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&lt;p&gt;Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  &lt;/p&gt;
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              <text>&lt;pre&gt;&lt;strong&gt;
 Interview Transcript
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Interview

Dr. Davida Coady with Interviewer Chris Vaniser
Transcribed: January 2009 | Duration: 0:33:21



Chris Vaniser:   This is an interview with Davida Coady on July 11, 2008  at
           the Centers for  Disease  Control  and  Prevention  in  Atlanta,
           Georgia about her role in the Smallpox Eradication Project.  The
           interviewer is Chris Vaniser.

           With this  interview  we  are  helping  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. For the  record,
           could you please state your full name and that you know you  are
           being recorded.

Davida Coady:    Davida Coady, and yes I realize I am being recorded.

Chris Vaniser:   Thank you again for coming and sharing your memories  about
           the Smallpox Eradication Project or Program. I guess  to  start,
           if you could talk a little bit  about  your  early  days  before
           going on to college and if you knew what you wanted to  do  with
           your life, or what you wanted to be when you grew up; and  share
           a little bit of that information with us.

Davida Coady:    I grew up in Berkeley, California  in  a  family,  none  of
           whom had graduated from High School previously. I was  fortunate
           enough though to be living in Berkeley, it had  some  good  role
           models and decided that I wanted to something worthwhile with my
           life. I met two women doctors, pediatricians, running a camp for
           diabetic children and I decided  that  I  would  try  to  go  to
           medical school and I did so. I read about Dr. Tom Dooley and his
           work in Southeast Asia, and I decided I wanted to spend part  of
           my life in the Third World and went to medical school with  that
           idea.

Chris Vaniser:   Were you thinking of being more of a clinician?

Davida Coady:    I was thinking more about being  a  clinician.  I  went  to
           Columbia Medical School and of the acceptances I  got,  I  chose
           that school because they  had  an  elected[inaudible0:02:49]  in
           Liberia in the fourth year, and  I  went  there  and  I  made  a
           decision that I would definitely  go  into  pediatrics.  I  also
           realized that I really loved working in a third world country. I
           think up until that point I had kind of a  moderate  complex.  I
           thought I was going to die young of malaria or something, but it
           hadn't occurred to me really that I would  enjoy  being  in  the
           third world and working in places where you could be  innovative
           and where people really needed  you,  where  the  young  people;
           people who were being trained as nurses would  be  so  eager  to
           learn, and any time that you would spend with them,  they  would
           pick your brain about everything you knew, and  I  saw  lots  of
           people getting well. I also became aware of the need for  Public
           Health. So during my Pediatric Internship and Residency at  UCLA
           I found time to go to Mexico and then to Guatemala where  I  met
           Dr. Thomas Weller from the Harvard School of Public Health and I
           talked to him about career development and he persuaded me  that
           I needed an MPH if I really wanted to work in Prevention which I
           certainly did by that point. So I went to the Harvard School  of
           Public Health and then jumped into Third World work from there.

Chris Vaniser:   So where did you go then after Harvard?

Davida Coady:    I went first to Nigeria, only I was in the  part  that  was
           then called Biafra. I was there obviously  during  the  Nigerian
           civil war. I worked with a small relief  agency  run  by  Normal
           Cousins inside of Biafra and got out the night that the  country
           collapsed. I was sent back to Nigeria on a Government assignment
           shortly thereafter as part of the relief efforts  for  what  had
           been the former Biafran enclave and it was there  I  got  really
           acquainted with Bill Foege and Stan Foster and people who became
           my heroes, my mentors, my gurus; and I became so  interested  in
           smallpox campaign. I then went to work at the Peace Corps, first
           as their Acting Medical Director and then as a Health Programmer
           and it was during that time that I met  D.A.  Henderson  and  he
           became one of my big heroes in life and I was  involved  in  the
           Peace Corps involvement in smallpox at that point. Then later on
           I left the Peace Corps, I went to UCLA to teach and  I  went  to
           Bangladesh after their revolution and was working there  when  I
           ran into Dr. Henderson in the airport in Dhaka. Actually he  was
           getting off a plane and I was getting on a plane. He  said  "Hey
           Bill Foege is in India and he is looking for people to  work  on
           smallpox on three-month assignments;" and I said "Oh wow,  I  am
           interested!" and the next day I got a telegram from  Bill  Foege
           asking me to come to Delhi and talk about it which I did and -

Chris Vaniser:   Where were you based with at the time? You  were  with  the
           Peace Corps at that time?

