24 12 2286 https://www.globalhealthchronicles.org/files/original/35c8696b4dd6f0f097dcaf1c630112ff.jpg f8baece4f8f23a894202c3887c5a2a74 https://www.globalhealthchronicles.org/files/original/d04627830a2d6e8669f59fda68ccc468.pdf b992c68df44827472101ef704d64308f Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> INTERVIEW WITH RON WALDMAN Elisa: This is an interview with Ron Waldman on July 11th 2008 at the Centers for Disease Control and Prevention in Atlanta, Georgia about his role in the smallpox eradication project. The interviewer is Elisa Coskey. With this interview we're hoping to capture for future generations the memories of participants and their families involved in eradicating smallpox. This is an incredibly important and historic achievement and we want to hear about your experience. I have some questions to guide you but please feel free to recount any special stories or anecdotes that you remember about events or people. The legal agreement you just signed says that you're donating the oral history to the U.S. Federal government and it will be in the public domain. For the record could you please state your full name and that you know you are being recorded? Ron: Ron Waldman. Yes, I know I'm being recorded. Elisa: Okay, thank you very much and thanks again for being here today. I just want to start with a few chronological questions and if you can describe for me briefly your childhood, your college education and what influenced you to become interested in public health in general. Ron: Well, my childhood was spent in New York City and then in Long Beach, New York where I graduated from high school. I went to college at the University of Rochester in upstate New York and then to Law School at the University of Chicago in nineteen sixty seven where I studied for one year until I left the U.S. during a period when many people my age then were leaving out of objections for the Vietnam war and I ended up in medical school at the University of Geneva in Switzerland. I can't honestly say that while there I had any exposure to public health at all and I really didn't know what I wanted to do in medicine with my medical degree when it was awarded to me somewhat surprisingly in nineteen seventy - in May of nineteen seventy five. Being a foreigner in Switzerland that time meant that without having the benefit any more of a student permit to live there I had to leave the country and I really didn't have much knowledge of what I was going to do. While there I had been coaching a high school baseball team and I was talking one day to my star pitcher from the team who was graduating from the international school in Geneva at the time. And we were talking about what we were going to do. I asked him what he was going to do and he said he was going to go out to Colorado to ski. And he asked me what I was going to do and I said I didn't have any idea, that I had just finished medical school at the university and I would probably end up doing something related to medicine. And he said, "Oh that's pretty interesting. You ought to meet my girlfriend." And I said, "Why?" "Well her dad works with the World Health Organization," and I said, "Okay well bring her to the next game." So, he came to the next game accompanied by his girlfriend and she said, "Well you ought to go up and see my dad," and her dad turned out to be D.A. Henderson. So I went up to meet with him and was long hair and all at the time ushered up to the smallpox offices where I don't remember exactly what happened but the upside of it was that they asked me if could leave for Bangladesh within the next few days and I said sure. And that's how I got my introduction to public health and to smallpox, which has been basically the beginning of career that's still going on. Elisa: So, quite an unanticipated chain of events. Ron: Very serendipitous event as had other previous events been so yeah, not the usual pathway into the program. I don't think so. I left as a basically - no basically I left for Bangladesh a few days after that meeting as a WHO volunteer so smallpox eradication was really my first job of a serious nature but I didn't get paid really any more than just the subsistence that WHO volunteers had at the time. I didn't know anyone who was working in public health. I didn't know what public health was. I'm sorry to say and maybe it doesn't reflect well on the very strong academic program at the University of Geneva medical school, but I hadn't really heard of smallpox and I am not entirely sure that I had heard of Bangladesh either but there I went. Elisa: Quite the adventure you were beginning. Can you tell me a little bit about your arrival there in Bangladesh and? Ron: Yeah. We went - I remember leaving Geneva and we were heading off for training in Delhi. I remember distinctly flying into Delhi and when they opened the door of the plane there was this rush of heat that I had never experienced before in my life and I knew I was somewhere different. We had a small orientation group there in India. I remember some of the people who were in that group with whom I'm still good friends. I think that orientation took about five days. Some people stayed in India, others were sent on to Bangladesh that's where the action was and I remember that first plane trip t o Bangladesh. I never thought I was going to land at all. It was May, the beginning of the monsoon season and the plane flew over Dhaka, tried to land, storms came in, the plane was rocking, it was just awful. For about an hour they kept circling around and trying to land. They couldn't and eventually the plane went back to Calcutta where we spent the night. This is all like in the fog of all of this newness happening to me. We were forced to spend the night in Calcutta, got out the next day. They took us to the airport, put us on a plane again and flew us off to Dhaka where this time we landed and we were greeted by Daniel Tarantola who was - I don't know exactly what but high up in the smallpox bureaucracy in Bangladesh - and taken into another orientation session that lasted about a week. And that's where I met all these acquaintances and many of which were with people that I'm still in regular contact with as I am with Danielle just now. At the end of that orientation where they were talking about things like imprest accounts and administrative matters and stuff that I really didn't understand and which I had frankly little interest, they shipped me off. I was young and there were few of us, a number of volunteers like myself. They shipped me off to the northeastern corner of the country, Syhlet district and there I went. I went from Syhlet - the smallpox base in Syhlet they shipped me off even further towards the Indian border to a upazila I think they're called now, a thana called Chhatak - a town called Chhatak where there were no roads. They had given me an outboard motor. I had no experience with motorboats but they gave an outdoor motor. I carried it up there on my back, found a boat, found a driver and started doing what they had instructed me to do which was to conduct surveillance activity. Elisa: You mentioned that you traveled further outside of your central village and had an outboard motor. Can you tell a little bit about what travel was like, did you have a team with you? Ron: I had one person with me basically, a driver who I had hired. I located up there. This was a place it was really far out in many ways but it was a place that had a big paper pulp factory that was run by an Eastern European country and when I got up there I didn't speak the language or anything. But I went over there and with a translator -- I had a translator -- just to find somebody who could drive me around in this motorboat. And we located a guy who just turned out to be fantastic and who literally saved my life a number of times. He'd been a freedom fighter during the Bangladeshi war of independence and those guys, Rakkhi Bahini they were called, were very highly respected by everyone. This was a guy of indeterminate age I would say. He had long flowing white beard but I don't think he was very old. He was probably in his forties or early fifties. And he attached himself to me and when we explained what I was there to do and what the program was about and became a very, very loyal, faithful, dedicated and incredibly competent colleague. We went around with fliers and posters and obviously had supplies of vaccine, bifurcated needles, everything else that we needed to control outbreaks of smallpox should we find them. We went around to - there were no roads literally. We only had the rivers to follow and then when enough rain had fallen and as I mentioned we were on the Indian border and when they created Bangladesh they just - the surveyors establishing the boundaries would walk and walk and walk and as soon as they took a step up, that's where they drew the border. So, Bangladesh was completely flat and there was no rock to build with. So, all of the stones for construction came from the Indian side of the border and they would carry them along the rivers in these long - I don't know - canoe like boats that they would load with rock until there was no free board whatsoever on the side of the boat. They were going with the top of their boats flushed with the waterline. Why not? There wasn't really any motorized traffic in these areas until I came along with my motorboat. So, I basically held their lives in - my driver did cause if we had created wake going past them with their boats filled with rock they were going down. So, the upshot of it was that basically I was king of the river or my driver was. So, it was really kind of we went everywhere. Like we went to market places, mosques, other gathering places, every little village we could find. After it had rained enough we could go straight as the crow flies. We didn't have to stay to the course of the rivers. Little rice paddies filled with water and the whole place was under water. I remember that we would just go straight from one point to another. Sometimes they had these little dykes between the rice paddies and sometimes we would hit our motor up against those dykes and we would break off what's called a shearing pin that keeps the propeller in place. So, we always had to have a hefty stock of shearing pins whenever we traveled. I remember that and I remember having to change them quite a number of times. As time went by I learned how to deal with the boat and I learnt enough of the language to get by so that on the weekends when we would go down to Syhlet to get a little R&amp;R; for a day or so with the other smallpox workers from the region, I used to take the boat down myself. I'd leave the driver up at home with his family and I used to go down probably about a three-hour ride with this little maybe thirty horsepower Yamaha engine that we had. So, I got to be pretty good with the motorboat in addition to smallpox. And you know by now many people must have explained what the deal was. We would ask if people - we had these recognition cards that the WHO had given us and we'd show them around and we would invite people to tell us if they had seen anybody with a rash that led them to suspect that this person might have smallpox. And then we would go out to that place, to the person's house. We'd try to get enough information to know where it was. And if indeed we identified the patient as a person who had smallpox we would institute containment activities which meant that we would isolate the patient in the home, hire guards from the village to make sure that no one could come in or out of the person's hut and we began vaccination routine. That's when we started hiring people and we would round up as many people as we could. They were usually younger kids who were interested; at least interested in earning the pittance that we were paying them. Six taka a day I remember really. It wasn't very much money and they would begin to - we would instruct them on how to vaccinate and they would begin vaccinating everybody. I don't remember exactly what the protocol was but it was maybe within the first day to vaccinate everybody within a one hundred meter radius of the index case and then within five days maybe three hundred meter radius or five hundred meter radius and eventually up to a kilometer around the case. For us it wasn't difficult at all because this was a pretty sparsely populated rural area and as I mentioned everything was water. So, the little villages if you could call them that, the clusters of homes were all on little islands basically that just were slightly elevated above the water. Maybe there'd be ten or twenty homes or something like that so we do 00:15:25 and vaccinate everybody and then just get back in the boat and go to the next line and get out and explain what we were doing there and vaccinate everybody. So it really wasn't for me all that many people. On the other hand we had a lot of smallpox. So, out of all the people that you will be talking to, I've seen as many cases of smallpox as anyone. This happened I think it was in March or April or maybe early May in Bangladesh the government knocked down the slums in the capital city of Dhaka and when they did that people fled back to their home villages and they transported diseases all over the country. During that - I know it's a big event that the WHO people really tried and CDC people really tried to get the government not to do this but the government was intent on knocking down these slums and they did and because then when smallpox was carried throughout the country that's when they had this huge resurgence. They had been doing quite well in bringing it under control but in that spring of nineteen seventy five there was a huge resurgence in the number of cases which is why coming full circle, they were so interested in taking anybody who would go basically and sending them out there. So, when I turned up on the basis of D A's daughter's recommendation at the offices in WHO they were really happy to see a warm body who was willing to go out there. They were throwing everything into trying to bring the epidemiological situation back under control. Elisa: Very interesting. Can you tell a little bit about your reception in some of these villages or as you called them like clusters of homes in combination with the social circumstances at the time? Were there ever any challenges that arose for you? Ron: Yeah, that's a terrific question and one that my answer will maybe be a little bit controversial and has been at other meetings of smallpox people. One of the reasons why the smallpox eradication effort in countries like Bangladesh was so successful was that those of us working in the program were fanatically committed to its success. I think that the tone was set by those people who were leaders and Bangladesh for us it was Stan Foster, Daniel Tarantola, a number of others, people from the CDC but we were going to get this job done. And I can't even tell you with tremendous accuracy what the reception was. Sometimes it was quite warm, we were always invited. I remember before we did anything when we arrived there and remember I was traveling with a guy who was incredibly respected in society there and who everyone knew. But we were always asked to take a seat; we were always offered green coconuts and the coconut water. We were offered tea always with - whatever little bit they had to offer guests we were always offered right off the bat. The hospitality was incredible. When it came to doing the job of if it meant isolating somebody in a home, if it meant vaccinating people who might not want to be vaccinated for one reason or another, the reception could become at times a little cooler. But it never really dissuaded us from getting the job done. So there were times when things were done even forcibly. If people tried to flee when it was their turn to be vaccinated because they were afraid of what it might be and it was never I don't think all together adequately explained to people or maybe it was and they didn't understand. They could be at times physically restrained and forcibly vaccinated. I have a very deep and abiding interest in human rights and in the relationship between communicable disease control and human rights. But I have to say that at least in my - from my personal experiences in Bangladesh there were times when one could be questioned about one's respect for other people's rights to have a particular intervention explained to them. And I know that this was the case in India as well and there was some papers and the literature to talk about this. There were times - I was very friendly because I had this big motorboat, not big but I had a motorboat, which was unusual for the area so the military forces would come by at times and you know just to see what I was up to because I had something that could be of value to them under certain circumstances. So, I was kind of friends with the military and people knew that and it was interesting. But we always got the job done and I really, really hope that we did it with the maximum amount of explaining to people what we were after and to the largest degree possible with their assent and their accord. Elisa: Okay. I'm really interested in hearing a little bit more about your relationship with your guide. It sounds like he was an incredible asset to your whole experience there and you mentioned really early in our conversation that there were a couple of times when he may have even saved your life. Could you discuss that a little bit more? Ron: Well sure. So, you know he was a Rakkhi Bahini. He was with the Bangladeshi Liberation Fighters during the war of separation from - of independence, Bangladesh independence from Pakistan, which was in 1971 and 1972. These are the