58 12 2286 https://www.globalhealthchronicles.org/files/original/92f1dcd4e3657ca9dadf9f5bf86a3c1b.JPG 098b8173feb04ea56df5a7786b0895c9 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> Media Powerpoints, Recorded lectures, movies, training films, and interviews Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/19vPxmSfEdg" 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 presentations (communicative events) motion pictures moving image Date A point or period of time associated with an event in the lifecycle of the resource 2006-07-15 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/15mz3 emory:15mz3 Subject The topic of the resource CDC Smallpox Eradication USAID WHO Reunion Format The file format, physical medium, or dimensions of the resource 4705920000 bytes video/x-dv Creator An entity primarily responsible for making the resource Foege, Bill (Speaker); CDC Contributor An entity responsible for making contributions to the resource Reunion of West and Central Africa Smallpox workers (2006 : Atlanta, Georgia) Title A name given to the resource FOEGE: SUMMATION Description An account of the resource Bill Foege summarized the West African Smallpox Eradication Program. Shares anecdotes from his time in West Africa, and reflects on the search for wisdom from the experience of smallpox eradication and the emerging field of global health. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/4ff0bd2e2873666492863ad78b649af6.pdf 8bd1ce0344109c1bee82bde2f1b796ed 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> Documents Government Records Keywords smallpox, measles, Nigeria, eradication immunization, program 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 FORM – Job Description Nigeria Description An account of the resource “Smallpox/Measles Program, Western Region/Nigeria: Operations Officer Job Description,” a single page job description for the position of "Operations Officer" outlined with an introductory, supervision, guidance and a duties and responsibilities section. Position for the Smallpox Measles Program in the Western Region of Nigeria offered by the Communicable Disease Center. Creator An entity primarily responsible for making the resource Communicable Disease Center Source A related resource from which the described resource is derived CDC Date A point or period of time associated with an event in the lifecycle of the resource 1967 Identifier An unambiguous reference to the resource within a given context 2007.013.84 David J. 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Source A related resource from which the described resource is derived United States Department of Health and Human Services (HHS), Centers for Disease Control and Prevention (CDC), Republic of Liberia Date A point or period of time associated with an event in the lifecycle of the resource 2014 - 2016 Identifier An unambiguous reference to the resource within a given context 2014.510.003 https://www.globalhealthchronicles.org/files/original/fddf5bb25b20f18a420277baddfa3220.pdf ba95d9702da133eee4b2b0c09da86863 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> Documents Government Records Keywords team, sterilization., vaccination, equipment, Iwo, Ikire Ile 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 FORM – Team Inspection Description An account of the resource “Team Inspection Sheet,” a Smallpox Measles Eradication evaluation form that describes the work of team 4 in Iwo, a town in Southwest Nigeria. Produced by the Communicable Disease Center. Source A related resource from which the described resource is derived CDC Date A point or period of time associated with an event in the lifecycle of the resource March 10th, 1970 Identifier An unambiguous reference to the resource within a given context 2017.013.74 David J. Sencer CDC Museum Creator An entity primarily responsible for making the resource Center for Disease Control https://www.globalhealthchronicles.org/files/original/ce508125192e7e891ce91187ea662685.jpg bd6fcb0e09b93b96233acef808482b8a Omeka Image File The metadata element set that was included in the `files_images` table in previous versions of Omeka. These elements are common to all image files. Bit Depth 8 Channels 3 Height 336 Width 378 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> 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. Guinea Worm Oral History Project - Global Health Chronicles Interviewed by Nancy Hilyer, Wednesday, February 16, 2011 Michael Forson – UNICEF, New York; Water, Sanitation, and Hygiene Specialist – Headquarters Consultant to UNICEF in Guinea Worm Endemic Countries; Formerly Responsible for UNICEF Guinea Worm Eradication Support in Ghana This is an interview with Michael Forson. This interview is about his life and his activities with the Guinea Worm Eradication Program. This interview is being conducted at the Indigo Hotel in Atlanta, GA on Wednesday, February 16, 2011. The interviewer is Nancy Hilyer. To begin with, I want to thank you on behalf of David J. Sencer, who initiated this project to document oral histories from persons who have been instrumental in eradicating Guinea worm from the world, and you are one of those persons. Michael, would you please state your full name and state for the record that you know this interview is being recorded. MF My name is Michael Akyeamfo Forson, and I am aware that this interview is being recorded. NH Thank you, thank you. OK, first of all, you are representing UNICEF at this international review of countries that remain with Guinea worm here at The Carter Center. Tell me about your current position with UNICEF, and what led you to this position. MF Thank you. My current position with UNICEF is a, I am a WASH Specialist When we say WASH it’s Water, Sanitation, and Hygiene, it used to be WES, Water, Environment, and.. NH I remember that it used to be WES just a few years ago. MF Yes, it is now WASH. NH That is the acronym. MF Because Water, Sanitation, and Hygiene; yeah, I am a WASH Specialist, and I just got transferred to New York to take up a new position. And within this position I have four main schedules. One of them is Guinea worm. So what I do in Guinea worm which is relevant to this interview, so I will talk about, is that I render support to countries that are still Guinea worm endemic, and then UNICEF is programming in those countries, so that together we can work and see how best we can eradicate Guinea worm from the world. NH And will you be travelling out to these countries, or do you do that from the office in New York? MF No, I'll be traveling to these countries. NH You will be traveling a good bit. MF Yes. NH What has been, and is, the role of UNICEF in the eradication effort? I know UNICEF was a major support in the three countries that Elvin and I have been in: Uganda, Sudan, and Ghana. But what is its role in this eradication program? MF I usually call it a partnership. In this partnership UNICEF's role actually is to look at the water supply component of the eradication program. But you see, one may just look at it as a physical engineering intervention, but then there is the behavioring change component that goes with the water supply. So what UNICEF does, is we strategically try to refocus our interventions in water supply in these countries that are Guinea worm endemic towards the provision of safe water and proper hygiene behavior changes so that it will be able to help. For example, when you talk of just filtering the water, it's an issue of behavior; it's a behavior change. So all these come in the package that UNICEF delivers. In some other countries, especially I quite remember in Ghana, UNICEF was also involved