Davida Coady:    No, I was still - I had gone to UCLA at that  point  to  be
           an academic, but I am not an academic, I don't like it.  I  like
           teaching, but I didn't like the rest of it, and by that  time  I
           was a part time academic, but mainly  working  on  my  own.  For
           years then I taught one or two Quarters a year at UCLA  and  did
           international work the rest of the time.

Chris Vaniser:   So you got this telegram from  Bill  Foege  asking  you  to
           come and talk to him in Delhi?

Davida Coady:    In Delhi-and I was actually on my way home and I  did;  and
           I arranged to go back a few weeks later. I was  getting  married
           at that point and my husband - I thought it would be much easier
           to work out in the Boonies in India with a partner, and  he  was
           interested and we went back to India; Bill sent us to Gorakhpur.
           So I was the first woman field epidemiologist and there  were  a
           number who followed me. They were watching me very closely and -
           you know, it was a real highlight of my life, it was just such a
           wonderful thing to be  part  of.  I've  been  part  of  lots  of
           different Public Health initiatives of one kind or another,  but
           this was something that was so clear  that  you  could  see  the
           results. So we put a 1000 miles a week on our Land Rover, a  lot
           of it on dirt roads going around to the villages  in  India  and
           many villages there, in those Northern districts  of  the  Uttar
           Pradesh, they had never seen a white woman.  In  fact  they  had
           really never had any women visitors and all kind of rumors would
           go around the villages about who I was. The one I liked best was
           that occasionally the rumor would go round  that  I  was  Indira
           Gandhi and so I - that was kind of fun; and I  would  tell  them
           that I was not, but I -

Chris Vaniser:   How long did you go over for? What was your - ?

Davida Coady:    I think we were there for  a  three  month  assignment  and
           then we were extended for several months after that and then  we
           went back to Los Angeles for a couple of months, and  then  went
           back for a second assignment, and the second assignment  was  in
           West Bengal. I had asked particularly to go to Calcutta, I  love
           Calcutta, and so we were based in Calcutta in charge of the four
           districts to the North and the East, East - No I  am  sorry,  it
           was actually the North and the West of Calcutta  and  then  when
           Calcutta - when  West  Bengal  was  free  of  smallpox  we  were
           transferred to Bangladesh.

Chris Vaniser:   Going  back  to  Gorakhpur  again,  which  was  your  first
           assignment in India and your first smallpox assignment, can  you
           tell me a little bit about your team that you worked with?

Davida Coady:    We had an Indian doctor,  Dr.  Rao[inaudible  name0:10:14],
           who was from South India who worked with us, and he kind of took
           two of the districts and I took two of the districts. We  had  a
           wonderful paramedical assistant and a driver who we became  very
           close to; and we went touring around the  countryside.  I  think
           one of the things that I did was  I  realized  that  the  people
           working on it in the villages, the doctors, the health  workers;
           they had no idea when I got there  that  this  was  part  of  an
           international effort. So I managed to get a map of the State  of
           Uttar Pradesh, and another map of India, and another map of  the
           world. These were not easy to come by in Gorakhpur,  but  I  got
           them. Now we would take them around to the districts and we'd go
           through and I'd show them what they were part of,  and  hundreds
           of people would gather around and listen to this and they  would
           get so excited and then when I'd go back weeks later  or  months
           later, they'd say what is happening  now  in  Ethiopia.  Are  we
           going to beat Bihar, are we gong to beat Bangladesh  or  are  we
           going to beat Ethiopia in eradicating smallpox; and  they'd  get
           so excited and the quality of work would improve tremendously.

Chris Vaniser:   How were you received as a Caucasian woman working in  that
           area of India, which I am sure that most of the  physicians  you
           were dealing with, I assume, were male?

Davida Coady:    Right.

Chris Vaniser:   At least most of the other people.

Davida Coady:    I think fairly well-very well in fact.  I  think  in  India
           there were no problems really. You know, I dressed appropriately
           and all, and got my legs covered and all those  things,  and  in
           Bangladesh it was a little harder. If I went  somewhere  without
           my husband, people would say well bring your husband next  time,
           and they didn't my traveling without him, and we'd  often  split
           up and did different parts of the work. But in India  there  was
           none of that. There was  a  village  character  in  one  of  the
           villages who wrote a song about me and evidently the chorus - he
           was a man suffering from tertiary syphilis and was quite crazy -
           the chorus was translated to me saying: "Dr. and Mrs. Coady is a
           wonderful doctor, she's the  best  doctor  in  the  whole  world
           because she carries herself like a doctor and she  acts  like  a
           doctor." So I thought that was very, very nice.

Chris Vaniser:    Very  nice-Yeah  respectful.  Did  you  have  any  special
           challenges or  events  that  happened  when  you  were  in  that
           Northern part of India that kind of stand out as very  memorable
           events during the smallpox?