guys who - they're the - that war was terrible as wars are in that part of the world, in any part of the world and the Pakistani forces would pillage villages, rape women and so on and so forth. And the major resistance was in the peripheral areas where these, I guess you could call them to a certain extent guerilla fighters who would do what they could to resist. Hit and run activities. Just you know, sabotage and whatever. These are guys who would when they were being chased they would stay underwater. The apocryphal stories were that they would stay underwater for 12 or 24 hours at a time breathing through a reed they would have plucked from the brush on the side of a river. So they were legendary and he happened to be a part of that and in the post independence days they could pretty much do what they wanted. And he was just a really upstanding guy who wanted to continue to provide service to the people and the country that he loved. And he was very, very happy to hook up with the smallpox eradication program. I don't remember if he had had relatives who had died of smallpox but everybody knew people who had smallpox. It was a fairly common disease in that part of the world. So yeah, I was really lucky that I had him because I'm sure I could have made some serious diplomatic faux pas and probably did and I'm sure I don't know of all the many times that he protected me actually. But I did say that there were times when he did save my life and that's true because as I said I didn't really know what I was doing with the motorboat at all and I would go and get in trouble with it a lot of the time. And I remember one time leaving - I lived in a guesthouse on one part of this town of Chhatak and he lived on the other side of the town along the river still. I remember I took the boat out one evening just to go for a little spin and it stalled. There was a big river we were on, the Surma River and I took the boat out and I didn't know what I was doing. And the motor stalled out and I got caught in a current and I was going down, down the river to places I didn't know. I didn't speak the language; I didn't know where I was going to end up or how I was going to get out of it. I just remember that as I was going down past where he lived I was waving my arms and everything and somehow he was there and he saw me. I don't know how. And he hopped into a canoe like thing and paddled out to the motorboat and got it started and took me home. It was dark by then I remember. I was a little scared but I remember him coming to the rescue. Elisa: Great story. Can you tell me anything about your relationships with other country counterparts and your relationship with other WHO team members, CDC team members? Ron: Yeah. In terms of the country counterparts I didn't have - in that iteration I later was transferred - actually maybe I was transferred because of this incident that I might recount now. So I did - I was up there for about five or six months in that part and then I was transferred down. We took - smallpox was over and I was assigned to an area that was on the Bay of Bengal so in the southern part of the country, Noakhali it was called. My relations with the Bangladeshi Ministry of Health officials who were up there in Chhatak my first posting were not so great. I remember - you know we worked a lot - a lot of people who have been working in the malaria program came over and were assigned to smallpox. And for the most part the ones I had to deal with were not - maybe they were malaria people but I remember there were some district medical officers. Remember this is my first job ever and I was - you know we were focused is what we wanted to do and that my impression is that as I remember it now is that I wasn't impressed with their dedication to their job. I thought that they were not working hard enough to get the job done. I thought that they could have been doing a lot more and basically I didn't have so much respect for their competence. Now I've been working in global health ever since then so for the past thirty or some odd years or more and I know a lot of things now that I should have known then about how much they were being paid, how they had to do other things to earn a living to support their families. I didn't have any of these things. I had never had a paying job and still didn't have a paying job. I didn't have a family. I had nothing but smallpox eradication. And I went in and I suspect I was probably an imperious, self-centered, uncaring foreigner who didn't know anything about the place where I was working. I didn't even have an appreciation for learning the culture or having an understanding of the history of the place. I was a young kid, brash, brazen and interested in only one thing which was getting the job done that I was there to do as quickly and as effectively as possible and I was probably pretty obnoxious. On the other hand there were things that in the way that I was treated there also they were pretty annoying and people will tell you Bangladeshis have this strange habit that I've really never seen any place else of staring and gathering around foreigners and staring at them and sometimes just poking. And just you know they don't have the same at least then or at least my perception then was that they didn't have same respect for individual space that we have. On top that I'm left handed and they eat with their hands and I ate with my left hand which wasn't a really cool thing to do in a society like that. I remember I had to go out to a restaurant in town. I always went to the same place every night to eat the small amount that there was to eat but people commented. I'd be trying to eat and people would be - you'd have a crowd around you cause they didn't see 00:29:04 standing there looking, staring at you or what you were doing. And I'd be eating and I'd be eating with the wrong hand and eventually the restaurant owner took pity on me and built a small little - put a curtain up in a corner of the restaurant and that would by my area where I could go and eat in peace. So it was tough. It was a lot of pressure on me. It was a strange environment, it was my first job and so on and so forth and it got at times a little lonely up there. I was on my own in terms of WHO team and it was tremendous. It was just a phenomenal learning experience that I tried to handle as well as possible. I'm very happy that we got the job done. I'm very happy to have had that experience and to have grown so much from it, to have learned from it and to have launched my career there and I've had a great career since then. So, that was good. In terms of other people from WHO there was another guy like me a young - I think he's going to be here this weekend, in the thana next door, much bigger thana. I had - most of us had a - I forget what the words that the administrative areas were called; you know the equivalent of a province or region or something. And most of the people were assigned to a region of a country that contained a number of districts. I had one district under my - in my area of supervision. It was a large district and it was so difficult to get around. But there was a guy in the one next-door called Sunamganj who had the same job as I did and we would get together occasionally. Not all that often cause it was probably an hour down the big river between us. An hour one way and an hour back the other way against the current. It's a lot. We did get together as I mentioned on weekends probably about eight or ten people. Steve Jones was the sort of overall supervisor of all of us working in that area and we would go down to his place in the center of Syhlet and meet up for a weekend. Elisa: Did you find it helpful to have a group of people that you could sort of commune with to share your experiences with who were also foreigners doing the same type of job and what sort of things did you do when you got together? Ron: Yeah. Yeah, I found it great. It was a good break from the field. I think we went every two weeks. It was a good break from the field. It was only a couple of days which was fine because after a day you wanted to get back to the field and back to work anyway. But it was a nice house and it had a roof. I remember we used to sit up on the roof and you know if somebody got their hands on a couple of cans of beer or a bottle of whisky or some marijuana or whatever it was we would have a nice little time and it was a good break. And then we'd go back and back to work. But we really only went down for the Dhaka very, very rarely maybe. Maybe I went in the whole time I was up there twice at the most except that in the middle of all this I had mentioned my relationship with the military. In the middle of all this the President of the country Sheikh Mujibur Rahman was assassinated by a military coup and it was basically a lock down every place. And they came because they knew where I was and took my boat because they needed it to get around. So that was a little scary too cause you know we communicated with the center by radio, walkie-talkie and communications were down, they took my boat. It was a little scary for a little while but I don't remember how eventually I got down to Dhaka but I know that during that period we were called back in and I know that I got there somehow so that was okay. Elisa: I'd like to talk a little bit about how your experiences in Bangladesh impacted the rest of your life and as you said it started you on a long career in public health. Ron: Yeah, it sure did. I mean I - while I was there obviously I met a lot of the people from here from the CDC who had gone out there. Some people were there for a long time like Stan and Steve Jones. They were doing - they stayed in smallpox for a while. Other people, a lot of people came through on a regular basis from the CDC. We used to call them 90-day wonders. Those of us who were the hippie volunteers in the field after a month or so you were a veteran and you knew what you were doing and you were totally experienced. And here came these new coming guys from the EIS or whatever and they were going to come out for three months where we had all made two year commitments or more. And we just, 'big hot shot docs from the U.S.' and we used to look down on them a lot. Try to make fun of them whenever we could so we called them ninety day wonders but I met a lot of them and asked them questions like you're asking me, "Why did you get into public health, what are you doing, do you like it?" and I liked a lot of them and they liked me. And before I left they asked if I would consider joining the EIS program and I said, "Yeah let me in. It sounds good." I'd finally found my calling. This is really wanted to do was the kind of stuff I was doing, the field work that I was doing in Bangladesh. Elisa: Sure. I was just asking about how your experiences in Bangladesh influenced your subsequent career in public health? Ron: So, I met a lot of people from the CDC and I liked them, they liked me and before I left they asked if I would consider joining the EIS. I said sure but I had remembered I didn't have any internship. I had just graduated from medical school and had my degree. So, it was a requirement that you had to do an internship so eventually when I left smallpox, I guess it was in seventy seven, I went back to the States where I hadn't been in some time, almost ten years and I did an internship. And then I liked that so I stayed another year and I started doing a residency in internal medicine. But then I started not liking it so much but what I did was I had called D.A. Henderson. I went Johns Hopkins after having contacted D.A. again and I got my Masters in Public Health degree. They had then a preventive medicine program and the second year of their preventive medicine program that I was in they would place the students with state and county health departments and things like that. So, I remember that the chief resident, the head of that residency program asked me, "Well Ron for your practicum how would you like to go work with the EIS officer in Maryland?" And that sort of triggered my memories of EIS. I was a student. I was paying them for the privilege and here they wanted me to go and work alongside of whoever the EIS officer was who was making what was a not bad salary. So, I basically said, "Listen that reminds me. I don't want to work with EIS officer I can be the EIS officer." And I applied to the EIS that year and got in and there you have it. I was assigned to the state of Michigan to do my EIS and that time I was one of the few people in the EIS class that had substantial overseas - international experience, my Bangladesh experience but I don't know if they counted my Switzerland experience or not I don't know. But early on they asked me if I wanted to go and work in the Cambodian crisis. The genocide from Cambodia had resulted in large numbers of people fleeing to Thailand and they asked if I would head a team from CDC to - no they asked if I would work as a epidemiologist on a team of people going out there and for a number of reasons I didn't want to do that so I didn't go. I was involved in other stuff in Michigan actually but a few months there was a crisis, a refugee crisis in Somalia and they asked me again. The CDC had very good ties with Somalia because it was the last country that had smallpox and there was a guy there in particular named Abullahi Deria who had been instrumental in the Somalia effort to control smallpox and he had friends -- Bill Fagee notably -- at the CDC. And they asked me if I would head a team going out to Somalia. And by that time I had things in Michigan under better control and I was happy to do that. So, I went out to Somalia for about three months we organized things with the ministry of health. Now I really had the benefit of much more experience than I did the first time I had done this and we did a pretty darn good job. Some people came over who I met who were excellent. We had a number of EIS officers and we did a really good job there organizing what was called the refugee health unit at the ministry of health in Somalia. And was actually the first time that we were able to undertake a series of fairly decent epidemiological studies that enabled us to define and describe the kinds of problems that refugees face when they are settled in refugee camps as at that time was so often the case. With other colleagues here and people that we brought in here afterwards we really kind of developed the epidemiology of refugee health and that's - did that for a long time. After EIS I'd gone to Somalia two or three times 00:40:14 EIS. Then there was - I applied for a position here in what was called the international health program office and I was accepted into that and I came down to Atlanta to work. But there was a reduction in force in the public health service so they shipped me out to Somalia again and I was there for another six months and we developed primary health care programs and so on and so forth. But the point is that I basically stayed connected to the CDC here for about five years in the international health program office. Eventually I became a division director in that office. Stan Foster was - there were three divisions. Stan Foster was the other division director on the country support side and I was the head of the technical support division. We were implementing a program called Combating Childhood Communicable Diseases in fourteen African countries, a programs funded by USAID so I was traveling all over the place doing a variety of stuff. Before taking the division director job I had been posted as an epidemiologist in Africa so I was in Abidjan, Ivory Coast for three years for the CDC as a regional epidemiologist in the context of this combating childhood communicable diseases or Triple C D Program as it was called. Interestingly there were three of us in Africa, three regional epidemiologists. Myself, there were two people during that time in then Zaire and then in Malawi David Hamen was posted who had also been in smallpox in India in west Bengal at the same time that I had been in Bangladesh. So we were pretty close friends and we still are to this day. After that I stayed here until about - I don't know - eighty eight, eighty nine, something like that and then I moved to Geneva to WHO and became eventually the head of cholera program there but continued doing refugee work. So, I served in a - I was asked to coordinate humanitarian assistance for CDC. I was still at CDC. During the Gulf War I was in northern Iraq and Turkey and then continued to work in these humanitarian crises. I was seconded by CDC to the UN to coordinate infectious disease control policy in Zaire after the Rwanda genocide in Goma and just continued on. And I had - eventually I built up a reputation here of getting very creative assignments and in nineteen ninety four still on a CDC billet, I was actually assigned to the private sector to a company called John Snow Incorporated that is a contractor to USAID. And they had a very large child health program, a hundred and twenty five million dollar program called BASICS and I was the technical director of that for a while. And then still on a CDC billet I did that for about five years and then I was asked to start this program at the Mailman School of Public Health of Columbia. It was called the - it is called still the program on forced migration and health. And then I eventually retired from CDC although I'm still - well now I'm working for USAID on pandemic preparedness. So yeah that initial experience not only exposed me to public health but also exposed me to the CDC where I've spent the better part of my career doing different things all directly involved in global health. And so I'm really grateful to have had