in the surveillance in the early stages, logistics support, surveillance until we reached a point where the partnership was very strong, and we limited ourselves to water supply and behavior change. NH Who makes that decision? Do you make that decision of how you will be supporting a particular country? MF Globally UNICEF is known as one of the heavyweights in water supply. And Guinea worm … NH It fits into that perfectly. MF I mean, water supply is very vital for Guinea worm. I won't call it the magic bullet, but I would say it's very essential to keep a country at zero cases. When a country breaks transmission, water supply is very essential to keep the country. If not, they will go back. NH And not just for Guinea worm, actually for many diseases. MF Yes, for these water borne, water related diseases. NH You have had practical experience in water sanitation programs in countries with Guinea worm. You know, we worked with you in Ghana. Obviously clean water is key to the eradication program. Tell me about how UNICEF gets clean water. What do you do? I know there are boreholes. Is that the total picture, boreholes? MF Not really. You see, talking about the water supply, how we go by the water supply. One is we try to look at the most cost effective way to get safe water, OK, cost effective and sustainable. For example, where you have a number of options, then you do an assessment feasibility study And then you choose the most cost effective and sustainable because the issue is, you are dealing with the rabble, with the raw (?c.5:45) people, so, when we talk of sustainability, after putting in the water supply, who maintains it? Why do you put in a complex water system where they would have to be buying treatment chemicals and all those things when you know they can't afford it at the community level? The most sustainable water source that we usually go for is the ground water. NH Ground water. MF That is why you see a lot of boreholes because boreholes are very cheap because you don't need to treat the water. It's already treated underground. It’s purified because it's water that moves from the surface, filters through.. NH Gets filtered naturally. MF Yes, gets filtered naturally before it’s, I mean, stored in the, in the earth, you see, what we usually call the, I mean, is stored in the rocks, I mean, under the earth. So when you get this water, it is pure. NH All over the world is that true? MF All over the world. But there are one or two situations where the groundwater may have some high chemical components like fluoride. Some may be high in iron, and that may need some treatment. NH Sulfur? MF Yes. So based on what you get, like some cases like iron and sulfur you can aerate it, introduce a bubble through it, and it's OK. But where you have salt intrusion and those things, it becomes a bit complex. So that is one. Then the second, there are times too, some places, you just don't get a ground water. It's a very dry, arid situation. So where we have such situations like this and there is a surface water that's good, I mean good through the dry season, that has enough volume, we try to create infiltration beds that we filter the water through for the people. NH Filtration beds. MF We use sand filters,.. NH Sand filters. MF Yes. We just create a bed of sand that the water comes on and filters through and comes out clean, and they are able to drink it. NH Did you have any of those in Ghana? MF Yes, we have done - after you left, we did a couple. NH Did you really? MF Chirofoyili is an example in Tolon. We have Gbungbaliga also - a couple of them we have. NH OK, explain that a little bit to me, a sand filter...you dig a hole? MF OK, what happens, the open pond.. NH OK, an open pond is there. MF Yes, that the cows and the people, they all go and drink. NH Sure. MF So we can create a well by its side, and then by the well we have pipes, you see. We just, as the well is here, we dig a layer first before where we put perforated pipes, cover it with jute, jute sack, and then fill it with a sand which is permeable to allow infiltration. So this pipe now leads into that well. So the dirty water now filters through the sand, through the jute sack.. NH Into a well. MF And then into the pipe and goes into the well where we put the hand pumps on the well. Then you can fetch from it, and you get the water clean. If the water is too tepid, that is, I mean, the water is too dirty and so much clay - I am trying to use the layman's language, not technical - NH Thank you. MF too much clay that, I mean, it clogs the filter, then what we do is we create one that requires a settling tank. So we first pump the water out into a tank where the first batch of clay settles, and then by gravity it goes to the filter bed and filters into a clear well where they fetch it. NH What is more expensive, these beds or boreholes? MF It all depends on the situation. These beds, at times you may look at it as expensive, but then where we have no choice and no option… NH You would try boreholes first; they are simpler. MF Like Chirifoyili, for example, we drilled boreholes a couple of times, all dry. Meanwhile they have this big dam that was the Guinea worm, that was creating the problem for Guinea worm. So donating is fine. Let’s make the water safe. And we pumped in some money, and it worked. NH Really? How exciting! Really very exciting, isn’t it? MF You need to go back and have a look at these things. NH I do need to go back! I do need to see that. Boreholes, aren't they problematic with things breaking ...isn't that somewhat of a problematic answer? MF It's all the issue about sustainability. You see, where this is the challenge we've had on this program because water supply, if you look at Guinea worm you say it's an eradication program. So it's like the military; move in; (?c.10:55); get it out; and you move on. But water supply is a bit different in the sense that you take the engineering approach - I'm a typical engineer - we can just go in, do the hydrological studies, fix the wells, fix the hand-pumps, and then we move on But then who owns the pump? When there is a problem with it, that means we have to come back. So just imagine as we are going, dirt in the bore-holes, the numbers move from single-digits, to tens, to twenties, to hundreds - and now you get thousands. Can you come back to all these wells again? NH And the rest.. MF So this is where we introduce the community ownership and management. This is where the community mobilization comes in. So before we put in the well, we mobilize the community. We train them to own it. That is where the community ends up, by maybe selling the water for a token to generate some money, so that when a hand-pump breaks down, they can fix it and they don't need to wait. Because if we have to come back to thousands of wells, it will take years before we reach someone whose hand-pump has broken down. And interestingly, let me share this experience with you from Northern Ghana. NH Yes, please. MF You know because of these break downs of hand pumps, because we are putting in pumps, we are moving, they are breaking down. So one of our partners, the Church of Christ Water Development Program, managed to mobilize the area mechanics, the pump artisans-mechanics and then trained them to form an association where they have their constitution drawn. And now they have shared the pumps among themselves. So each mechanic is in charge of about 10 pumps in an area where he visits regularly to make sure things are OK. And the communities know which mechanic to contact if there is a problem. So this has really solved some of the problems in the northern Ghana, yes. 