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                  <text>Smallpox</text>
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                  <text>&lt;div class="landing"&gt;
&lt;p&gt;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.  &lt;/p&gt;
&lt;p&gt;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.&lt;/p&gt;
&lt;p&gt;The links above connect you to a database of oral histories, photographs, documents, and other media.&lt;/p&gt;
&lt;p&gt;Use of this information is free, but please see &lt;strong&gt;“About this Site”&lt;/strong&gt; for guidance on how to acknowledge the sources of the information used&lt;/p&gt;
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              <text>&lt;pre&gt;&lt;strong&gt;
 Interview Transcript
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Interview

David Bourne with Elisa Koski Elisa Koski
Transcribed: January 24 2009 | Duration: 0:31:00



Elisa Koski:     This is an interview with David Bourne on July 11, 2008  at
           the Centers for  Disease  Control  and  Prevention  in  Atlanta,
           Georgia about his role in the Smallpox Eradication Project.  The
           interviewer is Elisa Koski.

           With  this  interview,  we're  hoping  to  capture  for   future
           generations the memories  of  participants  and  their  families
           involved  in  eradicating  smallpox.  This  is   an   incredibly
           important and historic achievement and we  want  to  hear  about
           your experience. I have some questions to guide you, but  please
           feel free to recount any special stories or anecdotes  that  you
           remember about events or people. The legal  agreement  that  you
           signed says that you're donating the oral history  to  the  U.S.
           Federal Government and it will be in the public domain. For  the
           record, could you please state your full name and that you  know
           you are being recorded?

David Bourne:    Yes, my name is David  Bourne  and  I  understand  this  is
      being recorded.

Elisa Koski:     Thank you so much, and thanks again for being  here  today.
           Now David, we just want to start with a brief  background  about
           you, how you  grew  up,  your  pre-college  education  and  your
           college education, and how you came to be interested  in  public
           health?

David Bourne:    You bet. I was raised in New Mexico and I moved there  when
           I was about five. My dad was a Public  Health  Officer  for  the
           State of New Mexico for most of his career while I  was  growing
           up. So I became interested in  public  health  and  in  medicine
           generally through him and I graduated from high school  in  1967
           from Robertson High School  in  Las  Vegas,  New  Mexico  and  I
           attended a couple of years at New  Mexico  Highlands  University
           there in Las Vegas and then I graduated from the  University  of
           Utah in Salt Lake City in 1971. During the  course  of  my  last
           year or so, I applied  to  the  Peace  Corps  and  was  accepted
           approximately a year later. So I was accepted  around  March  of
           1972 having graduated in August  of  1971.  So  my  interest  in
           general in the Peace Corps was to help with the health  programs
           and they offered me the Smallpox Eradication Program in Ethiopia
           and I accepted that and became a volunteer in  April  1972  with
           the intention  of  coming  to  Ethiopia  and  working  with  the
           Smallpox Eradication Program.

David Bourne:    Okay. So that's a unique way to  get  involved  with  CDC's
           Smallpox Program.

David Bourne:    Right.

Elisa Koski:           So what was your role when you arrived?

David Bourne:    I'm sorry?

Elisa Koski:           What was your role in the program when you arrived?

David Bourne:    Okay. In the smallpox program, I was  called  the  Smallpox
           Surveillance Officer.  So  what  they  did,  they  had  us  have
           orientation here for a day or two in Atlanta with Dr.  Foege  on
           smallpox generally and after orientation we went to Ethiopia for
           approximately eight weeks of language and cultural training, and
           then we went to our various provinces where we were to  work.  I
           was a Smallpox Surveillance Officer, as they were called. So  in
           Ethiopia, the way it was setup, it was run jointly by the  World
           Health Organization (WHO) and the Ethiopian Ministry  of  Health
           and the Peace Corps Volunteers worked  in  concert  with  people
           from the Ministry of Health and the WHO to do  the  eradication.
           So our job or role was to go village to village  from  where  we
           were assigned and look for smallpox. When we found it, we  would
           in effect, evacuate - vaccinate the  affected  village  and  the
           surrounding villages. Functionally, I think the goal  was  a  2-
           hour walk around the village, but the villages were sufficiently
           spread out, so it worked out that the affected village  and  the
           surrounding villages - the adjacent villages, vaccinate them and
           move on to the next area where there was smallpox. I  worked  in
           two areas of North Central Ethiopia primarily.