that experience because while I was in medical school what I was entertaining most was becoming a thoracic surgeon which sort of would have taken me in a different direction all together. Elisa: A very different direction. Ron: Yeah. Elisa: Well, thank you so much for sharing your experience. It sounds like experience with smallpox in Bangladesh certainly started off a very long and rewarding career in public health. And in closing I just want to ask if there is anything else you would like to share, anything I didn't touch on that you would like to add to our discussion? Ron: I guess the only thing that I would say in regards to smallpox eradication, it's really taught me a lot about programming and I think that different people have different thoughts about not so much smallpox eradication which everyone accepts has having been an inordinately successful program. But you know it spawned a number of other programs I think we need to learn from the smallpox experience both the things that were good about it but also the potential pitfalls that a program like this created because it really was a big employment industry if you will, smallpox. It went in and it really took control of a lot of ministries of health in a lot of poor and developing countries. And all of the other programs that were going on in a country like Bangladesh or like India, I won't say all I don't want to exaggerate, but this really cut the legs out from a lot of other programs because we took the personnel, we had the resources, we had the action and we really set the agenda in a lot of these countries. And I think we have to learn from that because from smallpox you've had a lot of other things happening. One thing led to obviously the guinea worm eradication program, the polio eradication programs, soon there will be a measles eradication program. And I think we have to learn that the most important thing that's come out of my experiences and my career for me is that people have a right to access health care for whatever their needs might be. And we have to make sure when we're undertaking these very singularly focused programs that we're doing it in a way that strengthens rather than weakens health systems in poorer countries where people can still go to a public health facility near where they live and make claims on that facility to meet their current health needs. Not everybody is going to require smallpox services. We should make sure that when these other programs are being implemented and they're all good programs, that they're not cutting the legs out from under malaria control programs or diarrhea control programs or pneumonia programs or whatever else it might be. Those things that are so important to people's health and their ability to survive and towards meeting the overarching millennium development goals that have been set for all of us working in public health. Elisa: Okay. Thank you again for sharing with us and we appreciate it. Ron: Thanks. </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/bi_KyDH9Qks" frameborder="0" allowfullscreen></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource interviews motion pictures moving image Date A point or period of time associated with an event in the lifecycle of the resource 2008-07-11 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16rv5 emory:16rv5 Format The file format, physical medium, or dimensions of the resource 10340160000 bytes video/x-dv Creator An entity primarily responsible for making the resource McNatt, Kellie (Interviewer); Emory; Student Waldman, Ronald (Interviewee); WHO; Epidemiologist Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of Southeast Asia and East Africa Smallpox Workers (2008 : Atlanta, Georgia) Title A name given to the resource WALDMAN, RONALD J. Description An account of the resource Dr. Ron Waldman describes experiences in the Peace Corps working with the Smallpox Eradication Program in Bangladesh during 1974-1975 Subject The topic of the resource Language A language of the resource English https://www.globalhealthchronicles.org/files/original/9e73adb0276dae8e3e81b079dded3264.jpg a6b7596f97213fa0478af4a827dbca76 https://www.globalhealthchronicles.org/files/original/593067580a4e333a354d709d49ccd453.pdf c49df0c586f37185344bfce41561d04a Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> INTERVIEW Audio File: Stan Music Audio File Transcribed: January 29, 2009 Interviewer: This is an interview with Stan Music on July 11th, 2008 at the Centers for Disease Control and Prevention in Atlanta, Georgia about his role in the smallpox eradication campaign. The interviewer is Melissa McSwegan. With this interview we are hoping to capture for future generations the memories of participants and their families involved in eradicating smallpox. This is an incredibly important and historic achievement and we want to hear about your experience. I have some questions to guide you but please feel free to recount any special stories or anecdotes that you remember about events or people. The legal agreement you signed says that you are donating the oral history to the U.S. Federal government and it will be in the public domain. So for the record could you please state your full name and that you know you are being recorded. Interviewee: My name is Stanley Music and I know that I'm being recorded. Interviewer: Thank you. To start out with can you talk a bit about how your education and upbringing led you to work in the health field? Interviewee: Yeah. My father was an immigrant although he came to this country at a very early age. He was the oldest of five or six children and when his father died he was still a teenager and he had to quickly abandon any of his hopes at a higher education and start earning a living for his family. As a result of that he always encouraged both his sons -- me and my brother -- to become a professional man whatever that meant to him but he wanted me to be a doctor or a lawyer or something professional and not have the financial worries that he had pretty much all of his life. Interviewer: And so then once you did - begun working in health how did you get involved with the smallpox campaign? Interviewee: Well I went to - I got accepted to two medical schools one of which was in the same city in which I lived and the other was an hour away and would require that I be in residence away from home which opportunity I jumped at because I had been to college in the same city in which I lived. So I went to University of Maryland, medical school and fell under the influence of professor of medicine Ted Woodward who was quite well known in international infectious disease circles. Because I fit his profile of whatever he was looking for, during my junior year summer between third year and fourth year of medical school he sent me as a research assistant to Pakistan. And I saw an incredible variety of infectious diseases, human rabies, smallpox, cholera and a few others that made a deep and lasting impression on me and probably set my values for somebody who wanted to help make a difference in diseases of poverty in tropical areas and generally trying to bring the benefits of twentieth century medicine to a population that was living in hundreds of earlier times in effect. Interviewer: So, when you first began working with the smallpox campaign what was your role? Interviewee: Oh. We have skipped an awful lot of history then. So I was very much interested in infectious disease, internal medicine and actually specialized in infectious disease but couldn't quite see myself as an academic fighting for grants etcetera. So I followed a friend of mine, Mike Greg down to CDC and paid him a visit where he was part of the EIS program and editing the MMWR and got very interested in a career in the public health service in epidemiology. And the following year I applied to the EIS - excuse me - and was accepted and because of my Pakistan experience when I was an EIS officer and Pakistan and - West Pakistan and East Pakistan had a falling out and East Pakistan wanted to become an independent country called Bangladesh. I was part of the team that was sent by CDC to work in Bangladesh on a nutrition survey designed to make sure that the food that was in the country was given on a priority basis to the areas that needed it the most. That experience in turn led me to learn Bengali and that's why Stan Foster was very interested in recruiting me to the Bangladesh program because I had been to the country before and I spoke enough of the language to get around on my own. So that kind of set the stage for my smallpox involvement. I protested mightily when he asked me to join because I had just acquired admission and a full federal scholarship to University of London to get an MPH equivalent degree. But he agreed that if I gave him two years of smallpox eradication that he would see to it that I continued on in my academic studies before joining CDC permanently as a staff member and he was good to his word as was I. Interviewer: So tell me a little bit about the working relationships you had with your counterparts on the ground and what were the successes and failures you had with that. Interviewee: Well, counterpart was I think in many ways an exaggeration because they really had no clue as to what was expected and what was going to be done. We ended up actually setting up a whole parallel system of employment. We used Ministry of Health personnel to be sure but by giving them - by basically doubling their salaries and giving them access to motorbikes and Land Rovers and other transportation we elevated their status and they became very loyal to us. They became reliable surveillance partners who could go out on a schedule and be in a village market on a given day at a given time and advertise about the smallpox program and get information about whether there was any smallpox showing pictures of kids with smallpox and asking if they knew of anyone. But we set up a whole parallel system. The government of Bangladesh was very good at acquiescing to our stated and carefully thought out -- most of the times -- needs but they really weren't partners in the delivery of the services. They just stood aside and let us do our things mostly. Interviewer: What were some of the biggest challenges you faced on the work on the ground? Interviewee: Well, one of the biggest challenges was getting people to do what they were supposed to do. They weren't used to being inspected. They weren't used to being challenged, they weren't used to having somebody count the number of vaccines vials and then three weeks later come back and ask how many people had been vaccinated and then go back and count the vaccine vials again and see if things actually jived. I learnt very early that the Bengali intellect is quite well formed and they know for example that there are exceptions to every rule. So when I said you know if you find a smallpox case the whole village is quarantined and you vaccinate everyone, but if I then did an inspection when they said everyone had been vaccinated, they would - I would discover a guy dying of TB or congestive heart failure or something lying off in a corner of a hut, and he had been exempted from vaccination. But I said there are no exemptions and they said every rule has exemptions and I said okay, thought about for a while and then I said, "Okay. We are now going to vaccinate everybody with one exception. We will vaccinate no dead persons." And they laughed but they understood and then I had no problems. So it was a matter of understanding the culture, understanding their attitudes and the challenge then of translating my desires into something that they could follow and give me results that I was looking for. Another big challenge was these seasonal fairs that pulled people in from many, many miles away. They were a source of revenue to the district commissioners who got a piece of the commercial action but when I found that a particular fair was actually a disseminating source of smallpox because people who were infectious were coming, mingling with people who were still susceptible who then spread out and returned to their villages, I had a big problem. And I had to - people who were earning the money threatened me because I was going to report this. In the end I went to Dhaka and informed my superiors about it but basically got no support until D.A. arrived from Geneva, listened to my tale of woe and did his little magic with the political heads of the health department and WHO and then we managed to put vaccinators into the fair areas and stop the transmission. So there were challenges all the time. Another challenge we had was a lack of petrol in the area that I was designed to cover. So we had Land Rovers and we had jeeps and we had motorbikes but we couldn't run them because we didn't have any fuel and there was no way to get any fuel. But we ended up doing something quite inspired, quite illegal and quite dangerous. We found a train siding run by the army with cars full of petrol. We ended up one night unpinning the connection to the last car, rolling it a couple of miles down the track and siphoning out all the gasoline and finding ways to store it and returning the car under the cover of darkness back to the train as if nothing had happened only it was now largely empty instead of being full. But we needed the petrol to make our surveillance rounds and to keep pressure on this disease to stop it from spreading. So, yes there were challenges every day of many, many kinds. Interviewer: Tell me a little bit more about life in Bangladesh from a cultural perspective. Not so much just about the work but what was it like living in Bangladesh? Interviewee: Ha. It meant when the sun went down the lights went out. It meant learning to be patient, it meant learning to enjoy the simple things like a home cooked meal. There were a mixture of Muslims and Hindus and a few Christians and a few non believers of every variety. There were some people of the old ruling class under the days of the Maharaja who still lived in crumbling palaces but it was a wonderful education and at night there was nothing to do but talk. There was no radio or television or anything although I did have a little portable shortwave but the culture was rich, the people were wonderfully talkative. The oral traditions were great and I learnt a lot about the people and their culture, their habits, their food, their clothing, their rituals and the way that they accepted life. And although they had by my standards a very primitive existence, they actually enjoyed their lives I thought to a much greater extent even with all the poverty and the disease and the premature mortality and the excess morbidity to a greater extent and with more relish than I could recall from the United States. Interviewer: As you were working with the smallpox campaign, was there a particular point where you knew that smallpox could be eradicated and would be eradicated? Interviewee: Well, actually no. I had the belief that it could be because I understood the epidemiology and nothing in my experience had given any reason to believe that my understanding was different than reality but every day in Bangladesh ten thousand - that was the birth rate - ten thousand new susceptible would be born. So even if as in my dreams we could fly B-52 bombers wing tip to wing tip over the country spraying vaccine so that everybody who took a breath would be vaccinated, the very next day we would have ten thousand new susceptible. And I knew that just vaccinating, trying to vaccinate and keep a population fully vaccinated wasn't going to work. What we needed was an epidemiologically oriented program that Bill Fergie designed and clearly when we were working efficiently with good surveillance and good follow up, good containment, good ring vaccination, good quarantine, we stopped the spread cold and it worked every time. So I knew that once we had it all together it was going to happen very quickly and it did. Interviewer: Now that you have thirty some years of perspective on this campaign is there anything you would have done differently? Interviewee: No, I don't think there was actually. I think it was a treasure of an experience, it shaped my life and my career and my attitudes, my values. I thought that smallpox was just the beginning, that we would then march on to measles and all the other vaccine preventable diseases. After all we had the surveillance organized, we had the trained staff, we had people in place, all we had to do was implement it but that was not going to be. But my generation of CDC epidemiologists were always somehow more empowered and more aggressively public health oriented than our colleagues who didn't have this experience. Interviewer: What are the most important lessons that you learned from smallpox that you then applied to other areas of your career after the campaign finished? Interviewee: Well, to a certain degree smallpox was about breaking the rules or interpreting the rules with flexibility bordering on breaking the rules because nobody sitting back at a desk could figure out what was really going on in the field. If you went to the field you learned about the fairs that were spreading smallpox, you learned about the people not being vaccinated because they had some other illness and etcetera. So smallpox taught me to break the rules if I was going to be successful, if I was going to be carrying out the disease reduction, following through on the results of an investigation. But you can't operate that way in the civilized world and in modern European or in America. So I had to change the way that Bangladesh had taught me and learn how to be patient, learn how to educate, learn how to involve the public and not be the kind of imperialistic