13:00 NH It’s a beautiful solving too, because it gives a person work. MF Yes, it creates work for the private sector.. NH Yes, it does. Well what a smart thing. Who thought of that, Michael? MF Well, we’ve been battling with this in the water sector for longer sustainability. It is coupled with the parts supply chains. You see there are parts in it. When making the spare parts available is one Then two is the cost of the spare parts. Then three, the personnel to manage it. And I must be honest with you, the spare parts don’t wear off quick. So it’s not a lucrative business for those who would sell the spare parts. NH They don’t wear out quickly. MF Yes, they don’t wear out quickly. NH Okay, so it is not a good business … MF If you install it well, a pump can be in operation for two to three years before you get just one part going bad. And at times that part may cost just about fifty cents. So most… NH Not a good business. MF So the artisans, we try to find people who are already like bicycle mechanics, and those who have something doing. So this become a top up to the business, you see. And then the other thing is the availability of the spare parts. If you just release it, the prices vary. So at the same time, the government also comes in to try to make sure the prices are regulated so that it be affordable by the village folks, you know, in order to replace them.. NH It’s not simplistic is it? MF It is not as simple. And this one thing that I personally saw as a challenge to the Guinea worm program, because we had a lot of communities in Ghana. I mean, about five years back, five/six years back, where they had water, and the pump broke down. And because they can’t afford it, they went back to the contaminated sources, and Guinea worm re-emerged. NH Sure. MF So here we also have to do a lot of lobbying in the government in order to regulate the prices vis a vis the private entreprenuer and, let me say, the mechanic’s profits margin and cost of the people’s life. I mean, it’s a whole complex thing. So you see it’s not just Guinea worm. It’s bigger. NH It’s much more; it’s much more complex. Well, that’s very interesting Michael. And I’ve been in Africa in these countries, and I never heard that complex situation. It always seemed to me that you built a borehole and that should be it. And then I never understood why you didn’t come back and fix it the next day. Now I understand. What have been, or has this been, or what do you think is the major challenge in this effort for UNICEF? MF Okay, for UNICEF… NH How long has UNICEF been working with you? MF Oh! Since I joined UNICEF in 2002. And before the new UNICEF in the … NH You joined UNICEF when? MF 2002 - that is about nine years. NH 2002? MF Yeah, 2002. That is about nine years now. Yeah.. and before then in the.. I think it was in the 80s or 90s that I started operating in Ghana. What I see as a big challenge in this UNICEF, the work we do in terms of our water supply towards Guinea worm eradication. One is that work is a bit capital intensive. And interestingly the Guinea worm was also prevalent in areas where groundwater was very difficult to find. So you keep drilling, and it is all dry. And anytime you drill, money goes, because the contractor is using diesel, diesel fuel, which you are paying for it; the wear and tear of the rig; and before you drill, you need to move about three or four trucks to the sites - personnel costs all coming. So we were faced with a question of pay for dry well, or don’t pay for dry well. But the interesting thing here is that ground water exploration, how we look for ground water- underground we have fractures, cracks underground. And that is what the physical investigation where we use a method to find out where these cracks are, because those cracks serve as a pipeline that will move the water underground. The water also flows under ground just like the surface, and they float through these cracks. But interest at times when you find the crack, it might not contain water; it will be air. And you cannot tell until you dry, you drill to the crack. So when you drill there - like I said, I’m trying to be a bit, use the layman’s language a bit – NH Good. MF When you drill to that fracture, and there is no water in it, do you pay the contractor? Or you don’t pay? Because the investigation don’t tell you there is water or not; it only tells you there is a crack here. So this is the possible place to get the water. Then secondly you may get the water and the quality is bad. It has fluoride. Or it has salt. So what do you do? That is one challenge. And in the Northern Ghana where the Guinea worm was prevalent also, because of these drys, we have to invest a lot of money to build the capacity of our partners. So, one, we brought in Desert Research Institute… NH Which Institute? MF Desert Research Institute. NH Oh, Okay! Desert Research Institute. MF … to train our partners to explore deeper below and read meters, so that we could find if there is water beyond that. Prior to that we were drilling up to 60 meters, because the equipment we all had to investigate with we could go up to 60 meters, and beyond that is not reliable. So, one, we have to invest a lot into our partners. We have to buy new equipment. We have to buy a new drilling rig. It was so expensive. But then these things produced a lot, because when we got this equipment, we started getting.. NH Better water. MF Better water. NH More often. 19:47 MF Yeah. But you know, the interesting part of the whole thing of which I saw as the challenges. When you get the water running, and now the nice thing is how best the people can use the water and maintain it, and that is the behavior change part of it. How does the water transfer into economy gains? How does it transfer and give the disease reduction results that we are looking for? Because there are situations, there is water in the community but people will pass it and go to the dam, the pond, and say that they like the taste of the pond. So here… NH It is the familiar taste; no matter how bad it is, it is familiar. MF It is familiar. So, the behavior change component, we have to devise ways and means. It’s more of a communication strategy, pointing the people to a new something. NH What do you do, do you do educational materials? MF Yes… NH Does UNICEF do that, educational? MF Yes, we do that a lot, a lot of educational materials. But interestingly one of our partners introduced something that they said the whole rationale is: find out what they have in their village and use it. So, their workers stay right in the village with the villagers, spend some time - about two weeks - with them in the village eat their food, sleep in their houses, I mean mix up with them and gradually introduce the new water and all those things in situations where we have very difficult situations. And this partner did really very well. NH What partner was that? MF I think you know them. Afram Plains Development Organization. Oh, that’s after you left that we brought all these people in. NH Oh, are you serious? MF Yes, because we saw that we need to do something out of the ordinary, because we were doing the same thing over and over even when not achieving much results. So we have to combine these behavior change with the water supply. NH How smart. MF Apart from the surveillance then we ___(?c.21:54) ; in fact it resulted, that is what resulted in the development of the overall behavior change communication plan for the Guinea worm in Northern Region. NH Your partner now, tell me the name again of the partner again. MF Afram Plains Development Organization. NH African Plains? MF Afram. NH What is