: But when you get into a complex project or major issues of administrative health programs...One of the things I did in Philadelphia was to start an Employee Assistance Program for the City of Philadelphia employees. I figured if we were taking care of the citizens of the city, we ought to try and figure out how to take care of our own because the statistics were clearly the same: 10%-15% of the people in any work force are involved, either actively or just recovering from, some form of addictive disorder. So anyway, I started this program. I had the city administrator working with me, as well as the union person. Because city employees, of course, were all union, and it was very clear from the model that I'd learned employee assistance from, that if you didn't involve the union, they would never cooperate with administration, and vice versa. So I got to be the middle person as the doctor, saying, "Look. This man has just driven a truck of hundreds of thousands of dollars worth of equipment, nearly off a bridge"-which was one of the headlines that occurred at one point when I was doing this-because he was drunk. But he was also a member of the union. So if the administration had tried to fire him, the union would have put up a battle. And if the union tried to brush it under the carpet, the city would have said, this doesn't work. So anyway, employee assistance was a beautiful way to give everybody a piece of the pie. And my job was, first of all, to train administrators to not be diagnosticians, just to pay attention to the job that needed to be done, and if somebody wasn't doing their job, they just had to report that, period. And then to get the union people to trust me enough to say that, even though I belong to administration, I'm not selling you out. I'm here to keep your voting member alive and well. So it worked, very well. The model is a tremendous model. It came out of the Cornell School of Labor and Management. A guy named Harrison Trice. Harden: Let's transport that back to Niger, now. Tell me how you conceptualized what you had to do and worked with your operations officer to do it. D'Amanda: Niger was a special project that we all shared, doing an assessment of neighboring countries. My countries were Ivory Coast and Upper Volta (now Burkina Faso). My home was in Ouagadougou, which is the capital of Burkina Faso. Harden: So perhaps we should start with Upper Volta and Ivory Coast? Okay. Sorry. D'Amanda: No problem. Well, one of the things I learned very quickly was, because I'm blue-eyed and white-skinned but happened to be bilingual, I was frequently taken to be a French person. And I learned very quickly that all the French carried a very significant and generally pejorative aura because they were the colonial powers. And they were still interfering with the local African people too much with their autonomy or their hoped for or desired autonomy in whatever francophone countries that I went to. So I learned very quickly to identify myself as an American, and of course that was very popular because Kennedy was President, and everybody loved Kennedy and loved the Americans. The second thing I learned very quickly was I had access with my OOs [operations officers]-a brilliant guy named Bill White [William J. White, Jr.], in Upper Volta, and then Tom Leonard [Thomas A. Leonard], and then Bob Hogan [Robert C. Hogan]. They were just special, wonderful human beings, as well as highly skilled technical people. I had to learn to be patient. Because even if I declared myself an American, it didn't mean that that would work all the time, and it didn't mean that it worked right away. So for the first year in Ouagadougou, I can remember still having to learn to wait for 3 hours to get to see the Minister of Health, whom I needed to see to discuss the program. And so I used to bring books and I used to read, and I used to get restless. But I also reminded myself that I was a guest; this was their country. They could treat me any way they wished. But after about a year of what I now think of as eating humble pie, so to speak, then I got to be able to get in ahead of people. I used to say to the Ivorians, as well as to the Voltaic, "You know, I'm being paid by America, but I'm not working for America. I'm working for your country." And that was the way we felt. That's the way I felt. And it was important as I see the practice of medicine now, and certainly family therapy, you don't tell people what to do. You ask the questions, you learn the ways, and then help them make decisions. So it was not in any way dictatorial, "we know better than you." The difficult part was, in some ways, working with the French, especially the man I worked with in Ouagadougou. There was a fair amount of disregard between the French and the Americans anyway, at least the French didn't like the Americans very much in those days. I'm not sure they're that much more comfortable with us now. But in any event, Colonel Sansarricq's first words to me were, "You know, D'Amanda, I don't know why you Americans think you can get rid of smallpox in 5 years. You know, we French have been here for 30 years, and this disease is not going to go away just because you came here." But that was another lesson I learned. We can segue up to Niger at this point because I was involved with the actual campaign in Ivory Coast and Upper Volta, in terms of the up- front sort of dealing with the higher-ups in the health administration. I'm an internist, and trained, as we all were, to identify smallpox, to determine whether an illness really was smallpox or not. The longer we were there, smallpox was getting less and less common. I ended up seeing about a hundred people with smallpox in Upper Volta. But near the end of my stay, most of the time, people who did not know the distinguishing characteristics thought that a lot of the old, but most of the young, people who had these