           The first problem area I've worked in  was  Gojam,  and  then  I
           worked in that province along the Western edge of the Blue  Nile
           and then I transferred - they transferred us out of Gojam and  I
           went to Wollo which was essentially on the  other  side  of  the
           Blue Nile, and I worked in Eastern Wollo. So I spent most of  my
           career on each side of the Blue Nile, the Blue  Nile  Gorge  and
           there was an awful lot of smallpox. By that time, '72 into  '73,
           a large part of the remaining smallpox was in the North  Central
           Highlands of Ethiopia and that's where I  was;  and  during  the
           course of the year, during the rainy  season  which  is  in  the
           summer, all of us in Wollo, of which  there  were  four  or  six
           volunteers, we would move to the desert because the  rain  would
           make the - we didn't have roads or vehicles but the  paths  were
           impassable due to the mud, so during the summer we would move to
           the desert in Western Wollo  and  then  we  would  deal  with  a
           totally different type of people, these were  the  Nomads,  they
           were subject to a Sultan, and we would work with the Sultan  and
           his people to find out where the Nomads were at that  particular
           time; they always knew where they were and  we  would  vaccinate
           them, so that's essentially - I spent most of  my  time  in  the
           Highlands, probably about 9,000 feet elevation. The weather - it
           was near the equator, the weather  was  beautiful  most  of  the
           time, and then in the summertime I would go to the dessert.

Elisa Koski:     It sounds like you were quite a young man  when  you  first
           arrive there, coming out of college and then  the  Peace  Corps.
           Can you describe to me a little bit  of  what  it  was  like  to
           arrive in such a foreign place and begin  to  work  on  such  an
           important program?

David Bourne:    It was to me very exciting, initially certainly, to what  I
           found - I was probably 23 when I arrived there and it was  very,
           very new and very exciting. No one spoke English. What  we  did,
           we lived in a provincial capital. There were probably  three  of
           four of us in the Peace Corps that had a house together, and  we
           would  go  to  different  parts  of  the  provinces  -  of  that
           particular province. So I, for 30 days at a time would  not  see
           any Americans or any white people for that matter or anyone  who
           spoke English, with the exception of a translator that I had the
           first year, and I would fly to, in effect, the county seat of  -
           fly commercially to the county seat of the district where I  was
           working. In that particular area there was very little smallpox;
           the smallpox was focused in the Northern part  of  that  county,
           so we would walk approximately 50 miles the next day, leaving at
           dawn and getting there at dark to  get  to  the  center  of  the
           Northern part of the county where most of the smallpox was.  For
           the next 30 days, I would go village to village or  to  markets,
           trying to find smallpox which was relatively easy to find. There
           was a lot of it.

           One of the most interesting things, and far the most interesting
           ultimately was that the second year I didn't have  a  translator
           so I never heard English or spoke English during those entire 30-
           day segments, I had a guide, but no translator. So that  made  a
           very enriching experience; and then it got quite  mundane  after
           the initial excitement; months after months,  year  after  year,
           going village to village vaccinating. The people were not - they
           were very, very - always very hospitable. They were  not  always
           very enthusiastic to see me. They had other diseases  that  they
           were worried more about than smallpox, but they were always very
           hospitable even though they were very poor. I'd  live  with  the
           people; there was nowhere else to live. They gave me  what  food
           they had, they share that with me. That was the most  incredible
           thing and it was very interesting to live in a place where  they
           had not seen white men. Certainly the children never had, and it
           was very good and to deal with; and from time to time the people
           at WHO in Addis Ababa, Dr.  Henderson,  came  there  once  in  a
           while, so  I  did  meet  him  once.  So  it  was  very  exciting
           initially, then it became quite mundane and difficult throughout
           the course of the two years and a half.