Afram? It’s a… MF Afram is a place in Ghana, it’s a river, River Afram. So the Afram Plains is a area; it’s like a suburb. So it is a development organization in that suburb. NH Afram Plains. MF So, yeah, for short we call them APDO. NH OK, all right. And that was your main partner in Ghana? MF Yeah, we had two main partners.. NH Only, in Ghana? MF Did I say two? Yeah, I would say we have about four main partners. Church of Christ for water development program, Diare for water drilling, World Vision.. NH World Vision? MF Yes, World Vision, also for water drilling, Afram Plains Development Organization for the behavior change and communication. Then we have the Red Cross for surveillance and also part of the hygiene promotion. NH It’s a great partnership, isn’t it? MF Yes, it was good, and I really enjoyed working in that partnership. NH I should think so. MF And it was so good. And the people were so committed. I mean, there were people who were prepared to live in the villages. NH Are most of these people local people in these partnerships? MF Yes, they were all Ghanaians, yes, they were all Ghanaians. And they were people who grew up in the villages,. Most of them had had Guinea worm before. NH So they understand… MF They knew what it is and were prepared to live in the villages and help change lives. NH Very nice. Well now, The Carter Center is one partner. MF The Carter Center is one partner also, yeah. I did not want to talk much about The Carter Center, because you know in Ghana when you talk of surveillance, they really carried the bigger burden on the surveillance system. 23:51 NH On surveillance. MF Because when you look at the structure of Ghana in terms of surveillance in general, you see there was a missing gap between the village and then the district. So The Carter Center filled in where the area council is in order to get directly in contact with the village. Because the District had to work through an Area Council where it was missing. NH And that's what they did is sort of establish a program for communication with villages, zones. MF Yes. NH Okay. That was their major contribution. Now you've worked with a lot of Carter Center people, I assume. MF Yeah. NH You worked with Elvin. MF Yeah. NH That was a good communication? I mean was that good with your various... MF Yeah. Well when I joined UNICEF I think it was Elvin who was... NH It must have been because that was 2003 was almost the time we left. MF It was Elvin in Tamale and Nwando in Accra. NH And Nwando, yes, right. So those were the first two Carter Center people. MF The first two people I met with. So by that time I was also trying to find--because I was coming from a pure urban project from World Bank urban environmental sanitation project for which I was a sanitary engineer in Accra. NH So this was brand new for you in Tamale? MH Yes, I was coming from an urban perspective into a rural perspective. So honestly I took some time to study what was going on for me to make a good impact. OK, so I learned a lot - how the procedures are being handled, what is going on, what is the best practices going on, and then try to fill in the gap. So I would say that the first year was more for learning for me than my contribution. I think it was around that time Elvin left. So I didn't really contribute much in the first year, because it was rather all learning for me, because I was learning what was going on in order to make an impression. NH Interesting, very interesting. I do remember Elvin's first year in Africa. I think there was a lot of learning that was going on in Uganda. You know, it was almost.. MF I quite remember during that time I used to join the case searches. Yes. And especially over the weekend we would be in the house and there would be a call that there was a Guinea worm outbreak suddenly somewhere detected in some village. And we would all rush there, try to do. So to me initially it was like, is this an ad hoc? You just get a ring, and you get up you go, or is there a plan? NH Now was this with The Carter Center or.. MF No, it was basically with the program, the Guinea worm program. NH With the government, the government program. MF Yes. NH OK, OK, all right. MF So, like I said, I learned a lot during the first year. NH Sure, sure. MF And I remember when I came to Tamale first, and I came to meet Elvin. At that time my predecessor, Wally, there was one Bangladesh guy was leaving so he went to introduce me to Elvin. We talked at length about the whole Guinea worm program. Then I think within a week or so there was this review in Ho, where I went for the review; I learned a lot. So when I came back then I started to find what role UNICEF is playing in the partnership and what can be done with it. At that time there were some contractors who were - UNICEF used to contract out rather than with partners - and some contractors take the money, and they run away. I spent the first two months chasing contractors to get back to work. NH Is that true? In Tamale? MF In Tamale. NH Nice experience your first year with the Guinea Worm Eradication Program! When you were in Tamale, was that strictly for Guinea worm or was that water projects and.. MF No, it was water project. Honestly I was alone at that time. I was the water officer. I was the one-man water officer in UNICEF, based in Tamale. But the focus was on Guinea Worm. NH Was it? MF Yeah, because at that time water was part of health. So it was a project called the Environmental Health Project. So we were basically looking at Guinea worm eradication, trachoma control. Yes. So we were looking at these two diseases. NH A major thing. Okay, what about field experiences? Any field experiences or interesting stories you want to share for posterity? Anything you ran into in the field that you think might be interesting? MF Yeah, we had a lot of interesting things. I remember when there was this JICA volunteer who came 28:40 and in one community, the name escapes me, in Tolon which was endemic for a long time. And we've been trying to get water; we are not getting water. So we decided to install tanks and then draw water about 30 kilometers away from Tolon. So when we were going to deliver the tanks that time my country representative Dorothy Rozga, came to Tamale. And the tanks were moving the poly tanks, and we were going there. It rained heavily, and we got stuck. I think I still have those pictures. All the Land Cruisers got stuck. By the time we managed to pull out the trucks we were all covered in mud. NH I guess – sure. MF It was so interesting, but at the end of the day we managed to get the tanks to the village. NH Did you? MF Yes, we managed to get to the village. NH How many of you? She and you and a couple of drivers. And how many other people? MF There were two big trucks,.. NH Their drivers. MF Their drivers, then two Land Cruisers. Then I think there was another utility truck and the crane. NH Oh my gosh. MF Because the tank was very big and it needs to be lifted by the crane. So all these trucks -- the crane didn't get stuck -- but all the rest got stuck. But all the others got stuck. NH It was a mess that day! But it was an adventure. Now that it's in the past it was a big adventure. MF Then there was another one. Where you remember that time we did, we were doing polio immunization and we added Guinea worm case search to it? NH Uh huh. MF I went to the Volta Region to supervise it. NH Volta Region. MF Volta Region. So we went to the villages. That time, Volta Region we were seeing in Akachi District there was no cases. We went, and to my surprise, when we showed a picture in one village in Akachi they said, “Yes, it's here.” I said "What!" And there was no report. And they said "Well, the assembly man said that if we report it they always say we are not doing well, so we should never report it.” NH Aaaaaah. MF I was taken aback! 