dictator that solved the smallpox problem but was not going to cut the mustard in the real world after that. Interviewer: And how did the overall experience impact your life? Interviewee: Well it made me a public health believer because I had a monster success under my belt. They gave me a quarter of Bangladesh, twenty five million people then, five districts, a suitcase full of money and some vaccine and some bifurcated needles and said go do it. And I had a driver and we did it. It was amazing and it filled me with a desire to have a full public health career and to carry out those initial dreams that I had when I was but a medical student wanting to bring those people up to the twentieth century in terms of their morbidity, mortality and infant child mortality experience. Interviewer: Did you continue working in infectious diseases? Interviewee: Well I continued working in epidemiology but I came back to CDC and worked with Lyle Conrad in supervising EIS officers that were assigned to state and local health departments. I kept my hand in international consultation and did a few WHO and USAID consultancies. I used the time to understand a lot about other countries and eventually was recruited to the global EIS by Phil Brockman and then when he retired I was named his successor and I put programs in Thailand, Indonesia, Mexico, Saudi Arabia, Taiwan, Philippines, Peru, Italy and Australia. And said no to a couple of very big countries to the disappointment of my boss because those countries weren't ready and they weren't going to participate but that was India and Egypt which have since changed and there are now cooperative programs with those countries. But I used that, that was - that helped define me. Interviewer: Can you tell us one - one of the most memorable moments you have of your time in Bangladesh? Something that happened, an event that happened, something that you remember and think back on. Interviewee: Yeah, I think I can. I don't think that there are very many people who know this story. There was a famine in Bangladesh at that time, at least in my area. There was a - they had two or three rice crops a year depending on how much water there was and the physical geography of individual areas. And a rice crop had failed so there was quite a bit of [inaudible 24.14] starvation and it was getting hard to hire people because the wages that we were authorized to pay wouldn't give them enough money to buy the food that they needed so we weren't really competitive. And then the new rice crop which was not failing was about to come in and here they got a living wage plus they could put handfuls of rice in their pants pockets and they could earn a lot more, in essence take home take a lot more than they could working for me. And working for me meant being guards, vaccinating around infected villages. Well I couldn't live with the idea that we could identify villages and then not protect them and not vaccinating those villages and not break the chain of transmission. And I sat down with one of my subordinates an Egyptian physician, Ali Salim [inaudible 25.32], wonderful man, and we sat up at night and thought about our dilemma and how we were going to resolve it. We had radioed back to Dhaka and they told us the price that we pay for each guard was fixed. I don't remember how much it was, fifteen taka a day or something like that but we couldn't pay anymore and we needed to pay more. And I said, "Look you're leaving me in an awkward position. I've got infected villages. I can't quarantine them, I can't vaccinate any of them. I don't have enough people." "Those are the rules." Okay. So Ali and I sat down and decided we were going to invent villages and were going to invent outbreaks, and we were going to invent workers and we did and we paid them the right wage on paper. And we encumbered then a lot of need for money which we then divided up among the real workers and paid them enough to keep them working for us and not harvesting the rice. So yes, I can tell you that and probably other stories as well about what we had to do to stop smallpox. Interviewer: Wow. Interviewee: Yes. Interviewer: Well, is there anything else that you would like to add or any other stories that you think? Interviewee: I think I've probably gotten myself in enough hot water you know. Interviewer: Like do you really want that story [inaudible 27.18]? No. Well, thank you very much. I appreciate your time in sharing your experience with us. It all looks very interesting so thank you. Interviewee: Okay. </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/-tJBUIy58qc" frameborder="0" allowfullscreen="allowfullscreen"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource interviews motion pictures moving image Date A point or period of time associated with an event in the lifecycle of the resource 2008-07-11 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16rzk emory:16rzk Subject The topic of the resource Bangladesh Smallpox Eradication Smallpox Eradication Smallpox Eradication Format The file format, physical medium, or dimensions of the resource 5947080000 bytes video/x-dv Creator An entity primarily responsible for making the resource McSwegin, Melissa (Interviewer) Music, Stanley (Interviewee) Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of Southeast Asia and East Africa Smallpox Workers (2008 : Atlanta, Georgia) Title A name given to the resource MUSIC, STANLEY Description An account of the resource Dr. Stanley Music describes his experiences as an epidemiologist in Bangladesh with the Smallpox Eradication Program from 1973-1975. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/0843abd88cc294f90db33766f4b7c825.jpg 734a6e2a6c9efd7069a6aa95d953dcdc https://www.globalhealthchronicles.org/files/original/3384eae5eb6f0643c7cd40f8547f017b.pdf 422a478224aa92acdf2b855c7dce12da Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong>Interview Transcript </strong> INTERVIEW Audio File: Stephen Jones Audio File Transcribed: January 30, 2009 Interviewer: This is an interview with Stephen Jones on July 11th, 2008 at the Centers for Disease Control and Prevention in Atlanta, Georgia about his role in the smallpox eradication project. With this interview we're hoping to capture for future generations the memories of participants and their families involved in eradicating smallpox. This is an incredibly important and historic achievement and we want to hear about your experiences. I have some questions to guide you but please feel free to recount any special stories or anecdotes that you remember about events or people. The legal agreement you signed says that you are donating the oral history to the U.S. federal government and it will be in the public domain. For the record could you please state your full name and that you know you're being recorded. Interviewee: Full name is T. Stephen Jones and I acknowledge that I'm being recorded and agreed to that. Interviewer: Very good. Thanks for coming in today Steve and I guess [inaudible 01.15] good place to start would be before you ever came to CDC and I'm curious about have you - did you always want to be a physician? And so think back to your early days and when you went to college and if you could talk a little bit about what you wanted to do when you were getting out of high school? Interviewee: Well I had a great interest in science and math and at the time of the Sputnik there was a big U.S. government response including setting high school students working in engineering companies and I went to work at the Salvenia Company near Boston and pretty quickly came to the conclusion I wasn't really interested in engineering. And I had always been interested by medicine and that just took over my future planning. So that's how I got into medicine basically. Interviewer: And then did you intend from the beginning to go into public health or did you see yourself more as practicing clinical medicine? Interviewee: Well when you go to medical school and you - and I was trained in medical medicine, you're in a world where all the values are academic medicine and practice. And so I knew relatively little about public health until I was an intern in nineteen sixty nine at the Stanford, [inaudible 03.01] Stanford Hospital and had to take into consideration that as a healthy male doctor I was going to be drafted into government service and probably spend a year in Vietnam. And at Stanford there was Dr. Tom Merrigan a very good infectious disease doc, talked about the communicable disease center as a potential option and knew about this program called the epidemic intelligence service. So I applied for EIS and Mike Greg was my interviewer and although it was a little bit - I applied late and it wasn't clear I was going to get in. Then I - so I was in the EIS class of nineteen sixty nine and I was posted to Alaska and had an extraordinary experience there. But finishing there I wanted to live and work overseas and I went to Guatemala and worked as a primary care doc for a year and a half. And was in the process - and was living in Texas in early nineteen seventy four and intending to probably work for LARASA as a clinician in south Texas. And then I received a letter from Lyle Conrad which was sent out I guess to former EIS officers and others and said that CDC were working in cooperation with WHO and trying to recruit people who would be willing to work for three months in India as part of smallpox eradication efforts. And that was such an extraordinary offer it took me only a small fraction of a second to make the decision that I wanted to do that. Interviewer: And were you still with CDC when you were in Texas or were you working with the... Interviewee: No, I had ended my connection to the public health service when I left Alaska and... Interviewer: Okay, and EIS. Interviewee: And EIS, yeah. I was a private citizen. Interviewer: Okay. And so you got the letter from Lyle Conrad inviting you to participate in the smallpox eradication program and about then what was the time frame in terms of how much longer before you - did you come back to Atlanta then for training or? Interviewee: No. There was no - there was nothing - I didn't go to Atlanta. I basically agreed to go and then had, I don't remember what the interval was between the letter and my departure. I went in early to mid June. I flew from Texas to the west coast and then from the west coast to New Delhi and arrived on June fourteenth of -- or sixteenth I can't remember -- of seventy four at the New Delhi airport at two or three o'clock in the morning. Was met by Bill Foege. Interviewer: And then had you ever been to south east Asia before or India? Interviewee: I had - because I lived in a developing country namely Guatemala I sort of assumed I was a seasoned, experienced international traveler or worker or whatever but I found India to be totally overwhelming at least initially partly I'm sure because it was the middle of the hot season and I was substantially jet lagged. But it was an extraordinary experience and much more challenging then central America. Interviewer: Interesting. Where did you - where were you posted in India? Interviewee: I was posted in Bihar and we had some training in New Delhi and then we traveled by train from New Delhi to Patna and it was - this was a coal fired train and I learned about how people who used to travel in trains in those days became covered with the grimy soot of the coal burning engine even though we were in first class. Interviewer: Wow. So were you part of a team in India when you went over as the smallpox? Were there others that were kind of in your cohort or? Interviewee: Yes. There was a group of something on the order of ten to fifteen people who had all been, I guess had responded to this letter from Lyle and other reasons and we were in a group that was trained and we had training from Larry Brilliant and Bill Foege. And when we got to Patna we had - we went to the field where I saw the first person I had ever seen with smallpox and Bill Foege was training us in the basic parts of identifying smallpox and doing the surveillance and containment activities. Interviewer: And was that still in the New Delhi area? Interviewee: No. That was in - that was near Patna. I don't remember where exactly. Interviewer: Okay, okay. And then what do you remember about your early days kind of getting involved with the program, figuring out who your counterparts were going to be? Interviewee: Well I - basically we had this couple of days of training in Patna and then each of us were derived - almost all of us had no prior experience with smallpox or India. We were - and we had a driver, a jeep and a paramedical assistance, a PMA who was basically a translator because most, almost none of us knew any Hindi. And we were sent off to a district to start working with the civil surgeon and the district medical officer and the - I'm now forgetting the chief administrative officer. And I was assigned to Muzaffarpur district which is one district south of the border with Nepal and at that time it was a very simple place. Muzaffarpur town had one restaurant and I stayed in one of these old British empire dock bungalows. And it was quite an experience to get started there because we were - in the beginning the expatriates were - the amount of support that we had at that point was quite limited. It was the PMA, the driver with whom you always had to have this game of trying to make sure the petrol wasn't stolen and then making connections with the local officials and then going out to the basic walks, places where the local medical officers who were in government service were providing family planning and curative services to people and finding the smallpox that was there. And there was plenty of smallpox at that time. Interviewer: You mentioned making sure that the petrol wasn't stolen. I know that Bihar has a reputation of being a I think the lawless state and I'm wondering if it was like that back in the seventies as well and... Interviewee: Well it... Interviewer: ...was it harder than some of the other places in India? Interviewee: Well the - Bihar's reputation in those days was particularly as a place that was very conservative and very quote unquote backward. And when Mrs. Gandhi in an introduction to the history of smallpox in India and eradication she said something like smallpox is a disease of underdevelopment. And in India the places which had better government services and a higher - things worked better such as all of the south, had basically eradicated smallpox already. So smallpox had remained in India was in the places which were more traditional, where there was less economic development, where there was less education. And so that was Bihar, Uttar Pradesh and West Bengal were the primary areas where smallpox was and that contributed to the pattern of where smallpox was at that time. Interviewer: How did you find out about the smallpox cases that were out in the field? Interviewee: Well, one of the things that had been instituted was a reward system so that people in the general public and health workers could earn and I don't remember what the level was when we started but it was quite low, a small amount of a number of rupees for reporting a case or an outbreak of smallpox once it was confirmed. And so that was one mechanism and the other was that there was an increasing sense among people in India that smallpox was a problem that ought to be dealt with and confronted so there was a - people had a desire to report the smallpox and also presumably to try and get some help dealing with it. Interviewer: What was the reaction of the people who were in the field in the remote rural areas when you showed up with your few colleagues to give the immunizations and to investigate the case? Interviewee: Well, you know the smallpox had been in India for a long time and was such a part of everyday life that there was in fact a deity Sheetla Maha, was smallpox and sort of infectious diseases that involved a rash but more smallpox than anything else. And that was - so there was some belief that smallpox was a blessing or came from deities but on a day to day basis when you - when we would go to a place where there was smallpox, a village where there was one or more cases of smallpox, people were very cooperative and we did a process of finding cases. We had a set of forms for listing cases and then in the beginning doing only a relatively small number of houses, the nearest houses to the home where the or the home or homes where the people lived who had smallpox, enumerating all the people that lived in those houses and vaccinating everyone and keeping track of the evolution of their smallpox vaccinations and finding out where people had - the cases had traveled and giving notifications to other areas that might be affected because someone had traveled to another place. It was a fairly easy to operate system. Interviewer: Do any of your trips back to the villages stand out as exceptional, remarkable, perhaps unique in what you encountered there or the reception of the people to you? Interviewee: Well it was - in the beginning it was all unique and exceptional and extraordinary because here I was, we were dealing with this classic killer. And I guess that the ravages of smallpox and what it could do to people and how it killed people and in particular this form known as flat smallpox where there was just a confluent rash so that people were just all pox, rash. And there was a way that you could particularly with a person who had flat smallpox there was a certain odor that you could smell that you could identify and you could almost make a diagnosis of smallpox based on that. But it was - the devastation to people and families of smallpox was extraordinary and it