Elisa Koski:     Thank you. You  mentioned  that  you  lived  with  families
           while you were staying in these villages?

David Bourne:    Right.

Elisa Koski:     Are there any specific memories or stories you can tell  me
           about that experience? That must've been interesting.

David Bourne:    The interesting - there's a tremendous - I understand  that
           those guys that worked in  Southern  Ethiopia  had  a  different
           experience than those of us  that  worked  in  the  North.  Even
           though the people in the North were always very hospitable, as I
           mentioned, they weren't particularly enthusiastic, but each  day
           it was assumed that you would be able to spend  the  night  with
           someone, and it would be only for one  night  typically  because
           you would be moving on and the people would talk to the Governor
           and the Governor would - usually have him yourself,  but  if  he
           weren't  available,  occasionally,  there'd  be  a  -  I   could
           understand everything they could say even though sometimes  they
           didn't realize it. Sometimes they'd say, "You  take  him."  "No.
           You take him." "No. I don't -" But it was fun for us  to  batter
           with our Southern colleagues when people would fight over  them,
           "I want him." "I want him." They would  kill  a  sheep  for  the
           people in Southern Ethiopia quite often. Nobody  ever  killed  a
           sheep for us. They killed a few chickens, which was always  very
           welcome and very good. But now I don't think they had as much up
           in the North and they were certainly a different tribe, but they
           were always very friendly. One night, I  was  sleeping  outside,
           even though I was in the company of a family -  because  it  was
           very hot. I remember waking up to a dog barking very close to me
           and very scary because the dogs there, they're not exactly  pets
           and not all that friendly, so that was one  particular  case  at
           that point where I was pretty scared to be  out  there.  But  in
           general they were so friendly and I felt no danger whatsoever.

Elisa Koski:     You did say they weren't  always  enthusiastic  about  what
           your purpose was in the village. Oftentimes maybe  because  they
           had other diseases that they were a little  bit  worried  about.
           Did you ever run into any problems or difficulties accomplishing
           what you came to do?

David Bourne:    Yes. From time to time, they absolutely  would  refuse.  In
           general, the way it worked is that the decision makers  had  had
           smallpox before, so these  were  the  adults  and  it  was  very
           [inaudible0:13:26] minor  in  Ethiopia  so  the  mortality  rate
           wasn't very high. So they would often be  able  to  survive  and
           they knew they  couldn't  get  it  again,  so  the  people,  the
           governors,  the  decision  makers,  the  adults,  they   weren't
           enthusiastic, but they would almost always let their children be
           vaccinated. But you had to go seek them out, generally speaking.
           They might come in small groups. I  understand  many  times  our
           colleagues in the South, they would  have  to  have  the  police
           control the crowds too because they wanted to be vaccinated.  So
           it was  a  little  different.  But  occasionally,  people  would
           absolutely refuse. "No. Get  out.  We  don't  want  you  in  our
           village. Leave." In that  case,  I  would  ignore  the  affected
           village, but vaccinate the surrounding villages.  Thereby,  they
           would be unwittingly protected to a large extent because I would
           be able to vaccinate those surrounding villages.

            Now during the course of our tenure there,  the  Emperor,  Haile
           Selassie, was overthrown in a coup but I  assume  they  are  the
           people who are still in power today. It was a Military Junta and
           the types of people at least - if they were still in power today
           - and that created a situation of anarchy to a large  extent  in
           the countryside because the Government had  been  overthrown,  I
           think in general, the Government did not affect the people, they
           were farmers, kind of under a feudal system, but everyone had  a
           gun in Ethiopia. There was one situation, where right after that
           revolution, in the county seat in the effect I flew  into,  some
           students  had  surrounded  a  judge's  house   who   was   being
           transferred and they were in the spirit of  the  revolution  and
           they said,  "No.  This  judge  expropriated  property  from  the
           people. He's unjust and he's not leaving." So  the  judge  hired
           some robbers, in effect, highway men, they  were  fairly  common
           there, "Shift" as they called them; and these robbers were  well
           armed and he hired them to escort him and  his  family  and  his
           stuff. They were planning to go by mule or whatever to the  next
           town, but when these shifters came, these highway  men  came  to
           his house, the students and the people in the town, they  had  a
           gun battle.