31:04 So we saw about three people with a worm. Even the volunteer himself had a worm. So immediately we looked for the zonal supervisor. In fact, we had to put a quick measure in place, quickly get things organized, and, in fact, we spent virtually the whole day in that community. NH You and all the people from polio all the various ones, I guess. MF Myself, we were a team of four doing the supervision. Myself, one, ____(?c.31:38), and I think there was someone from WHO, also someone from the government, I have forgotten the names here. So I turned the whole thing to water and Guinea worm. We allowed those doing the immunization to go, and we moved around trying to interview them to find out what water they are drinking. Interestingly, that village had very good rainwater harvesting system. So after talking, talking, then we realized, it is from the farm. So we took a walk and we identified some ponds and then reported to the Guinea worm coordinator in the region, in the district and then in the region for them to take immediate action to ABATE the pond, and all those things. In fact, it was a very shocking experience that time for me, you see, because it is human nature for... it’s just like a stigma so they wanted to hide it. NH Sure, sure. I think that’s just a beautiful story because there you were four who had nothing to do with The Carter Center at that point - that was four people looking for polio.. MF Yeah. NH and you come across this, but you are well aware. I mean, you are on the project, and you stop everything, drop everything, and try to organize for that village. Very interesting. Michael, do you, when did you ever - did-when did you know about Guinea Worm? What was your first awareness, I mean? MF Oh, I knew about Guinea worm when I was a kid, because one of my cousins had it. NH Okay, Okay. MF But I didn’t know the nitty gritties of it until I joined UNICEF. NH Okay, you just had a relative who had a Guinea worm., so you were familiar with it, just slightly. MF Yeah, I was familiar with it. I knew this thing comes from water. NH You knew it came from water? MF Yes, I knew it came from water because that time in my village in Central Region, when it was there, I mean, there was, the congon was beaten that nobody should drink from.. NH Really? MF the pond - yeah, that… NH What year was that? MF This was somewhere in the, I think it was in the early 80’s. NH Really, okay, so already the word was out by that time. MF Yeah they beat the congon that nobody should drink.. NH Yes, and Ghana, is this Ghana? MF Yes. NH You are from Ghana? MF Yes. NH And where are you from in Ghana? MF I am from the Central Region. NH Central Region, The green region? MF Yeah (laughter). NH It was always nice to get to the Central Region from Tamale, you know. That was very nice. Michael, Is there anything else? Any other memories or stories about this war with the Guinea worm that you would like to share? Any Questions? MF Yes, there is something I would like to say. When I was in Nigeria, on the evaluation of that, myself and one man from The Carter Center, Domusaline(?c,34:52), we even talked of writing a story by title, the scars of Guinea worm. NH What? MF The scars.. NH The scars of Guinea worm. MF Guinea worm because I fight, I saw a whole lot of people with very, I mean, terrible.. NH Devastating . MF Devastating scars: One on the chest, some have been crippled and all those things because, see, Guinea worm affects. And in that area we went to Sokoto, a northern part of Nigeria toward the Niger border, I mean, to do the assessment there. And that place like they had understanding of doing what they call Sakia; it is like using a hot metal to punch the worm… NH To kill it? MF I mean when the blister comes. No, and that even cripples them. I have a picture of someone who is a cripple now. NH Because they punched that in. It kills the worm; is that correct? MF It doesn’t kill really, I don’t know, but I don’t think it kills the worm. But the understanding is when the blister is coming, OK, and they punch it they think it should kill the worm and they’ll be free, but it rather has other diverse effects, because I saw very terrible scars. People were just showing it to me. And it was so devastating, I mean.. NH Well, if the worm was killed, it would probably cause scarring, because the worm dying in there is very bad. MF I-I don’t know whether the worm goes back in, but I was just moved by the scars. NH By the scars? MF Yeah, its… NH So you were just thinking of doing like a pictorial of all the scars? MF Yes, something like that. We took ___(?c.36.16) pictures of the scars of Guinea worm, but one other thing I realized during the evaluation is, you know, we’re doing a great job in terms of eradication. But from the villages I visited, and I worked in Nigeria, doing the evaluation, I can see about 20% or less who still remember issues of Guinea worm and how to prevent it. NH 20%? Only 20% sorta remember? MF Or less? Very few. You ask them how can you get Guinea worm, they don’t seem to remember. To me, this is something that if the government don’t really include the Guinea worm messages into their health behavior, I mean, their hygiene behavior change messages and there is a reinfection, it can be a bombshell. Because people totally forget about what to do. NH Especially if they haven’t had Guinea worm in a few years. MF Well, yes! Because these places I am talking about for a long time where they have not had Guinea Worm. So, in fact, most of the young people, you can ask them, they don’t know what it is. NH Never seen it. MF Yes, but at least their health promotion units, I think, should incorporate Guinea worm messages. Although it’s not there, but they should put it. Who knows so that in case a recalcitrant citizen comes back, the people will know what to do. NH Can work with it quickly. MF Yeah. NH Well Micheal, any other questions that you wish I had asked you that I didn’t ask you that be good for the record? MF Oh, I think one thing probably I would have liked to talk about is, you know, I think, Ghana sets a record of being the first country to drop from hundreds to zero . The cases, the Guinea worm cases. NH Oh, to drop from hundreds to zero? MF Yes, because we had I think 300 and something, and then this year, 8 cases. OK, one would ask what was the secret for this. And I say that what I realized is that we have a very beautiful plan in place and all those things, but we need people who will die for Guinea worm. People will give up everything and fight to do extraordinary things to get Guinea worm out. I am saying this because when this whole idea about what to do in Ghana came, a few of us got together to brainstorm and we came up with an idea. But then our bosses, (laughs) - the idea was not the ordinary idea to do because we thought of a water project that would be anchored in the Ministry of Health. NH That would be what? MF Would be anchored.. NH Anchored in the.. MF In the Ministry of Health. That is very strange. Usually a water project is for the Ministry of Water Resources. But here is the Ministry of Health that would run the show, and it would be implemented by the district planning and coordination unit, not the water unit at the district level. It was so strange. But then what we saw when we did that analysis, Guinea worm goes beyond a health program. It’s a development issue. So our objective was to get it on the development agenda of the