Davida Coady:    Just that it was terribly, terribly hot. We were  there  in
           the pre-monsoon season and  I  don't  remember  anything  really
           frightening. Our driver and medical assistant,  and  many  other
           people were very kind of cautious when we first  got  there  and
           they - the person before us had  made  an  error  in  trying  to
           vaccinate a woman - this is a male epidemiologist - without  her
           permission and the villagers had come very close to throwing him
           down the well. So they told me,  they  lectured  me,  but  after
           about a week they said, "It is fine. We know you are  not  going
           to cause any problems like that." But that always made me just a
           little bit wary.

           One thing we noticed was a - my having worked in  Africa  before
           where people  loved  to  get  immunizations  and  loved  to  get
           vaccinated; was that the Indians, they wanted some  conversation
           before they were vaccinated.  They  wanted  an  explanation  and
           their views of the goddess and  her  role  in  all  this  varied
           really from village to village, and sometimes - in  one  village
           they wanted us to come back next Tuesday because that's what the
           goddess wanted us to do instead of vaccinating  people  then.  I
           think we finally agreed to do that, it was just easier, but many
           times  they  would  say,  "No,  the  goddess  doesn't  want   us
           vaccinated;"  and  we'd  sit  down  and  go  through   all   the
           explanations and just at the point when we were  convinced  they
           were never going to let us vaccinate anyone,  they'd  say,  okay
           now we understand that it's a disease and it's not a goddess and
           please vaccinate us." I remember one elderly man, he said,  "No,
           I don't want to be vaccinated because I'm getting ready to go to
           God;" and my husband looked him right in the eye  and  said,  "I
           really think God would like you better vaccinated;"  and  I  was
           just thinking "Oh my!" And the man said "Oh, alright fine,"  and
           he said, "Please, please vaccinate me." So a lot of it was  just
           listening and realizing that nothing worked fast in India.

Chris Vaniser:   Now did you speak Hindi or did you have a  translator  with
you?

Davida Coady:    We had a translator.  Our  paramedical  assistant  was  our
           translator. I learnt a little bit of Hindi and  just  enough  to
           get around, just a little to ask where ask directions and  where
           people  were,  and  of  course  the  word   for   smallpox   was
           Bashanto[0:16:56] which is also the word for springtime;  and  I
           relied a little bit less on my Hindi after  one  of  our  fellow
           epidemiologists, a man from France whose name I forget;  he  got
           very good at Hindi, but he spent a long time, he had a  sprained
           ankle at the time, walking to a village looking for - he'd asked
           if there was any Bashanto and everybody said: yes,  yes.  "Where
           is the person with smallpox?" And after he walked a  long,  long
           distance he finally found this man out on the field.  It  turned
           out   that   the   man's   name   was   Bashanto.   So   I   was
           [crosstalk0:17:57]

Chris Vaniser:   A little bit more  [crosstalk  0:17:56]  after  that  about
           your Hindi. Was your husband a physician  as  well,  or  in  the
           health field?

Davida Coady:    No, my husband at that time was not, he was not a -

Chris Vaniser:   But he was - he sounds like part of the team?

Davida Coady:    Yeah, he helped.

Chris Vaniser:   In terms of going out and-

Davida Coady:    He liked to write and he  was  collecting  information  and
stories.

Chris Vaniser:   Interesting. So then it sounds like  soon  after  that  you
           went to Calcutta? Was that the same trip?

Davida Coady:    Right, we came back to the United States for  a  couple  of
           months and then we went back and went to Calcutta.

Chris Vaniser:   How did that differ from Gorakhpur?

Davida Coady:    Well, we  were  in  the  city  and  Bengal  was  much  more
           sophisticated, and there was much less smallpox. I saw  hundreds
           and hundreds of cases of smallpox in  Uttar  Pradesh  and  many,
           many ...[inaudible0:18:58]. We were doing the last of it and the
           reward was being offered by that time  and  the  amount  of  the
           reward was going up, and we  went  around  to  different  groups
           asking them to help us. One of the interesting  things  was,  we
           went to see Mother Teresa to see if she would have her nuns help
           us in looking for and reporting any smallpox; and Mother  Teresa
           like she always did - I went  back  and  worked  for  her  later
           actually - she turned it around on us and she got us to agree to
           bring our staff on our day off and vaccinate  everybody  in  her
           feeding lines; and our driver and our paramedical assistant were
           just so thrilled to meet her and to be part of that,  they  took
           their day off too, and we did that, so that was kind of fun.

Chris Vaniser:   Did she also agree to have her nuns help  with  identifying
           any cases and reporting them?