            The judge's wife was killed certainly and  most  of  his  family
           and about half of the highway men were killed. This is  the  gun
           battle that occurred the day before - the day of the  evening  I
           was walking back there. So the guy I was  staying  with  was  in
           effect the Public Health Officer who was a doctor,  and  he  was
           treating the wounded - the remaining wounded who were very badly
           wounded, and the people in the house, they  threatened  to  burn
           down our house, his house, the one I was staying in  because  he
           had done that, but they fortunately didn't do that. But  talking
           about refusal, the next day I was scheduled to go back North and
           no one would go with me because the people that got killed  were
           from the Northern part of that county; and they were rumored  to
           be coming down to burn down the town. Kind of like the Old West.
           Then the next day, the judge's  family  arrived  by  plane  from
           Addis Ababa, the capital, armed with machine guns and whatnot to
           exact revenge on the people and I left on that  very  plane.  It
           was time for me to go. In fact, that was the last time I was  in
           that part of the country.

Elisa Koski:           It seems like that would've been  quite  a  dangerous
      situation.

David Bourne:    It had appeared to be. Everybody  else  really  thought  so
           and I was ready to go, and I was pretty - I guess I  was  24  by
           that time, 25. But I could  understand  that  the  guide  I  had
           usually: he said, "What good would that do me if I got killed up
           there-I'm from the South;" and there was going to be a big  feud
           between the North and the South. During that whole period  there
           were a lot of situations  like  that  where  the  citizens  took
           advantage of the roles of the anarchy in the country,  and  then
           soon after that, Peace Corps offered people to leave voluntarily
           because of the deteriorating situation. Most  of  us  stayed,  I
           stayed through my tenure and a couple of months beyond, but  the
           next year, I'd say,  I  think  it  was  probably  in  '75,  they
           actually kicked the Peace Corps out of Ethiopia,  and  everybody
           left.

Elisa Koski:           How far along into your time  with  the  Peace  Corps
           did this occur; and after it occurred, did that change  how  you
           played your role in the Smallpox Program?

David Bourne:    I was pretty well - I was there a total of about two and  a
           half years and this was probably about two years into it.  So  I
           had about three months to go and I think  if  memory  serves  me
           right, it was time to go to the desert anyway which was  totally
           different. Their political situation was -  there  weren't  that
           much people, there wasn't much Government and the Nomads that we
           dealt with went back and forth between what was called then  the
           territory of [inaudible 0:19:42] in Ethiopia;  I  think  it  was
           Somalia Land or  -  So  the  political  considerations  and  the
           security situations were far  different  in  the  desert.  So  I
           finished out my tenure in the desert and then I agreed to remain
           a couple  more  months  to  train  the  new  group  of  smallpox
           volunteers, about nine or 12 of them that came, and I stayed for
           about  two  months  or  three  months  helping   the   Ethiopian
           contractors train this new group.

Elisa Koski:           Now you mentioned a little bit earlier that  you  did
           have some contact with WHO and  CDC  counterparts  such  as  Dr.
           Henderson. Can  you  tell  me  a  little  bit  more  about  that
           relationship?