district into the district planning and coordination units, okay? To foster that integration because the agric extension would be involved. The environmental health would be involved. The Health service would be involved, community development would be involved . The planning unit would be there. But once it is on their development agenda, they will also make budgets at the district level for it. You get it? And once it has also remeasured the sources with the health outcome. So assigning(?c.40:30) it to the Ministry of Health will be able to get the Ministry of Health also to take very serious note of the water project. And that's what we did in Ghana. NH Makes such sense, and you did accomplish that? MF We did! The eye WASH project, that’s the eye WASH project which had brought together all of the.. NH Oh, that's the eye WASH project. MF The all mighty eye WASH project. We spent sleepless nights thinking about what to, how to design this project , the indicators, what to look out for, and all those things. It took us two years to design that project. NH You and the others in Ghana. MF Myself, Jim Niquette, Doctor Seidu, John Adriachi from the Community Water were the key architects who designed this project. NH Now and that project has gone out now to, MF It is almost completed. That is what has moved water. Communities with one place of safe (?c.41:26)water to 93 percent in Ghana . You remember when we were there, we were always in the 20 percent. NH Sure. MF And within a year we moved from I think from 40 something percent to sixty and the next year from sixty to ninety something. NH Well, no wonder Guinea worm is gone from Ghana! MF It was a very.... let me see...that project was very ambitious, but we were determined to make it. NH You must have had some good leadership.. MF Yes. NH in Ghana to pick up on that idea and run with it . MFYes, that’s correct. The Ministry of Health embraced the idea. Then our country representative also supported a lot and The Carter Center at that time led by Jim Niquette was also supporting the idea. NH Supporting, sure. MF In fact, we, during the design of the project, we had very healthy confrontations. You see healthy head on collision. But it really promoted the work to go on. And you know, interestingly the partnership reached a point where if you go off forward, the other partners will lash at you. I quite remember when UNICEF, we were dragging our feet on the water provision. They took us on. In one meeting, they gave it to us. We sat up. Then in another meeting we realized ABATE was not going, and the question of some dams are non- Abate-able came, and we said no way. Carter Center were also not going to have it this way. Every dam must be Abated. We pushed,. They said there is no ABATE. We said we would look for ABATE wherever it is. So you see, among the partnership, we were more like monitoring each other NH A healthy.. MF That was vey healthy. NH I'm sure. MF You see, and it really helped. Now we all sit and laugh about how.. NH Going out to dinner with Jim Niqutte. Oh, Michael! You know what, it has been a very, very nice interview, and nice for me, but nice for posterity. Thank you for sharing your experiences and the role of UNICEF in the Guinea Worm Eradication Program with me and with posterity. MF Thank you. 44:01 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/132719?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 FORSON, MICHAEL Description An account of the resource Michael Forson is UNICEF, New York; Water, Sanitation, and Hygiene Specialist. Headquarters Consultant to UNICEF in Guinea Worm Endemic Countries; Formerly Responsible for UNICEF Guinea Worm Eradication Support in Ghana. Guinea Worm Oral History Project - Interviewed by Nancy Hilyer Source A related resource from which the described resource is derived The Carter Center Office of Public Information, Health Programs 453 Freedom Parkway, Atlanta, GA 30307 www.cartercenter.org Date A point or period of time associated with an event in the lifecycle of the resource 2/16/2011 Identifier An unambiguous reference to the resource within a given context 2011.125.mp4 Creator An entity primarily responsible for making the resource Interviewer: Nancy Hilyer https://www.globalhealthchronicles.org/files/original/42d04a0c043e1465edf7c4378eee44a0.jpg d2c372713d2f2b6caeadd4c850063f28 https://www.globalhealthchronicles.org/files/original/6c150150e330f9800b99042053735aae.pdf 09ea4693dcc7561feed6cda13b5624fc Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> This is an interview with Dr. Stanley Foster about his activities in the West Africa Smallpox Eradication Project. The interview is being conducted at the Centers for Disease Control and Prevention as a part of the 40th anniversary observance of the launching of the West Africa program. The date is July 14, 2006, and the interviewer is Victoria Harden. Harden: Dr. Foster, would you begin by just briefly describing your childhood and your growing up, and who made you who you are. Foster: Okay. I grew up in Melrose, Massachusetts. My family was very religious. My father died when I was 9 years old, and one of the things that happened soon after that was I met Gordon Seagrave. He was the famous missionary surgeon whose Burmese nurses provided the medical care to Stillwell's troops during World War II. And he became my role model. From that stage on, I was going to be a doctor. I went to Williams College and then went on the University of Rochester. I think the connection to CDC was through D.A. [Donald A. Henderson], who also graduated from Rochester, as did Deane Hutchins. At that time, in early '62, they were drafting doctors, so I decided I'd rather come to CDC than go to the Army, so I came here. One of the interesting things that sort of started it off was that with 2 "F" names, Bill Foege [William H. Foege] and I sat next to each other in the EIS class of '62. I was assigned to the Indian Health Service in Arizona and carried out 18 epidemiologic studies. My basic assignment was for trachoma. At that time, about 20% of the Indian children had trachoma. Harden: Had you specialized in infectious diseases or anything in your medical training? Foster: Internal medicine was my field. And, as was often the case, Alex [Alexander Langmuir] would try to seduce officers he wanted to stay. He sent me to Bolivia to investigate an outbreak of conjunctivitis in Peace Corps volunteers. I came back to my home in Phoenix, got to Atlanta at about 3:00 in the morning, and at 6:00 in the morning I was on a plane back to Phoenix and on the way to the Truk Islands in the South Pacific to investigate an outbreak of diarrhea with Palmer Beasley. The assignment was an epidemiologist's paradise because a boat would only go out to an island once a month. You would know the entry point, and there would be a health worker there who would write down the cases and the names. It was a great epidemic. And the pattern of transmission was that of influenza, but the disease was diarrhea. We brought back the specimens, and the lab tested them out. They couldn't come up with an agent. We tried to write up the article several times, but without an agent, we couldn't. Twelve years later, when I came back from Bangladesh in '76, the lab called me and said, "We just found out what your '64 outbreak was. It was a rotavirus." Harden: Rotavirus. Ah. Foster: So we pulled out the article, finished it, and got it published. Harden: So you were doing epidemiology up until 1966? Foster: Well, no, that's not quite true. I did my EIS training from '62 to '64. Then I left CDC and went back to Rochester for a year of residency. Then I went