particular kinds of rashes had smallpox, when in fact they had chickenpox. Harden: People have talked to me a little bit about differential diagnosis, but nobody has actually gone into detail. Can you? D'Amanda: Sure. First of all, smallpox is what's called an exanthem. It affects the skin. Virus affects basically lining, or squamous, cells. Squamous cells are on our skin, but they also line all our insides. They line our gut, they get modified in various specific ways. But, for instance, one of the common problems with measles patients is that they get otitis media; they lose their hearing. One of the worst things that happens to children who have measles and are nursing is that the whole lining of their mouths and their intestinal tract get these lesions on them, so they can't swallow; they can't even nurse. They get chronic diarrhea. That's how so many of them die. Or they get bronchitis. Again, these same cells are being infected with the same virus. So the distinguishing characteristic to do the differential diagnosis is really on the skin. And also time course of the illness. Each disease has what I call choreography, which is one of the words I use to define the withdrawal symptoms of various drugs that people take in the street. The time course, the process of smallpox, is 3 weeks long. And the lesions are in specific locations on the body. Harden: As opposed to chicken pox. D'Amanda: Chickenpox is sort of a flood of these same-looking lesions. On a black-skinned person, they're called taches blanches, white spots. Because as they erupt, they look like little blisters or pustules; but when they become scars, the black melanin hasn't gotten to that space; in fact, it's new tissue and it may never be replaced. In fact, that's how we do the assessment: we look for the white spots, the taches blanches. But the white spots have to be in different locations, and the patients have to have been sick for a different period of time. So that was a differential diagnosis. Harden: Someone spoke about a different smell for smallpox. Does this mean anything to you? D'Amanda: Not one I remember. It may have been, but I used those measures that I just described for you. I did not use my nose. Harden: All right. You were going to talk a little more now about the Niger assessment. Would you? D'Amanda: Okay. Our primary job was to make sure that we vaccinated at least 94% of the people with smallpox vaccine. Smallpox, like all infectious diseases, has something called herd immunity, meaning that you don't have to really cover every individual with whatever vaccine or inoculation to get immunity for the population. The only reason smallpox was eradicable was because the virus only lived in human cells. So it was known from work done here, before we even got out to West Africa, that if we got 90% of the population immunized, the virus couldn't survive. So our job was to first of all organize people in the various campements de marché [ph.], in whatever way we would bring them together to get them all inoculated with the Ped-O-Jet. And then going away and get the country done, within the 3-year period. We thought we could do the same thing with measles but that was an error. We thought measles infected children who were 5 or 6, when they first went to school. We did not understand that the epidemiology is a crowding phenomenon. And the crowding phenomenon in West Africa is going to marché. (market). Infants are carried on their mother's back. So as soon as they are born, they're introduced to the markets of whatever region they're in. And they get exposed. So in fact, the measles virus was transmitted very, very rapidly, and there was no way we could cycle in the 3-year time to get all the new children being born. So measles became actually a sticking point because in some of the African countries, especially places like Ivory Coast, smallpox had virtually vanished before we even arrived. There were a few cases, but they were imported cases, usually from Upper Volta because so many of the men from Upper Volta had to come south to find work. There was very little employment in countries like Niger or Upper Volta, and they lived by subsistence farming. So they'd go south to get money. But they'd also bring disease with them. Harden: So some of the countries were not supportive, then [of the smallpox effort]? D'Amanda: Well, that had to do a large part with how they were beholden to the French, their agent technique [ph.] who were French. Some of them were upset that we weren't eradicating measles. We'd set out to do that. That was part of our title: Smallpox/Measles Eradication. We did it with smallpox, but we in no way did it with measles, and so they were disappointed. There were a few slings and arrows thrown at us, but we had to do a mea culpa, or effectively so, that we didn't understand that the crowding phenomenon [that we assumed] had occurred in this country at the age of 5 or 6 and which would have given our cycle of 3 years ample time to vaccinate everybody, simply didn't work in the developing world. And so we did the best we could. Harden: In the forward to your journal in Niger, you stated that after being in Africa for a while, "The stranger begins to long for the leisure that cannot be had here, and he knows, even as he does so, that he has become a devotee of the special non-leisure that is Africa." Would you comment on living in Africa? D'Amanda: Well, it has to begin with us. It has to begin with the enthusiasm and the excitement we felt. We've talked about it a couple of times already here, in this reunion. It was really a new adventure for all of us. It was a new program for the country. It had extraordinary benefit in the potential to think that we could be helping so many people in such a distant place live, survive. So we were all fired up. And some of us enjoyed the clique of the American, sort of ambassadorial, residence