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              <text>&lt;pre&gt;&lt;strong&gt; Interview Transcript &lt;/strong&gt;
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.
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&lt;p&gt;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. &lt;span&gt;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. &lt;/span&gt;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 &lt;strong&gt;“About this Site”&lt;/strong&gt; for guidance on how to acknowledge the sources of the information used. .&lt;/p&gt;
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              <text>&lt;pre&gt;&lt;strong&gt;Interview Transcript&lt;/strong&gt;
	   
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]
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