to the University of California in San Francisco and did a fellowship in pulmonary disease. I probably would have stayed on in San Francisco in pulmonary disease, but I got the call from D.A., saying, "Do you want to go to Africa and get rid of smallpox?" My wife and I thought about it, and we decided after 24 hours that was right. We had 3 kids at the time, and I think one of the things we need to discuss is wives and kids. Harden: Yes. Foster: In terms of the impact of those experiences on the kids. Three or 4 of my kids' careers developed out of experiences with smallpox. My oldest son was interested in traditional medicines, and he now does Internet work in China. My second son, when he was in the 8th grade in Dhaka, Bangladesh, did a study of rickshaw drivers and how much of their income they spent on food. Now he's the chair of the Department of Economics at Brown. My third son got his start, really, in 1974 in Bangladesh, when we had tremendous floods and a famine. People were dying on the streets in front of our house. And he decided to go into medicine. I had no knowledge of the impact that the famine had on him until I read his Peace Corps application. And then I understood that that experience, back in '74, was the major event that sent him into medicine. Harden: This is very interesting. You said you came from a religious family. Were they missionaries or ministers? Foster: No, my wife's folks are missionaries. They went to Guatemala on their honeymoon. And her mother was interesting. She refused to go as a missionary wife. She said she'd only go as a missionary, and that was back in the '20s. They went down to Guatemala and learned Spanish. Then they learned Mayan and put the Mayan writing into a written language. And then they translated the New Testament. They had a school and a clinic. They stayed there for 45 years. Every year or 2, my wife and I go back to that same town. My wife is fluent in the Mam language. We have a nurse we work with, and she tells us what she wants us to teach. Harden: I'm interested in this streak of idealism. Foster: Oh, you should get a copy of my college caricature. I have a digitalized copy. It shows me sitting in a pot in Africa, with the pygmies standing around. "Bless this food to our use" and "Dr. Stanley, I presume" written at the bottom. I did have a missionary bent at that point in time. Harden: I'm seeing a different type of person who has been involved here at CDC with the smallpox program than what I have seen with investigators at NIH [the National Institutes of Health] in terms of the things that motivated them to go into research. Let's talk about once you were recruited into the program. They asked you apparently to recruit others, as well. And you mentioned that the recruitment of this 1 person. Foster: Andy Agle [Andrew N. Agle]. Harden: . . .was interesting? Foster: Yes, it was very interesting. Andy was a public health advisor and a good mechanic. I remember, I met him at a building in San Francisco. He walked in, and he said, "I saw this advertisement that you wanted a public health person who spoke French and was a good mechanic, and I knew you needed me." That was it. Harden: Very confident. Foster: Yes, he was, there was no question about it. Andy turned out to be one of the best. He worked for a long time in West Africa; then he was working with smallpox in Afghanistan. He was getting bored with Afghanistan, and I brought him to Bangladesh. Then he worked for many years at the Carter Center and was very close to [President] Jimmy Carter. He did a lot of agricultural stuff and really worked incredibly well with the Carter Center. And then he took a job in Nigeria. He died about a year ago. Harden: Initially, you were the medical officer in Nigeria. Would you tell me which region you were in, and what you found? Foster: Well, I was responsible for the whole country. At that time, Nigeria had 4 regions. the West, the Midwest, the East, and the North. About half of the population was in the North and about half in the South. We had Margaret Grigsby and Jim Lewis in the western region; Warren Jones was in the Midwest; Bill Foege, Dave Thompson [David M. Thompson], and Paul Lichfield were in the East; and Deane Hutchins and Vicky Jones [Clara Jones] were in the North. And it was a very different program in the North than in the South. Harden: Would you tell me about that? Foster: In the North, the traditional leadership was incredibly strong. I remember the first village I went to, Gwadabaw, in '66.I got there at 6:00 in the morning, and there were 6,000 men in a line. We vaccinated the men, and then they went home, and then the women came out. Well, for the women to come out was a big social occasion. They really didn't want to go back in. But I learned something that day, which was very interesting. It was a big district, and I told the district head that we should have 3 vaccination sites in his town because it would take us too long to do it at 1 site. He said, "I forbid you for doing that." He says, "Everybody has to be vaccinated in front of me. Nobody will tell me that they were vaccinated if it had to be in front of me, whereas if there were 3 sites, they could be tell me they were vaccinated when they weren't. The Emirs of Sokoto, Katsina, Kaduna, and Kano were very powerful people. The Emir of Sokoto would ride around in his Mercedes every night, and if there was no petrol, the Mercedes got pushed around town. But he was very powerful. So the only thing that you had to do in the North was to convince the Emir, and he would call in his district heads, and then everything would happen. It was easy to get 96%-98% coverage in that region. In the South, it was much more difficult. The people would not go 200 or 300 yards for vaccination. People were much more independent in the South. There was not the structure, and it made it much more difficult to get people to come for vaccination. Harden: Why would they not want vaccinations? Foster: Well, I think if you go historically back, there was a demand for injections. We believe that occurred secondary to the yaws program, which gave shots of penicillin to treat yaws. But it cured venereal diseases and pneumonia and everything else. So injections were always sought after. In the North, the structure was such that people would be told to do it and they'd do it. In the South, you had to really convince them or use enough publicity to get people to come for vaccination. So it was a totally different thing. And the epidemiology of measles was different. In the North, where the women are in purdah, or where the population density was relatively low, the median age of measles was about 36 months. In Lagos, where you have mothers carrying their babies on their backs to market, the median age was around 14 months, and then that was with a population of 600,000. When I went back in the '80s and '90s to Lagos, which now has a population of over 10 million and possibly 20 million, the median age of measles had dropped even further, to around 8 months. Controlling measles was impossible. Harden: What was the toughest problem you encountered? Foster: Oh, the Biafran civil war. I had flown to Benin to see Warren Jones there. I got off the plane, and Biafran hijackers got on and hijacked the plane. And that plane later was used to bomb Lagos. It was very interesting: we believe that they were using the passenger plane as a bomber, defusing the bombs, and throwing them out the door. We felt that probably the reason that the plane exploded was because the bomb went off before it got out the door. Of course, they had to find somebody who was asleep at their gun to