David Bourne:    I remember meeting him only once, but we had - with  regard
           to CDC, I only met only one CDC person. I don't recall his name.
           He was an EIS Officer that came from Atlanta  for  a  period  of
           time, three months or so, and he actually worked in a  different
           - in a neighboring province but I did meet him.  So  there  were
           very few CDC people in Ethiopia and there were a few WHO people,
           Dr. Vitello[inaudible name0:21:09] was the head of  the  program
           there  in  Ethiopia  for  WHO.  I   dealt   with   a   Brazilian
           Epidemiologist  Dr.  Ciro   de   Quadros   and   an   Indonesian
           Epidemiologist, Dr. Peter Kaswar[inaudible  name0:21:25].  There
           was actually also a Russian Epidemiologist I know who came  down
           there; so they had an office there in the capital city in  Addis
           Ababa. I dealt mainly with Dr. Kaswar, to some extent  with  Dr.
           De Quadros. So we would occasionally meet with Dr. Hen - I would
           happen to be in the office one day-It might have been literally,
           right after I'd left the troubled area, the plane was  going  to
           Addis, so I went there to Addis Ababa and I  may  have  met  him
           there. I remember the conversation, I was talking to  him  about
           my - the success with those jet guns, the people seemed to  like
           them on the one hand, but on the other hand, they so often broke
           down especially in the desert. So in effect that turned out -  I
           thought it was a good idea and told him so; and he thought  that
           was interesting, but in the end, they didn't work  for  me  very
           well. But I did have a brief conversation; he wanted to know the
           status, where I'd  come  from,  that  kind  of  thing,  and  the
           country. It was an honor to meet him there because at that time,
           he was the Director of the  global  program.  So  that  was  the
           extent of my dealing with WHO From time to time I  would  go  to
           the office, not very often: the day to day efforts would be just
           me and a guide and we're out for 30 days at a time and  then  go
           back to the provincial capital of the town of about 60,000;  and
           we had an office within the  Ethiopia  Ministry  of  Health,  in
           effect the Health Department. So we had a smallpox office  there
           that - even though there were four of us, we were gone so  much,
           we rarely saw each other.

Elisa Koski:            Were  there  any  specific  challenges  or  positive
           aspects to working with the Ministry of Health?

David Bourne:    With working with the Ministry of Health?

Elisa Koski:           Yes.

David Bourne:    They were very - actually I don't recall if we were in  any
           challenges  particularly,  they  were  very  enthusiastic,  very
           dedicated; and there  weren't  that  many  of  them  either.  We
           probably outnumbered them. They would have -  maybe  within  the
           province, they would probably have a staff  of  maybe  four  and
           there were four to six of us, so it  was  pretty  equal  and  in
           general we wouldn't have a lot of interaction with them  because
           like we did, they would go to different parts of  the  province.
           So when we did come together  they  were  very  dedicated,  good
           friends of ours and so forth. Then I had nothing but praise  for
           them and their dedication and their competence.

Elisa Koski:           Great. You mentioned early  in  your  interview  that
           you had about four to six team members who were also Peace Corps
           volunteers, but that you didn't see them incredibly  often.  You
           were on your own most of the time.

David Bourne:    Right.

Elisa Koski:           Were they doing the same sort of thing and how  often
           did you get to share your experiences together?

David Bourne:    They're doing exactly the same thing. Now this was just  in
           that particular province. So I think  we  might  have  had  four
           people there. Throughout the country, there might have  been  at
           any one time, 20 Peace Corps volunteers in the Smallpox Program,
           or 25, in different parts of the country. But  each  of  us  did
           exactly the same job. We would go to different provinces because
           they were - in our province, Wollo, that was  probably  -  if  I
           remember right it almost led the nation in a number of  smallpox
           cases by that time and I think they were among the last cases in
           Ethiopia after I left Wollo province or near there.  So  we  had
           plenty to do. I would say, my area and other people's might have
           been similar, but I in effect, I think was  responsible  for  an
           area maybe 40 miles wide  and  120  miles  long,  maybe  250,000
           people, the way I remember it,  but  there  were  no  roads,  no
           electricity, no towns. Well, there were some  towns,  but  there
           were no roads with the exception of an old  road  built  in  the
           '40s that was impassable, or mostly so. I would walk up and down
           that area for  two  years  and  mainly  in  the  North,  and  my
           colleagues would do the same. They would go to other  areas  and
           they did a lot of walking as well.

Elisa Koski:           I'd like to talk a little bit about  how  this  whole
           experience in Ethiopia really influenced your  life  after;  and
           how it impacted your career in Public Health?