and everybody of that sort. But most of us had to be out in the field, and we got to know the countries we were in well. I certainly got to know Upper Volta as well as anybody who was living in the capital because I was traveling all over the place. But in that process, you begin to realize that there's very little rest for these people. Subsistence farming is a cruel fate, and nature is there at every beck and call, either with too much water or not enough, either with seeds that can germinate or can't. There were very few animals in my area, so that there was no loss from predation. But it was just nature. And so people are always trying to take care of themselves, to get enough food just to survive. And then that's part of the traveling: people from Niger would travel through Upper Volta to go down to Ivory Coast, just to look for work. And I became aware of this energy that was often physical, was certainly mental. And it's not to say that there weren't warm, wonderful family units. And the camp, the compounds that we visited and the ones that I got to know in Ouagadougou and would be invited into for evening tea, were special, warm, loving places. But the real world was much harsher. That's what I was trying to get at: the fact that, in any developed country and certainly in America, we have the time to put punctuation marks. The time to take a break. Read a book. Watch TV. Listen to a concert. But that can't happen there. Harden: The program obviously had a major impact on you and the rest of your life. Would you comment on this and on the idealism of the '60s? D'Amanda: Let me deal with the first question. I never thought of myself as belonging. In fact, one of my regrets was that I was so busy in medical school that I didn't get into the idealism of the '60s. I mean, much of the Vietnam War went by me like that because I was too busy focusing. Harden: But on the other hand, you could have just come back and gone into private practice and made lots of money, and ignored the rest of the world. This is the kind of thing I'm thinking. D'Amanda: Oh, okay. Harden: It sounds to me, from what I've read, that you were very much committed to these people, and that they grew on you a lot. D'Amanda: Yes, they did. And the exposure to them. The simplicity and the dignity and the integrity. And I've learned the same with the poor people I work with now, from the inner city of Philadelphia, many of whom have not had much education. Literacy was, I thought, the way to get ahead in life. I had no idea, until I went to Africa, that literacy had nothing to do with wisdom. We met lots of very wise men and women there who couldn't read, couldn't write. But they were wise in life. Did I come out of Harvard, thinking that was possible? Not at all. In any event, it was possible, and my goal of becoming an academic doctor in some ivory tower was totally blown. One of the things that Sencer [David J. Sencer] asked us to do [to prepare for this interview] addresses that particular question. This was my number-one response: altered career plan and life: From academic medicine in an ivory tower, to addiction medicine in the trenches with citizens victimized by poverty, racism, and bigotry. Because that's what we've got here. We don't have subsistence farming, but we have people who are diminished in their value, and certainly in their ability to lead quality lives by a lot of "isms." And so, that's what, in the largest sense, those 3 years meant for me. Working with poor people, and, certainly in the northeast part of America, working with blacks, was not anything I had any experience with. We had had a black cook in the house I grew up in, and that was about my extent. I had read about the Black Panthers, and I had read about the freedom movements of various groups, and the "Black is beautiful" concept that was being promoted in the '60s. I knew that Stokely Carmichael had taken refuge in, or been offered asylum (I'm not sure what the proper phrase should be) in Guinea, and was a guest of the president, Sékou Touré. So I had friends in the airlines business, a wonderful... Vert Comboree, an absolutely statuesque, brilliant, and very, very intelligent and wonderful woman. And I asked her if she knew anybody who knew Stokely. Oh, she said, "I do. Because I'm a friend of the president's." Vert was a friend of virtually every man of power, as far as I was concerned. And whether she was courtesan or not didn't make any difference. She was just a very special human being. So anyway, she set up an interview. So I flew to Conakry and took a cab to the president's compound, a section of which he'd given over to Stokely. And I had a wonderful 3-hour talk with him. Strange, Caucasian- American, walking into this compound. . .I don't know whether he knew I was coming or not. I have no idea. In any event, one of the things he said, which was very, very special to me, was "Don't try and do things for black people in America." In other words, "Don't do a Teddy Roosevelt." He did use that phrase. Don't carry any big sticks on their behalf. He said (again, I'm having to paraphrase my own recollection, but basically, he said), "If you can open a door, that's fine. They may choose to go through it or not. But that's their business, not your business." Harden: Bill Cosby would tell them to walk through it. D'Amanda: Well, Bill Cosby's a newer generation. Harden: Right. D'Amanda: And one that has some legitimacy, I guess a lot, with the people who want to believe that they would or should. But a lot of people don't buy that. Harden: There must be a thousand stories that you have from your experiences over there. Is there anything that just impresses you that you'd like to get on the record here? D'Amanda: One of my difficulties, I guess, in the life I've led, is that I am enough in the moment so that even though I've got a reasonable mind, I tend to forget