contributed to my feeling that smallpox was an unmitigated evil. There was no apparent good side to smallpox that I ever could find so it was a worthy adversary. Interviewer: How did they react to use of the jet gun in the little towns, any problems? Interviewee: Now you - I'll help you know the proper history. By then nobody used jet guns. We just used the famous bifurcated needle and so smallpox being historically present in India and a huge problem there people were very familiar with vaccination and vaccination had been done by a variety of methods. So vaccination itself was not really a problem. I mean there was some - there are many schools or ways of medical care including ayurvedic and homeopathic in India. And the people, the practitioners of those types of medicine at times had opposed vaccination for one reason or another. And I can remember having some sort of a debate with a homeopathic doctors about smallpox vaccination. But there were always people - there was always a small number of people who refused to be vaccinated and one of the rules of the expatriates was to help convince people that they ought to be vaccinated. Interviewer: To follow up on one of the comments you made, one of your roles was to convince people that they needed the vaccine. How did you go about doing that? Interviewee: And I was going to extend on that. It became a - it was clearly something that as an expatriate, as somebody from obviously outside of India that the expatriates had a particular possibility of being influential with people that were declining to be vaccinated. And I remember I had many, many, many conversations with people who were declining to be vaccinated. And I remember in particular at least once and I'm sure it was many times, a sign of respect was to touch someone's feet or shoes and I did that multiple times in trying to convince people to be vaccinated. And another thing that you did was to vaccinate yourself so I in the process of a few months in India was - I was - I had vaccinated myself hundreds of times as a way to show people that it was a trivial thing to be vaccinated, a minor process. So those are some of the things. Interviewer: How did your relationship with the translator? Do you - it sounds like you always went in the field to the villages with your translator. Interviewee: Yeah. Interviewer: And how did that develop over time? Interviewee: Well, it - many people - obviously because of the history of India as being part of the British Empire there were many, many people who spoke good English and in particular the government servants and medical officers and all were fluent in English. So it was possible to function a lot without a translator but it was also essential to have somebody who could help you with Hindi. In the end I got to be moderately competent with Hindi and perhaps over estimated my ability to communicate and understand. And it was an important relationship. Your PMA was - the degree to which the PMA was interested, aggressive, concerned, involved was a big deal, while if you had a more passive PMA then expatriate was much less effective obviously. So it was a very important relationship and... Interviewer: When you went out in the fields, excuse me, when you went out in the field did you go for several days at a time from village to village or were these more long days in the field and then back to your headquarters in the evenings? Interviewee: Well, headquarters didn't really exist in those days. We had - I had a room in a dock bungalow which was basically a - if I remember it was a single living space with a bathroom and that was all the office we had. It was very low key and not very well supported in the beginning and as I stayed in Muzaffarpur for probably something on the order of five months and then gradually we got additional resources and we had more staff, more vehicles. We had local young medical officers from India who joined in and medical officers from other parts of India and so it became a much more elaborate operation and a much bigger team as those resources were added and they made a big difference. And so I couldn't tell you exactly when we ended smallpox in Muzaffarpur nor exact - we had - when I arrived it was - there were probably a hundred outbreaks and within four or five months it was essentially taken care of part of which was the weather and the fact that we got into the poor transmission season. But the surveillance and case finding and then containment activity was a very effective tool for slowing and then stopping the spread of smallpox. And what happened is as the number of outbreaks dropped the amount of work that we did with each outbreak could be increased substantially and to some extent that was measured by how many houses we would include in the containment activity. So in the beginning it was a relatively small number of ten or fifteen or twenty and as we got more resources as there were fewer outbreaks it became fifty, a hundred, hundreds of houses. Interviewer: That you would go out and vaccinate at the reporting of one case? Interviewee: We would put a number on and then the houses and household would receive a number and there was a regular thing in which we put the number of people in the household written on the side and the vaccination status of how many of them had - cause you had to - you vaccinated and then you went back to see that - you had a vaccination take and monitored that. So that was part of the containment activity. Interviewer: How long after did you return then? Interviewee: Well, it would be - depending on what was going on you might stay in the local area if you have the time and there were other dock bungalows and other places that you could stay around the district. But when you have a hundred outbreaks you can't visit them, each of them for very long and the typical way that we worked at that time as we were in the field for probably twenty five days out of the month. And then we went to Patna for a couple of days of state level meetings in which we reported on our progress and heard from our colleagues about what was going on and had people like Mahindra Dhata or M. I. D. Sharma from the Indian health side and Bill Foege and Larry Brilliant and others from the WHO side inspire us not that we needed much inspiration. Interviewer: So were you pretty much working seven days a week when you were out in the field? Interviewee: When you're living in the country side in India particularly in nineteen seventy four, there was nothing. There were - I suppose there was some cinema but there was nothing to do and one of the things that always struck me about smallpox is it was an awful disease and it caused tremendous suffering. And so there was a kind of a feedback loop of encouragement or inspiration and so that - because as you could see that if you worked hard then you could reduce the number of cases of smallpox and if you worked even harder you could do that sooner. And then as you got the number of smallpox cases went down then you were sort of getting to the point where you were going to have local control, local eradication and you knew that that was part of a grander plan of eradicating smallpox in Bihar and in India and in the world. And so you had a feedback loop to keep you working harder and harder and harder or at least continue to be putting in tremendous amounts of effort because you were working toward an extraordinary goal of taking this killer disease and getting rid of it, 100% gone. It wasn't a - you didn't have to work - you didn't have to suffer for small gains. You could... Interviewer: Like you could see your - the results of what you were doing? Interviewee: You could see the results and you also knew that if you and everybody else worked hard that you were going to definitively get rid of smallpox. It wasn't something that was done by half or where you settled for a partial victory. We were headed to a 100% eradication which is an extraordinary achievement and in part why smallpox for me was the most - was the peak of my personal - my life and my professional experience. I mean it was an extraordinary one for that part of it and for a number of other things. Interviewer: Right. So you had mentioned that you saw this drastic decline in the smallpox cases in India and I think earlier you mentioned you also spent time then in Bangladesh. Is that about the time then - were you transferred or did you ask to go to Bangladesh or how did that happen? Interviewee: I actually - David Sensor was in India and I'm afraid I can't give the - this was I believe January of nineteen seventy five. And I remember riding on a train with him and I believe with Bill Foege and there was a discussion about - at that point it was clear that India was headed for success and the program in Bangladesh was in deep trouble in terms of having many outbreaks of smallpox. And I was one of the first people to go from the India program to the Bangladesh program as part of the beginning process of helping the Bangladesh program transform itself into what was the sort of India model I guess you would say. Interviewer: Were there differences in the composition of the teams or what were the differences? Interviewee: Well they - I believe this is the case and I'm - this is my impression. India, the India program was a transformed approach, a new approach because earlier in Asia in Pakistan and Afghanistan and other parts of and I think also in the Africa programs although I'm less clear about that, the model was a relatively small number of expatriates who were WHO employee, full time WHO employees, perhaps a dozen or so. And in India what had happened is that there was - it was such a large scale problem that the program model that evolved was the one that I sort of described where first you bring in some significant number of expatriates for short time work and then you amass resources and you have lots more money and government commitment and you provide lots and lots of vehicles. You provide - you pay for more local staff, you recruit the young Indian medical officers so that you have a huge, in the end you have a huge operation that was a sort of - I mean it was a parallel organization to the government and the local government, the government in India and the local government in the states and districts where you worked with a specific purpose. In the Bangladesh program was one where they were working with the old model and they were I think hoping that they would be able to show that the program in India was sort of overkill and that they could achieve smallpox eradication with a relatively small intimate group if you will of expatriates and WHO employees. And I believe that they had been offered resources but felt that they didn't need them. Interviewer: Did you have local counterparts in Bangladesh as well? Interviewee: Oh yeah. Interviewer: And was it - I'm sure a car and a driver and a translator. Interviewee: Yup. Interviewer: Others in addition? Interviewee: That was the pattern everywhere and the - in Bangladesh we had a - there was a different sort of type of expatriate. There were more people with young volunteers who were not medical officers and who came from a wider array of countries. There was more Americans in the India program and we had a lot of - substantial number of people from the U.K. and elsewhere. One of the aspects or the fascinating things of smallpox eradication work in India and Bangladesh was the fact that there was these many nations, people coming together from around the world whether it was the Soviet Union or France or the United Kingdom or the United States or Czechoslovakia or Poland or whatever working together in a team. So that was one of the extraordinary parts of working on smallpox eradication. Interviewer: Steve as we come to a close about this and you had mentioned a little bit about this before about how working in the smallpox eradication program really had a huge impact on your life and how you think about public health. Could you talk just a little bit about that before we close? Interviewee: Sure. I mentioned this aspect of smallpox eradication as this extraordinary in the sense of there was really nothing like the experience you could have of working on a killer that had existed for centuries and centuries and centuries and by your hard labor contributing to getting rid of a plague in the generic sense of it. And that - that's a life experience and I also in that process of work spent or got to know a lot more people from the CDC. And when I finished in Bangladesh in the summer of seventy six it was quite a challenging thing to think about coming back to the United States and changing from this sort of single focused monomania working on smallpox eradication to coming back to a quote unquote real world. And part of what I did was to gain time to get perspective by getting a masters in public health but I was just committed to work on public health. I was intoxicated by the experience and it was clearly something where you could have a huge impact. And my connections - the first work that I did after school of public health was to work on - with the immunization program in the Pan American Health Organization. And then I came back to CDC while working with that program and I was totally committed to public health and had no interest in clinical medicine whatsoever anymore. Interviewer: Thank you. It sounds like - I appreciate you being part of this oral history project and... Interviewee: It's a pleasure. Interviewer: ...just sharing your experience working with the smallpox program in both of those countries, around India and Bangladesh. It just sounds like it's had a tremendous impact and I know that you went on to have a very long and productive career in public health before retiring from CDC. So thank you again. Interviewee: Thank you. </pre> Player html for embedded player to stream video content <iframe src="https://www.youtube.com/embed/LJpf8xW7E_w" frameborder="0" width="560" height="315"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource JONES, T. STEPHEN Description An account of the resource Dr. Stephen Jones describes his experiences in the smallpox eradication program in India and Bangladesh Creator An entity primarily responsible for making the resource Jones, T. Stephen (Interviewee); CDC; Epidemiologist Date A point or period of time associated with an event in the lifecycle of the resource July 7, 2008 Format The file format, physical medium, or dimensions of the resource 8705880000 bytes video/x-dv Language A language of the resource English Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16s0t emory:16s0t https://www.globalhealthchronicles.org/files/original/53da523d4271248d7d65d8b6a75dc881.jpg b32364351a5ca7f3b07fdf5fff40a688 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/vGm3xkyWv9o" frameborder="0" allowfullscreen></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource FITZGERALD, STEVE Subject The topic of the resource Somalia Description An account of the resource Steve Fitzgerald describes his experiences in India, Somalia and Ethiopia during the Smallpox Eradication Program as well as, an outbreak of yellow fever in West Africa Interviewed by Melissa McSwegin Source A related resource from which the described resource is derived The David J. Sencer CDC Museum at the U. S. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333 www.cdc.gov/museum Date A point or period of time associated with an event in the lifecycle of the resource July 10, 2008 Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of Southeast Asia and East Africa Smallpox Workers (2008 : Atlanta, Georgia) Format The file format, physical medium, or dimensions of the resource 12417840000 bytes video/x-dv Language A language of the resource English Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16s1z emory:16s1z https://www.globalhealthchronicles.org/files/original/2c6fb3841eba06514830b5afa9ab4e7c.jpg b5827d1853179cc0066bca6e00375bc6 https://www.globalhealthchronicles.org/files/original/f421a75005a3047326938af9b1370218.pdf b92bbc1092439c0b5f12d28f0f22136f Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/ZXXH576_UWw" frameborder="0" allowfullscreen="allowfullscreen"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource MACK, THOMAS M. Subject The topic of the resource Smallpox Description An account of the resource Dr. Tom Mack discusses epidemiologic observations in Africa and Pakistan. Tom had not been part of the formal Smallpox Eradication Program team but has researched areas of smallpox epidemiology. Interviewed by Melissa McSwegin Source A related resource from which the described resource is derived The David J. Sencer CDC Museum at the U. S. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333 www.cdc.gov/museum Date A point or period of time associated with an event in the lifecycle of the resource July 11, 2008 Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of Southeast Asia and East Africa Smallpox Workers (2008 : Atlanta, Georgia) Format The file format, physical medium, or dimensions of the resource 8188560000 bytes video/x-dv Language A language of the resource English Type The nature or genre of the resource moving image Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16s23 emory:16s23 https://www.globalhealthchronicles.org/files/original/d6d8f6e0a7baee2ec152e3d916cdd917.jpg 9c82c9143b5028c1060873b6bb60a25f https://www.globalhealthchronicles.org/files/original/14c20f3205f97b3b2a9a23136d88498e.pdf 271551e47c57078b6293465233fdef7c Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> INTERVIEW Audio File: Vince Radke Audio File Transcribed: January 29, 2009 Interviewer: I'm Dave Sensor and I'm interviewing Vince Radke. Vince is an employee of CDC. It's April 1st, 2008. We're interviewing at CDC in the afternoon and Vince realizes that he's being photographed and recorded and he's signed the permit. First Vince in ten minutes or less... Interviewee: Okay. Interviewer: ...tell me about your early years. Interviewee: Okay, Dr. Sensor. Early years born and raised in Detroit, Michigan. Did my undergraduate at Michigan State University in biology and... Interviewer: Too bad. Interviewee: Too - yeah I know. Well, you know, these graduates from Michigan, you know. I always got to put up with them. But then after that - well while I was at Michigan State I put an application into the peace corps and about a year later I get a call from a gentleman and he said, "Vince would you come to Philadelphia? We'd like to tell you a little bit about Ethiopia and a little bit about smallpox." And I said, "Oh that would be great." Well the next thing I did, made a beeline for the library and got all the books I could on Ethiopia and tried to find out what smallpox was. To make a long story short, came down to CDC in nineteen seventy. They were having a training program for two weeks for the peace corps volunteers who were going to be going over to Ethiopia. So, the best, the best by far training I have ever had in my entire life was those two weeks here at CDC in smallpox. I had some great, great instructors. D.A. Henderson was one of them, Bill Fergie and others. It was just, just a fantastic time. Right after that then we flew off to Ethiopia and for the next three and a half years I worked in the smallpox eradication program there in Kaffa Province. Interviewer: What had you been doing before Ethiopia and after college? Interviewee: Well, right - I came in right in out of college. That summer is when I went to - I had just graduated from Michigan State. That was the summer of nineteen seventy and the - that July we were in Philadelphia for the first interview and then the summer I spent visiting some friends in Michigan. And then a call came in September to come down for the training at CDC and this was September/October of nineteen seventy. And then we were here for two weeks for that training in smallpox eradication and then we hoped the plane to New York and changed planes there and on our way to Ethiopia. And for the next three and a half years that's what I did. The two, it was only a two year original commitment but we were - I enjoyed the work. It was tough but I enjoyed the work so they asked me if I would stay for another year and I said yeah I'll stay for another year and then stayed for six months beyond that. And then came back and then I knew that I needed to get some more education. So I started at the University of Pittsburgh to get my masters degree in public health and while there I was contacted by D.A. Henderson and he said, "Vince we could use some help in Bangladesh for a short while." And I said, "D.A. I'd love to come," and so made arrangements and for six months I worked in the smallpox eradication in Bangladesh. Interviewer: In Ethiopia what were your main responsibilities? Interviewee: In Ethiopia we, my partner Mark Strosberg and I -- also a peace corps volunteer -- were assigned to Kaffa Province. That's in the southwestern part of Ethiopia and we were there to find cases of smallpox and vaccinate. We were told originally when we saw the reports that the number of cases of smallpox in Ethiopia, couple of hundred a year. I think the year before we arrived they reported like seven hundred cases. Dr. Sensor I think within the first couple of weeks we were there we had over a thousand cases of smallpox. We would contact, go to schools, go to market areas in Kaffa Province and we'd ask, show pictures of small pox and we would be inundated with people saying in their village or in their areas there was smallpox. And so we picked a couple of villages and I went one way and Mark went the other way. And so we were looking for cases of smallpox, recording them, we'd record each of the cases of smallpox, we'd record the number of people that we would vaccinate, names of the villages and then from there we would get reports that would take us on to the next village and every - inevitably we found some smallpox. So for the next about three years I did that. Interviewer: Was the work environment in Ethiopia a good one? Interviewee: It was good. We were - we had great cooperation all along the line from the Ministry of Health in Ethiopia, also the World Health Organization. Our two smallpox people there from WHO were Ciro de Quadros, Dr. Ciro de Quadros and Dr. Kurt Weithaler. They led the program. You were - I was assigned to the Ministry of Health and you had an official government car and that helped very much. We went out to the Provinces and met with the governor and the local officials. They gave us good cooperation down there. Sometimes they would supply us with a guide and a translator even though they trained the peace corps in the local language in Ethiopia or the government language which was Amharic. In Ethiopia you have seventy different languages and two hundred dialects. So each time you would go cross another mountain range or move into another area you would be in a totally different language and so we had to have a translator with us and a guide. So the government officials were very, very helpful in doing that. Interviewer: Were you married when you were there? Interviewee: No I wasn't. I didn't get married until I finished in Bangladesh. Came back from Bangladesh in the end of seventy six and then met my wife at the University of Pittsburgh and then got married in August of seventy seven and then shortly after that went to Kenya to work on the smallpox eradication program. That was the last stages where we were trying to document that there were zero cases in Kenya. Interviewer: While you were in Ethiopia what was the most gratifying thing? Interviewee: Oh wow. That's a tough question because there was - Dr. Sensor there were a lot of gratifying times. To pick one. To me I remember one village I had been in Ethiopia and there was a number of cases of smallpox already in the village. Some children had had smallpox and we vaccinated and got good coverage, good cooperation from the local chief in the area and we felt we had a good job. And so we left that area and then moved on, on to another area. I went back a couple of months after and I was coming down the road one day and here was this chief that I had met a couple of months before. And he got off his mule and he came up to me and he said, "Thank you very much and thank Haille Sellasse for bringing you because you had saved much suffering for the children by giving them the vaccination." So that made me feel great and just knowing that we were beginning to stop this transmission. That was gratifying that indeed this plan that had been worked out it was working now, it was working and there were less and less cases as we went through the years. It was very gratifying. There was one time I had been out for about three months or so and I had reported - in a two week period I had reported over a thousand cases of smallpox I had recorded. It was just incredible and I remember talking to D.A. Henderson and he had said that at that time those two weeks that I had reported he said, "You and Mark Strosberg and the others that were working in Ethiopia at that time in Kaffa Province," said, "you had 10% of all the cases of smallpox for that period of time," so that was another gratifying moment. Interviewer: In some countries it's alleged that undue force was used to vaccinate people. Was that ever an issue in Ethiopia? Interviewee: No for the most part. I remember a few occasions when we'd be in the market vaccinating. We'd go to the market. Usually these markets they had once a week in an area so Wednesday was their market day and we knew this. So we'd go there into the market area and we'd do a couple of things. One we'd ask for cases of smallpox and the other one was that we would set up a vaccination for those that wanted it. Sometimes the local person in charge, the chief or whatever, wanted to make sure that everybody got vaccinated so they would drag some of the people to us to get vaccinated. So in that sense that was - but it was very, it was very rare. I think it was more often that if people didn't want to get the vaccination we didn't force it on them. And we knew just the methodology that we didn't need to vaccinate everybody. We knew if we got the majority of the contacts that we could break that transmission and indeed that was the case. So it really wasn't necessary for us to do that. I know all the volunteers that I worked with in Ethiopia, whether it was in Bangladesh I mean we never forced people to be vaccinated. Interviewer: Was there a big contingent of volunteers? Interviewee: In Ethiopia I think there were thirteen or fourteen of us that went over in the first group of peace corps volunteers and then every other year cause we were on a two year cycle, another group of peace corps volunteers would come in to replace those that were going. In the second and third year we got some other additional international volunteers. Some of them from Japan, some of them from Australia. We had volunteers there also. We had quite an international group of people in Ethiopia and Bangladesh from I would say twenty, thirty different countries. It was great to see the cooperation and working with all those different people. It was really great. Enjoyed it. Interviewer: Do you remember the name of the Director of the Ethiopian smallpox program? Interviewee: Well that was - the Director for the program he was an Austrian and that was Dr. Kurt Weithaler. Interviewer: The Ethiopian one. Interviewee: Oh, the Ethiopian. I can't remember Dr. Sensor. I worked with - you know the Ethiopians that I remember are the ones that I worked with. The sanitarians, the dressers that were down in Kaffa Province. Interviewer: The Director of the program was the director of the control of diarrheal disease in nineteen eighty seven after the government had changed and it was unhappy situation. Interviewee: Yeah, it was, it was. I talked and maintained a lot of my contacts over the years in Ethiopia and almost to the person they expressed the time after Haille Sellasse as a bad time, as a bad time, yeah. Interviewer: How long were you in Bangladesh? Interviewee: I was in Bangladesh for about six/seven months from April until November and I think that was seventy five or seventy six. I can't remember now. Interviewer: You were there as a peace corps volunteer? Interviewee: No, I was WHO short term consultant. Interviewer: WHO then. Interviewee: Yeah, at that time, yeah. D.A. Henderson said to me at the time, he says, "Vince," he says, "Yeah, if you're coming I'll tell you basically we're going to give you $50 a day," and at that time I thought man that's all the money in the world. So and - but more so than that just to get a chance of getting back to the smallpox program you know. Interviewer: Where were you in Bangladesh? Interviewee: I was in Sylhet district. When I got there at the airport, Stan Foster, Dr. Foster was there and he met us. First of all we went to the office and then he took us to this house they had. I think they bought the house and it was for the consultants that were coming over to work on the smallpox program. And we had I think two days of orientation and then they - he says, "Okay you're in charge on Sylhet district." And so went up to Sylhet district and worked there for the entire time except for those occasional times we'd come back to Dhaka for a meeting or something. A couple of interesting stories there. Since you were in charge of the entire smallpox program in Sylhet district, you'd have to pay the vaccinators and translators and other people that would help you in the smallpox program and we had to pay them. So we'd come down to Dhaka, we'd have our monthly meeting or every couple of months we'd have a meeting and the other thing was to collect - get the money so when we go back we could pay the people for the work that they had done. Well the denomination in Bangladesh was taka and I forget what the amount was. I think it was like fourteen or fifteen taka to the dollar or something like that. So I'd have this suitcase of money okay and I probably had sixty or seventy taka in it and I'd feel so uneasy with the suitcase of money, throw it in the Land Rover and drive up to Sylhet district with all this money. And I couldn't wait to pay the people so I could get rid of all these thousands and thousands of taka that I had to operate the program but... Interviewer: And [inaudible 16.00] Diego was back in Dhaka worrying about the receipts. Interviewee: Right, absolutely. Receipt for everything. I mean you signed your life away you know, even though at times having the Bangladesh money, the taka there it sometimes was like monopoly money. I didn't really think it was real but I did want to get rid of it because I knew - for them it was very important, you know for the vaccinators and the other people that were giving us a hand. Well, a couple - I could tell you [inaudible 16.29] there are a couple of other stories here. Interviewer: Go on. Interviewee: One story which I'll never forget. I'd been in Bangladesh for a couple of months already and they had this - one of the problems we had was we of course had to document that there was zero cases. So any time we'd get a case of rash we'd try to collect this specimen, get a scab specimen from abrasions, send it off to the lab but we would still do containment even though clinically it might be chickenpox and not smallpox. We'd do containment cause we wanted to be sure. So we'd have to do that containment until we got the lab report back. Well, they had come on with a new test, a rapid test for smallpox which we thought was great because we wouldn't have to do the containment for so long. And so I collected a couple of specimen, sent them down to Dhaka for testing and they came back positive for smallpox and I said well there's no way that this is smallpox. I said this was chickenpox. These were two chickenpox cases. So I called up Stan, Dr. Foster and I said, "Stan," I said, "I'm sorry but they screwed up with the lab here okay." And I said, "These are not cases of smallpox, these are chickenpox." He goes, "Well," he says, "See if you can get some other scabs and ship them down but still do the containment." So I did and then a couple of weeks later had another case of reported rash, did the same thing and it came back positive again for smallpox. So I called up Stan again and I said, "Stan this test is no good. I mean we're getting false positives here. I mean I can't - these are clinically, these are not smallpox cases." He goes, "Yeah," he says, "Yeah we've been having some discussions about that here." He says, "But I want you to continue to what you want, to continue to collect the specimens and send them down." So I thought to myself you know what I'm going to send him some specimens but they're not going to be scabs of chickenpox or whatever. What I went ahead and did was to vaccinate myself with the smallpox vaccine. Once I got a scab - I vaccinated myself a couple of times in the arm and I collected those scabs from the vaccine and I put those in the container and falsified the records and sent them down to Stan Foster and they came back positive okay for variola virus. And I said, "Stan," I says, "You know that's vaccinia virus." I said, "That's what's on there." And he goes, "Okay Vince." He says, "I knew you were up to something because when you falsified that report the name that you put on there was a very common Bangladeshi name and I just knew that wasn't the true case." So later on that test indeed was no longer used so we went back to the old testing methods. The other story in Bangladesh that was, that I'll always remember was my last case of smallpox in Bangladesh. We had gotten a report that there was a person with smallpox on a public launch. This was a boat that would go from village to village in Bangladesh up the river and we heard reports that this person had gotten off this launch at about three or four different villages okay, but in one of the villages he had spent overnight. So we went out and visited all those villages where we had gotten reports where he had stopped especially the village where he had stopped overnight to visit. Well it turned out that the people that he was visiting were relatives of his and indeed from all the descriptions that we had this was a smallpox case. And we had gotten there -- I don't know -- maybe about a week after he had been there and there was a small child. It was a female, she was two or three years old if I remember correctly and the mother had told us that she had a fever and I go, "Okay." So I said, "Well we're going to have to keep you in the house and we'll supply you with food and water. We'll go out and get things for you but we need for you to stay here." And so we did that and that - even though the child had fever we vaccinated the child because we weren't sure if this was going to be smallpox or not. Well indeed it did turn out to be a very mild case of smallpox but it was smallpox. And a little funny story - and the child did well and recovered and everybody was grateful. But what's interesting, on the form that we had we had to put date of onset and date of discovery. Well, in most cases your date of discovery was a few days after the date of onset of rash. Now, in this case when I filled out my report, I put the date of discovery a couple of days before the beginning of rash. And I thought this is really great, this is good work. We're getting ahead of the disease. I said we're going to - we've got this down. So I was very proud of myself. I