David Bourne:    Great. Right after I came back, I came back around  October
           of 1974; and actually, as a result of my conversation with  this
           EIS Officer in Ethiopia, he told me about working for CDC, about
           the process, and that's what I wanted to do. That was the single
           purpose I had. At the time before  I  met  him,  earlier  in  my
           career in Ethiopia, I was thinking about coming back  and  going
           to Pharmacy School, but I decided I would try to work  for  CDC.
           So I immediately, probably the next day, applied to CDC there in
           October of '74 and I had an interview and I was hired  to  start
           in Los Angeles in January of '75 with the VD Program as everyone
           in CDC virtually then, and maybe today I'm not sure, I think  it
           may have changed now; but that was the path. You started out  as
           a VD Investigator for CDC, and I started out in Los Angeles.  So
           I went from Los Angeles to CDC; to  Anchorage,  Alaska,  and  to
           Gallup in New Mexico. So New Mexico happened  to  be  where  I'm
           from, so when the time came  to  be  transferred,  I  decided  I
           didn't want to be transferred and wanted to remain in New Mexico
           so I resigned from CDC after about eight years and then I  -  So
           the Peace Corps was directly responsible  for  my  remaining  in
           Public Health and remaining in and being at CDC, and I did  that
           for about eight years and then for other reasons I  didn't  -  I
           remained with CDC. From there I  worked  for  the  U.S.  General
           Accounting Office for similar number of years, maybe  10  years,
           and I currently work with the U.S. Department of Energy. So I've
           stayed with the Federal Government from the time I  started  the
           Peace Corps in several different agencies including CDC, and  it
           was directly responsible for my decision and my ability to  work
           for CDC.

Elisa Koski:           Thanks. Just in closing,  I  would  like  to  ask  if
           there is anything else, any other particularly poignant memories
           or stories you would like to share about your time  in  Ethiopia
           that we haven't covered so far?

David Bourne:    It was basically a - it was a very hard job.  At  first  it
           was  very  exciting,  it  relatively  quickly  became  hard  and
           mundane, but it was very rewarding because  you  could  and  you
           would leave a village and know that they've had - that area  had
           smallpox for maybe 2000 years and  will  never  have  small  pox
           again. At the time, I think  that  feeling  and  perspective  is
           growing with time especially when you view the global program in
           perspective of disease control  programs  that  they're  seeking
           now. So it was very, very rewarding. I did have the  opportunity
           - also there was a massive cholera outbreak in the desert during
           one of the summers there, and that was  a  situation  where  far
           more people were dying and it was far more serious, but we  were
           able to - myself and a  colleague,  particularly  another  Peace
           Corps volunteer, were able to maybe vaccinate  several  thousand
           people and even start a couple of  IVs  which  we'd  never  done
           before and haven't done since. But that was rewarding  as  well.
           So on balance, it was really quite  difficult,  but  very,  very
           rewarding and I appreciate the chance talking about it.

Elisa Koski:           Thank you so  much  for  talking  to  me  about  your
           experience. It sounds like it was very rewarding and had a great
           impact  on  your  life.  We  really  appreciate   sharing   your
           experiences.

David Bourne:    Great. Thank you.

Elisa Koski:           Thanks.


[End of Audio - 0:31:00]
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              <text>&lt;iframe width="100%" height="100%" id="iframe" name="viewer" src="https://globalhealthchronicles.org/ohms-viewer/viewer.php?cachefile=JeffreyBryantXML.xml" frameborder="0"&gt;&lt;/iframe&gt;</text>
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                <text>Jeffrey L. Bryant, director of CDC’s Division of Emergency Operations, discusses his career leading up to his time at CDC, including his military service and his time with the Federal Emergency Management Agency (FEMA).&lt;br /&gt;&lt;br /&gt;A PDF OF THIS INTERVIEW CAN BE FOUND AT THE TOP OF THIS PAGE.
&lt;h2&gt;&lt;a href="/items/show/7784"&gt;&lt;button&gt;Go back for the other video&lt;/button&gt;&lt;/a&gt;&lt;/h2&gt;</text>
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