Davida Coady:    Yes, yes they did. I can remember that they did.  But  then
           in those times we spent a lot of our time with people coming  to
           us, being brought to us with everything from scabies to  chicken
           pox to hives, with people trying to tell us it was smallpox  and
           they wanted the reward. So I spent  an  awful  lot  of  my  time
           saying no that was not smallpox; and it was interesting, one man
           particularly who came  to  us;  and  I  still  have  his  little
           advertisement. He was an Ayurvedic Doctor of some  kind  and  he
           had a little advertisement which I have still,  with  a  picture
           that he'd drawn of somebody  with  smallpox  and  he  introduced
           himself as a specialist in smallpox from a part of our district,
           North of Calcutta, and he  had  a  man  whose  scabs  were  just
           falling off, or just forming I guess; and we said,  "Why  didn't
           you bring him sooner," and he said, "Because he just ran out  of
           money," and we said, "Well, explain this." He said, "You  see  I
           charge people when they come with the fever, I charge  them  and
           they pay, I have a medicine to make the rash break out, I have a
           medicine to make the macules..." - He knew the terms  -  "...the
           macules form into papules, and the papules form  into  pustules,
           and then for the scabs to form, and then for the scabs  to  fall
           off and for the scars to go away. They come back and I sell them
           each of these medicines. But he has run out of money, so I  came
           to get the reward." Then we talked with him further and  he  was
           able to tell us every case of smallpox, maybe then 25, 30  cases
           in that district, in that outbreak over the past  two  or  three
           months, and he was able to tell us everyone of them and who  got
           it from who and it corresponded exactly to the reports  that  we
           had gotten from the health workers. So he knew the whole thing.

Chris Vaniser:   But of course, he didn't have the vaccine. He  was  missing
           that part he had medicine to make -

Davida Coady:    He had no interest in the vaccine.

Chris Vaniser:   That's right; it destroyed his business I guess.

Davida Coady:    Right.

Chris Vaniser:   How did you find the conditions?

Davida Coady:    They were difficult. Gorakhpur: it was hard to eat; we  ate
           at the hotel where we stayed which was - and then later we found
           a Chinese restaurant, but we didn't find that for about a month,
           and we ate at the hotel and everything was so terribly, terribly
           hot. I am used to hot food, but this was really, really hot.  So
           we would just try things. Of course, we couldn't read  the  menu
           so we would point to things on other people's  plates  and  they
           would get those for us, and it  was  challenging,  but  we  were
           young. Life was easier in Calcutta, there  was  indoor  plumbing
           and -

Chris Vaniser:   When you traveled up in Gorakhpur, were you  out  overnight
           sometimes in the neighboring districts?

Davida Coady:    No, we were always  able  to  get  back  when  we  were  in
           Gorakhpur. In Calcutta we did, we had these four districts; we'd
           stay in the districts, we found places to stay. In Gorakhpur  we
           never - [crosstalk 0:24:17].

Chris Vaniser:   It was always maybe a long day trip, but you  would  always
           get back. How about any problems with getting  safe  food,  safe
           water?

Davida Coady:    We would find that we'd buy bottled water  and  Coca  Cola,
           and I think there was one time when we bought some cokes and  it
           was adulterated and we all got very sick.

Chris Vaniser:   Any other events that stand out from your  time  in  India?
           Now you came back to the States before going  back  to  Calcutta
           and then [crosstalk0:25:01] from Bangladesh also?

Davida Coady:    Then we went directly from Calcutta to Bangladesh.  I  know
           it  was  before  Christmas  because  we   spent   Christmas   in
           Bangladesh.

 Chris Vaniser:  Then, how was that in comparison to India?

Davida Coady:     It was very different. In Bangladesh they didn't have  the
           structure. In India they had the structure, these Health Centers
           and there was always somebody who was in charge that  you  could
           work with and some of them were wonderful and some of them  were
           not at all interested; but at least there was  a  structure.  In
           Bangladesh we were in the North in Saidpur, which  is  a  larger
           Bihari City and which was good because they spoke Urdu  which  I
           could understand;  I  never  really  got  hold  of  the  Bengali
           language at all, and the Urdu I could understand from the  Hindi
           that I knew. There was no structure, we just had to do the  work
           and hire the vaccinators and find the epidemics and it was  much
           harder and you had the feeling that you  weren't  teaching  that
           much. You were just trying to get the cases  and  get  the  work
           done.

Chris Vaniser:   When you say you had do the work, it was actually  you  and
           your team that was more - not the Bengalis that  were  there  as
           counterparts?

Davida  Coady:     Right.  We  didn't  really  have  counterparts,  we   had
           vaccinators that we trained and hired to work for us.