was going down to Dhaka to turn in my report to Stan Foster. He'd gotten my report and then he said, "Mr. Radke I've got your report here." And I go, "Yeah, I'm very proud." And he goes, "You've got the date of discovery wrong." "No that was the correct date." "Mr. Radke you cannot find the disease before it happens." I says, "Well we did." I says, "We were right on top of it." And he goes, "No we're going to have to change the date of discovery at least to the date of onset of the rash." So I had to change my report for the date of discovery but what was really important to me was at that point I knew we had gotten a handle on the disease and we were - we had broken that transmission then so that made me feel good, it made me feel real good. Interviewer: What were some of the main obstacles to your work in Bangladesh? Interviewee: Oh, the monsoon season was really tough Dave. It - and that was, for me that was one of the roughest periods because it was hard to move during the monsoon season. The rains were intense, sometimes the winds were very intense so you couldn't get out as much as you wanted and what would happen in Bangladesh when the monsoon hit, the entire land would just flood out. The rice fields and everything would just be covered in water and some of the water could be fairly deep, eight, ten, twelve feet deep. And the only thing you have then in Bangladesh were these built up villages and those were the only things that showed and the people couldn't - they didn't have a lot of boats so they couldn't leave the island. And sometimes if the people or the cows got too close to the edge of the water in these villages, they would slip into the water. And you would see - there would be bodies that would be floating, there would be dead cows would be floating down the water. And it was just - it was tough to work in those conditions, it really was. It was a really rough time in the monsoon season to get around and then to see the death as a result of the monsoon season. It was bad. Interviewer: How would you say your work in smallpox influenced your future? Interviewee: Oh man, it set me on the road to public health. You've got to imagine, I was graduating nineteen seventy from Michigan State. I got to put this a little bit in context here. The killings at Kent State had happened that spring and I along with a number of other students organized to shutdown the campus at Michigan State and we did okay. We shut it down for a couple of days and then the president of the university got smart, gave the school a day off and by the time they came back from school we had - the strike had dissipated. But I didn't know what I wanted to do. I thought well because I hadn't heard from the peace corps yet and I thought well I'll go into graduate school and continue with biology maybe work in a lab or something. So when that call came about to be a peace corps volunteer in Ethiopia and work in the smallpox program, I was excited. And then when I got into the program and to see how a public health program could indeed benefit many people, to me that was very gratifying and I have been in public health in one aspect or another very since, ever since nineteen seventy. It sets me - that's where to get my masters degree in public health and I've been at state and local health departments ever since I got back to the United States in nineteen seventy eight, seventy nine and now I'm in environmental health but it's still it's a practice of public health. So I think there was only a short six month stint in my entire work history that I was in the private sector. So it's always been public sector and it's always been public health so I haven't left it. Enjoyed every moment. Interviewer: Why did you pick University of Pittsburgh? Interviewee: I had applied to a number of schools and Pittsburgh was one of the schools and at the time I'd gotten some financial aid. They were the only ones to offer some financial aid and as a peace corps volunteer even though they set aside some money for you every month while you're a peace corps volunteer, it wasn't a lot of money. So I didn't have a lot of money. In fact when I got to the University of Pittsburgh with a little bit of - it was a U.S. public health traineeship that I got. I also got - had to do some - I had a work study program so that's why I went there. The other schools were a little bit more expensive so I chose University of Pittsburgh. Good school, good school. Interviewer: Did you know Dr. Cutler? Interviewee: Oh my goodness! Did I know... Interviewer: Yes. Interviewee: Dr. Cutler was my advisor. John Cutler was my advisor. He was an inspiration to me. I know some of his past but he was a true gentleman, a true scholar. He guided me on my masters papers that I did and I - I'm always grateful. And he was the one that I approached after D.A. Henderson had asked me to come. I went to him and I said, "Dr. Cutler I have a chance to work in the smallpox program in Bangladesh. Do you mind if I break my education here for a little bit?" He goes, "Vince take all the time you want. In fact we probably can even give you credit for it," for some of that and so I was very grateful. Stayed in contact with him and his wife until his passing but I knew John - knew Dr. Cutler and just a wonderful - just a wonderful man, just a wonderful man. Oh man, that brings back memories. Interviewer: Maybe we better stop then. Wow. Interviewee: You know I've been very lucky. I have met some of the top leaders in public health that have guided me and I just can't - I just can't say enough you know. That I've met either at the school of public health in Pittsburgh or in the smallpox program. It's just tremendous, just tremendous. You can't put a price on that, you can't put a price on it. Interviewer: The smallpox program brought forth an awful lot of good people. Interviewee: Oh, oh my goodness. I can't say enough about Don Millard, D.A. Henderson, Bill Fergie, Joe Breman, yourself. I don't want to embarrass you. You guys were just - were just great, just great. And the support, I mean Dr. de Quadros, Dr. Weithaler, tremendous, tremendous people. Larry Brilliant another one. I can go on and on. I could go on and on. I mean they're just - it was just - it was an honor. At the time of course you don't know it. Actually they're just one of the smallpox guys but later on I come back, it was a real honor and privilege to work with them. And you know Steve - oh I could go and on. Interviewer: You know Larry Brilliant had these tee-shirts made in Bangladesh that said eradicate chickenpox. Interviewee: Pox, right yes, yes. I have a shirt and I'll wear it when I come in July that my wife knitted and it has on the back of it, it has the smallpox target zero on it. So I'll wear that. Interviewer: You can still wear it? Interviewee: Huh? Oh yeah. I don't wear it too often because I don't wear it out but I have it hanging up in the closet and I bring it out occasionally so this will be - I should have worn it here. Interviewer: We'll look forward to it. Interviewee: Yeah, yeah, yeah. Because she even after we got married she knew. While we were married we went over to Kenya for that last year for the smallpox program and she knew how important this smallpox program was to me. So when she knitted that shirt so I'll... Interviewer: You've been fortunate. Interviewee: Oh my God. Interviewer: Another country has been fortunate to have people like you. Interviewee: Oh. No, I am fortunate to have known a lot, a lot of good people in the smallpox program in the public health. And you know another story. I had - when I came back after I got my masters degree at the University of Pittsburgh I had also tried to get into CDC and the EIS program. Well at that time they wanted doctors and you had to have an MD or DMV and so I couldn't get in and I was always - I was always sad about that because I had remembered the training I had gotten here at CDC and the great people. And I thought boy what an institution to be a part of but I didn't okay. So I thought well you got to go on with your life, you just can't do nothing. So I stayed in public health but at the state and local level and that dream of getting into smallpox that faded until one day I got a call - I got an email from two colleagues. One at CDC who I had worked with on food borne disease outbreaks earlier and another colleague in Minnesota that I was working with and both of them said to me, "Vince there's an ideal job at CDC for you." They were looking for a sanitarian for their program there, the environmental health services branch. And I go, "Well." I says, "Guys I'm not interested now. My wife and I are in Minnesota, we're doing great." And the one guy at CDC who was an EIS officer said, "No, Vince you owe me okay. You need to at least apply here." So make a long story short, I applied and got in. To me Dave CDC was always the temple, the public health temple on a mount and so I'm so grateful to be here. Just so grateful. This is a great place to work. Great place to work. Interviewer: On that note we better quit. Interviewee: Yeah. </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/kInVdz_LBis" frameborder="0" allowfullscreen></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource RADKE, VINCE Subject The topic of the resource Smallpox Eradication Description An account of the resource Vince Radke, MPH., describes his early life, his decision to join the Peace Corps, his work in Ethiopia and Bangladesh during the smallpox eradication programs in 1972-75. Explains how this changed his life and career path. Interviewed by Dr. David Sencer Source A related resource from which the described resource is derived The David J. Sencer CDC Museum at the U. S. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333 www.cdc.gov/museum Date A point or period of time associated with an event in the lifecycle of the resource April 1, 2008 Format The file format, physical medium, or dimensions of the resource 7336560000 bytes video/x-dv Language A language of the resource English Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16s37 emory:16s37 https://www.globalhealthchronicles.org/files/original/362850b2cd03d7f1ebced34a2d4774af.JPG c3d8fe2c0e1c1703b5d788c1f1dbbc1f 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 Guinea Worm Description An account of the resource <div class="landing"> <p>Guinea worm is poised to be the second human disease to be eradicated. The Carter Center, with partners like the U.S. Centers for Disease Control and Prevention, began leading the international campaign to eradicate Guinea worm disease in 1986. That year, it was estimated that 3.5 million cases occurred annually in 21 countries in Africa and Asia. Guinea worm disease is a painful and debilitating parasite that is contracted by drinking Guinea worm infected-water. There is no vaccine or drug to prevent the disease, only behavior change through health education. Working with the ministries of health and impacted communities, Guinea worm disease has been reduced by more than 99 percent. <span>During 2020, only 12 human cases of Guinea worm disease were reported in Chad, a dramatic 75 percent reduction from 48 the previous year. Eleven cases were reported in Ethiopia, and one each in South Sudan, Angola, Mali, and Cameroon. As for Guinea worm infections in animals, Chad reported 1,570 (1,507 domestic dogs, 61 domestic cats, and two wild cats), Ethiopia reported 15 (eight domestic dogs, three domestic cats, four baboons), and Mali reported eight infected domestic dogs. </span>The buttons to the right will connect you to a searchable database of oral histories, photographs and media. To conduct an advanced search, use the link in the blue navigation bar above. Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used. .</p> </div> Media Powerpoints, Recorded lectures, movies, training films, and interviews Transcription Any written text transcribed from a sound. <pre><strong>Interview Transcript</strong> Speech Don Hopkins Audio File Transcribed: February 5 | Duration 0:15:38 Welcome By Stanley: ...briefly of two of the programs that sort of learned from Smallpox and have gone on and are now doing tremendous things around the world. So first I'd like to introduce Don Hopkins. Don was in the original group in West Africa. His work in Sierra Leone where he had enough resources to do mass vaccination in one, and surveillance and containment in the other, showed the surveillance and containment was far more effective, and then he went on to work in India. I guess you were in Calcutta, Don? Then over the last few years he's been battling the serpent, so let's give a hand of welcome to Don Hopkins. Speech: Don Hopkins Good morning. It's great to be here and a wonderful occasion, and especially for me to be able to share a bit of the story of the Great Worm. To do so would really require another symposium to do so fully. But I've only got nine slides and I want to run through them quickly. Stan asked me whether I might need more time and I said, "No." Fortunately the story of Guinea Worm Eradication, or at least part of it, is told very simply these days. Thank God. Here you see this worm that grows up to two to three feet long, emerges directly through the skin on any part of the body. People who are infected by drinking contaminated water containing immature forms of the parasite, the parasite gets into the water when people with worms coming out of their body, go in to the water and the female worms spew these immature forms into the worm where they're taken up by water fleas and people drink water containing those infected fleas; and a year later the infection emerges. Someone has said, "This is the ultimate in an emerging and infectious disease." I have nine slides, but this is really the one that tells the full story or much of it to date. This initiative began right here at CDC or right here at what used to be CDC, in a different part of the place, with an estimated three and a half million cases. We began here at CDC in 1980. They called us in when President Carter took this up in 1986. But in 1986 we had an estimated three and a half million cases as you see, as of last year, and these are not provisional data; these are final data for 2007. We're down, for the first time, to under 10,000 cases. Two years ago when I presented this; we're still at over 25,000 cases. We've gone from almost 24,000 villages in 1993 to just over 2,000 villages now, infected, and as you see, from 20 countries infected when the program began, now to five. (Next slide) This shows on top there the less than 10,000 indigenous cases reported in 2007 and you can see here the years in which the last cases occurred; and two years ago when I made this presentation to the West Africa Group, we still had a number of other countries including these four which had their last case in 2006 which was still then considered endemic. We are now down as of the end of last year, to five countries: Sudan, Ghana, Mali, Nigeria, and Niger; and for a little bit of perspective, let me just note that when in the early 1980s, Ghana and Nigeria were each reporting on the order of 3,000 or 4,000 cases to the World Health Organization. When Ghana did its first case search in 1989, they found just under 180,000 cases, they're down last year to under 4,000 cases. When Nigeria made their count the first time that year as well, Nigeria then counted over 653,000 cases, so you can imagine how far around this room that bar would go, if these data were for 1989 for Nigeria. On the bottom here, you see the last five countries and we've listed Ethiopia here, even though Ethiopia recorded its last official case in 2006. Early this year, they became aware of 37 cases that reportedly were imported from Southern Sudan where there's a lot more Guinea Worm known, but we include Ethiopia here, again, to keep Ethiopia on its toes and not let them feel too comfortable. But here, you see through June of 2008, the number of cases reported so far this year and that in essence is where we are. Here, you see that presented in the form of a map in yellow, the countries that have already broken transmission including all three in Asia: India, Pakistan and Yemen. Then in Africa: Nigeria and Niger there in what appears pink to you; the countries that reported under 100 cases in 2007, and we think that both of them may well have broken transmission already with Niger having reported its last case in November of last year, and Nigeria having had no cases in April, May and June this year. Then you have Mali, Ghana and Sudan there in red, each having had more than 100 cases last year. Here you see cumulatively the global campaign as of the number of cases 2006, 2007, first seven months of 2008. Now the rest of the top three countries remaining, this is Sudan which has reduced its cases so far this year compared to last year by 54%. The Civil War, having ended officially at the beginning of 2005, we have a very energetic group of people there and things are proceeding very well, except for the political insecurity that still remains. Ghana, surprisingly for all of us, was an enormous headache for much longer that it should have been, but they have gotten now back on the straight and narrow and you can see here, Ghana having - this is a record - Jim Zingerser is here, they beat[inaudible 0:7:22] even Niger some years back, but Ghana has reported 85% fewer cases so far this year as compared to last year. This is not a calendar year, this is the epidemiologic year, beginning in July and someone mentioned earlier the importance - I think it was you, Stan, in Bangladesh of social will and involvement of the media and that has certainly been true in Ghana, after over a decade of stagnation in cases. Last year, 2007, Ghana had