moments. The memories that I could share at this moment are the friendships and the excitement of being on the move. That's why I took that little caper in Nigeria, even though I was supposed to only be working in Niger. And I loved the excitement. What stories, what stories... Part of being bilingual in Abidjan, which was a much more sophisticated city than Ouagadougou, meant that I got to know people at the university. One friend of mine and I used to give great parties. Dominique would know various restaurants that would be available, and we would know lots of people at the various embassies, and so we had these wonderful, sort of all- night dancing, drinking, fun parties, in Abidjan. On the work side, I would say that the most important piece for me was something I've already alluded to, which was, you don't walk with a big stick. You listen, and you are patient. You observe, and you figure out where the hook is, to use a family therapy term-how to get in. Because you've got to work on somebody else's territory, as well as your own, to influence change. And change is why I went into family therapy. I'll share a story to give you a perspective of part of what made Africa so useful for me, and part of why it was such a powerful experience. My first day in family therapy, there were 12 of us in the class. The supervisor was going around, asking each one of us why we had come. When she got to me, I said, without even thinking, it was totally reflexive, "I want to be free." And I'd be damned if I knew what I meant. Well, part of Africa was being free from here, my particular family of origin, the issues that my parents had, that my brother and I sort of united to be safe and separate from. There was a lot coming in, in family dynamics, that in quite significant ways, affected who I was, and I knew that. Just like I had the instinct that Harvard wasn't the real world. I didn't know what the hell it was, but I knew that I wasn't participating, and that's one of the things that Africa let me do. It's probably why I was so active. I had another fleeting thought. . .There are wonderful raconteurs that I have listened to. One of my favorite delights listening to Bob Hogan, who unfortunately isn't here. He could tell stories beautifully. Part of the issue of being over there, especially in Abidjan, was to go to the Fourth of July ambassadorial celebrations. You just talked to people you don't know and wandered around talking. And at one of them, I got into conversation with this fellow, who wanted to know how many people I knew in the government. He dropped some names. Did I know them? Yes, I knew them because I'd had to work with them and discuss things. A long story short, he began to ask me whether I would be willing to record my conversations with these people. I said, "What would I do that for?" "Oh," he said, "Well, there are people in America who would be interested." Well, it didn't take me long to figure out that he was a CIA [Central Intelligence Agency] operative, and he was trying to recruit me. And I just sort of stood back after a couple of minutes of this conversation. He even got to the point of saying, "Well, we know what you're doing here in Abidjan, and we could make it uncomfortable for you." I said, "What the hell do you mean? I don't play cops and robbers." And I was so fascinated by the way the system apparently works. I have heard this subsequently. There are people who collect data., conversations. And they reel them off into these recorders, and then somebody, somewhere, tries to fit them all together. I suppose that's a large part of what our "war on terrorism" was all about. Anyway, that was a story that made me understand, again, so powerfully, as so many other things in Africa did, that I just don't fit into any of those kinds of skullduggery cowboy stories. Cops and robbers is not my style. Harden: Before we stop, is there anything else about the program that you would like to talk about? D'Amanda: I guess I'd like to hope is that there are other programs like it in the future-where there's a mission that is humanitarian, requires scientific and administrative know-how, and can move ahead and get things accomplished. I've not been in the public health world, other than looking at addiction sometimes as a public health process and as a behavioral disorder. But I know there's a lot to do. And this country does have inordinate resources. I think we lack the will, too often. But this organization, 40 years ago, didn't. And I think that that's a tradition that could be remembered with benefit to everyone, including CDC. Harden: Thank you so much. </pre> Player html for embedded player to stream video content <iframe src="https://www.youtube.com/embed/_D4wKxBp6nk" frameborder="0" width="560" height="315"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. 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Dr. D'Amanda also describes a cross border excursion to Nigeria following a smallpox outbreak. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/918b4259284b9c431fe0160ba11d4cfe.jpg 764530ab74646477a427acbcb9936299 Omeka Image File The metadata element set that was included in the `files_images` table in previous versions of Omeka. These elements are common to all image files. Bit Depth 8 Channels 1 Height 2604 Width 3375 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. 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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. 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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> Photographs A static visual representation. Examples of still images are: paintings, drawings, graphic designs, plans and maps. Recommended best practice is to assign the type "text" to images of textual materials. 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/. 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