Chris Vaniser:   What year was that, when you were in Bangladesh?

Davida Coady:    That would have been '75; in late  December  '74  and  then
into '75.

Chris Vaniser:   So  I  guess  -  it  sounds  like  you  also  had  just  an
           incredible time as part of the  Smallpox  Program  and  you  had
           brought to  it  lot  of  experience,  international  experience,
           specially from Africa and  other  places,  Guatemala  and  other
           international locations that you had  worked  in.  How  did  the
           smallpox  experience  affect  your  future   career   and   your
           involvement in Public Health?

Davida Coady:    I became very, very convinced that the idea of  eradicating
           infectious diseases was very doable and feasible and helpful and
           everything right about it; and I  have  been  very  disappointed
           that other diseases have not been eradicated. I  thought  surely
           the lessons would be learned. We had this wonderful seminar this
           morning that I thought surely guinea worm and polio and  measles
           and some of the others would be gone by now with the lessons  we
           learned, and I think people made such valiant efforts to promote
           the principles. Dr. Henderson and Dr. Foege, Dr. Foster; and all
           of them; they had such a wonderful plan to really use all  these
           principles to  eradicate  other  diseases  and  it's  been  very
           disappointing that there  wasn't  the  political  will  and  the
           finances - the political will to do it.

Chris Vaniser:         [cosstalk0:29:05] the difference perhaps?

Davida Coady:    Yeah; and I think the idea  that  an  international  effort
           like that could work, has kept me going through some hard  times
           and some of the battles I fought are harder than  that  and  you
           have more foes, there weren't too many people  against  smallpox
           eradication.  There  were  a  few  people  who  made  money  off
           smallpox. I remember one very  overweight  politician  in  India
           railing at me one day,  when  we  drove  up  with  the  smallpox
           vaccines - with the smallpox van; and he said then: Why don't we
           foreigners and smallpox people go home and let our people die of
           smallpox before they starve to death  from  overpopulation;  and
           this man was fat and he was eating a plate of food, and  he  was
           one of the few people I  ever  met  that  said:  eradication  of
           smallpox is not a good thing to do.  It just  seemed  so  clear;
           one of the  battles  that  I  fight  today  in  my  hometown  in
           Berkeley, is we are fighting the tobacco industry very hard  and
           the pharmaceutical industry and the illegal drug industry; and I
           work in the addiction field now and you have these  giants,  the
           Alcoholic Beverage Industry and the Tobacco  Industry,  and  all
           the rest, are such hard foes that I look longingly at  the  time
           when I  was  fighting  smallpox  which  didn't  have  those  big
           interests against you.

Chris Vaniser:   [crosstalk 0:31:01] with lots of money to -

Davida Coady:    But it has given me - I had training in  epidemiology,  but
           the smallpox work gave me  the  field  experience  to  see  what
           epidemiology  could  really  do,  and  it  of   course   greatly
           influenced my teaching at UCLA - but really the way  I  look  at
           everything. I am in the addiction field  now  because  I  looked
           around  my  own  community  with  the  tools  I  learned  as  an
           epidemiologist and said: The biggest cause of  homelessness  and
           crime and misery and violence and child abuse in my community is
           the substance abuse, which is not being treated. So that's why I
           made that decision.

Chris Vaniser:   That's a pretty big decision to have ended up -  it  sounds
           like you had spent time in international health and trained as a
           pediatrician. Correct?

Davida Coady:    Right.

Chris Vaniser:   And now you are working in smoking  and  addiction  control
           because of lessons learned through the smallpox eradication.

Davida Coady:    Right.

Chris Vaniser:   Well, thank you very much again for sharing  your  stories.
           This sounds like it must have just been -  again  an  incredible
           experience.

Davida Coady:    It was a peak experience;  it  is  something  that  I  just
           wouldn't trade for anything. I am just so happy I  was  part  of
           that.
Chris Vaniser:   And it sounds like you made quite a few friends  along  the
           way that are legends in their own right in the  area  of  Public
           Health and -

Davida Coady:    I did.

Chris Vaniser:   Not just smallpox, but Public Health in general.

Davida  Coady:     Right;  and  I  just  loved  India  and  Bangladesh,  but
           particularly India. I loved working there. I loved the people. I
           love to look now at pictures of  Indians  and  see  that  nobody
           under 30 has got smallpox scars. That just chokes me up.

Chris Vaniser:   There's nothing else that you can really say  that  of-that
           has been so eradicated and know that you had a part  in  all  of
           that. It was just a huge accomplishment. Thank you again.

Davida Coady:    Thank you.



[End of audio - 0:33:21]
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