an explosion of cases in the first of the year, January and February, up in the North of the country; a very neglected part of Ghana from even Colonial times. The epidemic happened to coincide just before March 6, 2007 when Ghana was to celebrate the 50th Anniversary of its Political Independence from Britain. The month before that celebration in February, President Carter came and we used that occasion which unfortunately - fortunately for us - coincided with that terrible outbreak and they were represented on Ghanaian Television; there was just one reporter who was with us when the Chicago Tribune said, this was a scene from hell; of lots of pre-school-aged children crying. It was just awful, but all of that was on Ghanaian Television and there were reporters already, international reporters, beginning to come into the country for the 50th Anniversary of celebration and that helped to generate the requisite political will, social will in Ghana. Mali is having a political problem with Tuaregs in the North, but Mali was well on its way to getting rid of this disease when year before last, unbeknownst to anybody else. A Koranic student walked from an endemic area several hundred kilometers up to the North near the border with Algeria in the region of Kidal; and a year later we, and those people there, became aware of this outbreak. The only good thing about it was that these people in that area of the country were not used to having Guinea Worm disease and they were immediately hell-bent on getting rid of it, so we are having very good cooperation from that population. But we're still having some problems up in that area which we think we are getting on top of. The President of the country has promised to pay more attention to this now and he has been a very strong supporter of this eradication effort. In fact, now President Tour� has been proselytizing for Guinea Worm Eradication in all of the other endemic Francophone countries of Africa and now, to my great sadness, his own country Mali is going to be the last Francophone country to have Guinea Worm disease. This is my last slide showing that the countries in green that have been certified already by WHO as having eradicated - eliminated Guinea Worm disease. You see there that Cambodia in Asia is the only other country outside of Africa, remained to be certified. One of the spillovers from the Smallpox Eradication Program to the Guinea Worm Eradication Program is Joel Breman whose on the International Commission for the Certification of Dracunculiasis Eradication. There have been many other spillovers in the form of the surveillance containment, we call it "Case Containment Strategy" as supplied in the Guinea Worm Program; the use of data and indicators to motivate people and to make senior people uncomfortable. In Sierra Leone, we had a little newsletter run off by mimeograph called, The Eradicator - We Now Have Guinea Worm Wrap Up, put out through CDC. Use of hand-drawn maps with dots from Sierra Leone to West Bengal, India, in my experience; lots and lots of local heroes. Some of whom, you've heard about. One thing unfortunately, we do not share with the Smallpox Eradication Program, was a two-week incubation period. Oh! What I wouldn't give for a two-week incubation period of Guinea Worm disease. Let me just ask all of the people in the audience who are veterans of the Smallpox Eradication Program who have also now worked in the Guinea Worm Program to stand. Bill, thank you. That should have included you. Just to end with one smallpox story; we're aiming to get rid of Guinea Worm disease by the end of next year. Sudan is going to be the final battle. We're getting very close, but we're not there yet. I didn't tell a smallpox story last night, but I just want to note that I spent three months, Ernie and I, in West Bengal, India, in the fall of 1973 as part of the first Autumn Campaign. I went there very full of enthusiasm and enjoyed it much more even than I expected to, but by the time I'd left - you have to understand that as much as I loved India, I did not like Indian food and the thing that saved me was that we found a Chinese restaurant in Calcutta when we came back before I left. That, plus walking into the villages caused me to loose - and at that time when I went into India I weighed a little less than I weigh now, but I lost 17 lbs. going there, and I also came hell-bent on getting a replica of this Shitala Mata, Goddess of Smallpox. I had a copy from the program in Lagos, the last big reunion I attended in Lagos of the smallpox program, of the Smallpox Goddess of West Africa; and I wanted to get one of India, and the whole three months in West Bengal, asking, asking, asking; I never found one. Debriefed in Delhi and took a last quick trip down to Agra to see the Taj Mahal. Leaving the city in the vehicle going back to New Delhi, my last full day in India and I see - because I'm doing constant surveillance for my Smallpox Goddess - I saw in a little shop along the way this thing; and I shouted, "Stop!" to the diver, got out and bought - these were two marble, I think, small replicas of this goddess. I bought two of them and put them in my pocket because it's my last day there. Leaving the country, I was overweight, so I put them in my trench coat pocket, I didn't have any room to plant them [inaudible15:01] and I actually won a discussion with the airline people who wanted to charge me overweight baggage. But I explained that I weighed 17 lbs less than when I came here; and so, I got rid of it. That is how Dave Sencer came to acquire a copy of the smallpox goddess which he donated - you see it in the Odyssey downstairs there. They were not presented to me, I bought them. Thank you. [End of audio] </pre> Player html for embedded player to stream video content <iframe width="100%" height="1830" style="width:100%;height:1830px;" src="https://globalhealthchronicles.aviaryplatform.com/collections/2845/collection_resources/132702?embed=true"></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 2008 Guinea Worm Status Description An account of the resource Dr. Don Hopkins discusses the statuus of the Guinea Worm Eradication Program and relates that to the lessons learned from smallpox eradication. Cases still occuring in Sudan, Nigeria, Pakistan. He is introduced by Dr. Stanley Foster. Source A related resource from which the described resource is derived The David J. Sencer CDC Museum at the U. S. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333 www.cdc.gov/museum Date A point or period of time associated with an event in the lifecycle of the resource July 12, 2008 https://www.globalhealthchronicles.org/files/original/bc72461885eb2d899c3500421ddb4f06.pdf 838f83e2444062035ed130b68cfaf6fb 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 Malaria Control: CDC Beginnings Description An account of the resource <div class="landing"> <p>In 1942, when the U.S. was mobilizing for the Second World War, the U. S. Public Health Service set up a program to protect the personnel of military bases in the Southeastern states from malaria. This disease had long been rampant in the area, and posed serious threats to the health of the military and civilian populations. The program known as Malaria Control in War Areas (MCWA) was created to carry out the work. The lack of space in Washington due to the war effort allowed the program to base its headquarters in Atlanta, Georgia, and closer to the work at hand. During the war years, the program was expanded to include the control of other communicable diseases. Because its work was so successful, a new organization was created around the nucleus of MCWA, the Communicable Disease Center (CDC). The date was July 1, 1946. This archive chronicles the agency’s early history from 1941-1951, including the contributions of local businessmen and Emory University. The buttons to the right will connect you to a searchable database of documents, oral histories, photographs and media. To conduct an advanced search, use the link in the blue navigation bar above. 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> Documents Government Records 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 MCWA REPORT – Treatment Description An account of the resource “Treatment of Malaria,” an informational document about the drug treatment of Malaria, suppressive and clinical. Produced by the War Department, Army Service Forces, Office of the Surgeon General, U.S. Public Health Service, Malaria Control in War Areas [MCWA]. Source A related resource from which the described resource is derived The David J. Sencer CDC Museum at the U. S. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333 www.cdc.gov/museum Date A point or period of time associated with an event in the lifecycle of the resource June 7, 1944 Identifier An unambiguous reference to the resource within a given context 2012.015.4.pdf https://www.globalhealthchronicles.org/files/original/b0f547d90c6b082e9ea30f34b4d37878.pdf 51d3029f063f25e668fcb183476c4e2a 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 Malaria Control: CDC Beginnings Description An account of the resource <div class="landing"> <p>In 1942, when the U.S. was mobilizing for the Second World War, the U. S. Public Health Service set up a program to protect the personnel of military bases in the Southeastern states from malaria. This disease had long been rampant in the area, and posed serious threats to the health of the military and civilian populations. The program known as Malaria Control in War Areas (MCWA) was created to carry out the work. The lack of space in Washington due to the war effort allowed the program to base its headquarters in Atlanta, Georgia, and closer to the work at hand. During the war years, the program was expanded to include the control of other communicable diseases. Because its work was so successful, a new organization was created around the nucleus of MCWA, the Communicable Disease Center (CDC). The date was July 1, 1946. This archive chronicles the agency’s early history from 1941-1951, including the contributions of local businessmen and Emory University. The buttons to the right will connect you to a searchable database of documents, oral histories, photographs and media. To conduct an advanced search, use the link in the blue navigation bar above. 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> Documents Government Records 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 MCWA REPORT – Murine Typhus Epidemiology Description An account of the resource “Epidemiological Data for Murine Typhus Control Activities,” a report on the outcomes of Murine Typhus control programs enacted in the United States. Produced by the U.S. Public Health Service, Malaria Control in War Areas [MCWA], Medical Division. Source A related resource from which the described resource is derived The David J. Sencer CDC Museum at the U. S. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333 www.cdc.gov/museum Date A point or period of time associated with an event in the lifecycle of the resource June,1945 Identifier An unambiguous reference to the resource within a given context 2012.015.5.pdf https://www.globalhealthchronicles.org/files/original/4eda1ede285e3909221e09aa7f5734ff.pdf 06cb734260fa4a8519928e057b974d7e 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 Malaria Control: CDC Beginnings Description An account of the resource <div class="landing"> <p>In 1942, when the U.S. was mobilizing for the Second World War, the U. S. Public Health Service set up a program to protect the personnel of military bases in the Southeastern states from malaria. This disease had long been rampant in the area, and posed serious threats to the health of the military and civilian populations. The program known as Malaria Control in War Areas (MCWA) was created to carry out the work. The lack of space in Washington due to the war effort allowed the program to base its headquarters in Atlanta, Georgia, and closer to the work at hand. During the war years, the program was expanded to include the control of other communicable diseases. Because its work was so successful, a new organization was created around the nucleus of MCWA, the Communicable Disease Center (CDC). The date was July 1, 1946. This archive chronicles the agency’s early history from 1941-1951, including the contributions of local businessmen and Emory University. The buttons to the right will connect you to a searchable database of documents, oral histories, photographs and media. To conduct an advanced search, use the link in the blue navigation bar above. 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> Documents Government Records 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 MCWA REPORT – March-June 1942 Description An account of the resource “Organization Report in Lieu of Monthly Report of Malaria Control in War Areas,” a monthly report on the activities of Malaria Control in War Areas from March to June of 1942. Produced by the Federal Security Agency, U.S. Public Health Service, Malaria Control in War Areas [MCWA]. Source A related resource from which the described resource is derived The David J. Sencer CDC Museum at the U. S. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333 www.cdc.gov/museum Date A point or period of time associated with an event in the lifecycle of the resource 1942 Identifier An unambiguous reference to the resource within a given context 2012.015.10.pdf https://www.globalhealthchronicles.org/files/original/324ee535ddcf71cac61a8c20f969023c.pdf 69ad5e9865f1e601e36a71539686c701 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 Malaria Control: CDC Beginnings Description An account of the resource <div class="landing"> <p>In 1942, when the U.S. was mobilizing for the Second World War, the U. S. Public Health Service set up a program to protect the personnel of military bases in the Southeastern states from malaria. This disease had long been rampant in the area, and posed serious threats to the health of the military and civilian populations. The program known as Malaria Control in War Areas (MCWA) was created to carry out the work. The lack of space in Washington due to the war effort allowed the program to base its headquarters in Atlanta, Georgia, and closer to the work at hand. During the war years, the program was expanded to include the control of other communicable diseases. Because its work was so successful, a new organization was created around the nucleus of MCWA, the Communicable Disease Center (CDC). The date was July 1, 1946. This archive chronicles the agency’s early history from 1941-1951, including the contributions of local businessmen and Emory University. The buttons to the right will connect you to a searchable database of documents, oral histories, photographs and media. To conduct an advanced search, use the link in the blue navigation bar above. 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> Documents Government Records 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 DATA – U.S. Typhus October 1947 Description An account of the resource “Source Data on Endemic Typhus Fever Morbidity,” a document prepared to provide a general source for statistical information concerning reported cases of Typhus in the continental United States from 1941 through 1945. Produced by the Federal Security Agency, U.S. Public Health Service, Communicable Disease Center. Date A point or period of time associated with an event in the lifecycle of the resource October 1947 Identifier An unambiguous reference to the resource within a given context 2012.015.11.pdf https://www.globalhealthchronicles.org/files/original/26dc5a735395238be00574313baba78f.pdf 011009bee873187aedd65ca79445e22a 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 Malaria Control: CDC Beginnings Description An account of the resource <div class="landing"> <p>In 1942, when the U.S. was mobilizing for the Second World War, the U. S. Public Health Service set up a program to protect the personnel of military bases in the Southeastern states from malaria. This disease had long been rampant in the area, and posed serious threats to the health of the military and civilian populations. The program known as Malaria Control in War Areas (MCWA) was created to carry out the work. The lack of space in Washington due to the war effort allowed the program to base its headquarters in Atlanta, Georgia, and closer to the work at hand. During the war years, the program was expanded to include the control of other communicable diseases. Because its work was so successful, a new organization was created around the nucleus of MCWA, the Communicable Disease Center (CDC). The date was July 1, 1946. This archive chronicles the agency’s early history from 1941-1951, including the contributions of local businessmen and Emory University. The buttons to the right will connect you to a searchable database of documents, oral histories, photographs and media. To conduct an advanced search, use the link in the blue navigation bar above. 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> Documents Government Records 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 MCWA REPORT - Schistosomiasis Description An account of the resource “Tropical Disease Series: Schistosomiasis,” a manual designed to accompany the film strip “Schistosomiasis” which contains supplemental information on the disease. Produced by the Federal Security Agency, U.S. Public Health Service, Malaria Control in War Areas [MCWA]. Source A related resource from which the described resource is derived The David J. Sencer CDC Museum at the U. S. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333 www.cdc.gov/museum Date A point or period of time associated with an event in the lifecycle of the resource 1946