reward for shooting this plane down. That was tense, and a lot of people were evacuated. I was talking with Deane Hutchins at lunch. I took the kids and my wife up to Kaduna because I thought it was safe. The next day, they bombed the Kaduna airport. But one of the interesting things at that time, we knew there was no smallpox in Biafra; but I was really afraid smallpox would get into Biafra. So I convinced the government that the safest thing for them to do was to vaccinate a large area around Biafra so that the smallpox wouldn't get out of Biafra into Nigeria. That way we kept it out. We also vaccinated a lot of children coming through the lines. The malnutrition in pockets of Biafra was just absolutely terrible. I think the war was really the toughest obstacle. The regional office was shattered by the bombings in Lagos, and it was not as safe a place as it had been before that. Harden: How did you get along with your counterparts? Foster: Oh, I had the most wonderful counterpart in the world, a fellow by the name of Yeme Ademola, who had gone to the Harvard School of Public Health. If you go back into the history of the smallpox/measles program, USAID [US Agency for International Development] wanted to do all the countries except Ghana and Nigeria. And Ademola was one of the ones who achieved its inclusion in the program He actually went and met with Senator Kennedy [John F. Kennedy] to push that. Yeme was just so honest. He looked out for the poor. For example, he had a cooperative grain bank, where he would buy produce when the price was low, and then they would sell it when the price was high. He supported a clinic. He was just an absolutely wonderful guy, and he also was my neighbor. So he and my wife would often go out and have tea with Yemi and his British wife. He also is the subject of the most traumatic part of my time in Nigeria. I got a call one night about 3:00 in the morning, Rosa, his wife said that he had been attacked. When I arrived at the front door, the murderers went out the back door. He had been macheted across the neck. I went in and tried to save him, but I couldn't. And at that time, I wasn't thinking of my wife, who was pregnant. Panicked about me, she started to abort. It was a horrible day. And then the next day, the police came and wanted to put me under arrest for Yemi's murder. After a 6-hour standoff, the American Embassy got me off on account of my diplomatic status. So that was the single most traumatic event of my years in Nigeria. We had an incredibly interesting team. We had Deane Hutchins and Vicki Jones. My favorite story of Vicki was when she went out in the field once for 4 or 5 weeks, and she'd either broken or forgotten her mirror. When she came back to Kaduna and looked at the mirror, she said, "Something's wrong." And then she realized it was that her face was white. In other words, she'd only seen black faces for 6 weeks. But she was wonderful. The teams in the North were also just absolutely extraordinary people. They had a driver there. He would know, when he went into a village, who you needed to see first, who you see second, and who you should see third. He had driven for a political figure before that, and he was just good. The teams would go, and they could vaccinate with the jet injectors, 8,000- 10,000 a day. The most I ever remember vaccinating in a day was once in the Midwest: with 4 lines we vaccinated 14,000. Harden: Wow. Foster: I think it's important to put in perspective what Henry Gelfand had learned about India. The Indians had vaccination numbers greater than the population, but they still had lots of smallpox. So Henry Gelfand went out there and did an assessment. And he found the vaccinators were vaccinating the schoolchildren regularly, so that they could get high numbers of vaccination, but coverage was very low. So when we went to West Africa, we were absolutely sure that with high coverage (Rafe [Ralph H. Henderson] and Don Eddins adapted coverage surveys from the US immunization survey to Africa) we would stop smallpox. There was no question about it. And that was our strategy, and we were absolutely sure that with high coverage with the jet injectors and coverage surveys-if we got above 90% coverage, or 95% or even better-we'd stop smallpox. Four or 5 major events led to a change in that strategy. The first was that when we first arrived in Nigeria, there was a smallpox outbreak in eastern Nigeria, in Ogoja, where Bill Foege had been a missionary. They had a limited amount of vaccine. But by focusing the vaccine on the infected area, they stopped the outbreak. The second important thing was a series of spot maps that Bill Foege drew. Each year the smallpox would come from the North, and there'd be a few outbreaks on the northern border and in the East. Then the outbreaks would increase in number and frequency, so you could just see it spread southward. And although Bill doesn't remember this, I remember Bill sitting on the steps, looking at these monthly maps and seeing how the smallpox spread. And he raised the question, "If we stop these first few outbreaks, will we stop them all?" The third major event in the shift in strategy occurred in Abakaliki. (There's a nice paper about this by Dave Thompson and Bill.) They'd done a coverage survey, and Abakaliki had over 90% coverage. Then all of a sudden they had an outbreak of smallpox. The outbreak occurred in a religious group that had refused vaccination; I think it was called Faith Tabernacle. Smallpox even though the coverage in that area was 90%; the small group of unvaccinated people was able to sustain an outbreak. The fourth factor was the shape of the epidemic curve-a low in September-October and epidemic in the early spring. Bill figured it out that every chain of transmission in the fall caused 74 cases in the spring. He realized that the peak time for surveillance was when the chains of transmission were fewest. So, in my opinion, those were the major events that shifted the strategy from mass vaccination and surveys to surveillance/containment. And that was certainly a major shift. And I think, although the disease eradication programs were different, when you compare smallpox to malaria, malaria was a centrally directed program, and they never really responded to the signs of drug resistance, and insect resistance, and the program failed. Smallpox was different. The program was driven by data collected in the field. We learned from our failures and changed strategies to address them. When I teach on lessons learned from smallpox/measles, one of the major things is learning from our mistakes, being willing to learn from our mistakes. My favorite story on this is about Sabour. He was one of my team leaders in Bangladesh. At this time, India was free of smallpox, but we were still having trouble. And I went up to see Sabour in Mymensingh, near the Indian border. If we did everything right, once we found an affected village, there should be no cases after 14 days-after 1 incubation period. So I asked Sabour, "How many outbreaks do you have?" And he said, "Sixteen." And I asked him, "How many had gone more than 14 days." And he said, "Eleven." Well, this was a disaster. The people could've walked those cases across to India, where the reward was big, and made a lot of money. And so I said to Sabour, "What are you doing?" His response was, "I'm doing everything the book says. I'm putting the patient in the house; I'm putting a guard at the front door and the back door. I have an extra guard at night to keep the guards awake. I am making a list of visitors, vaccinating them, and putting them under surveillance. I'm vaccinating everybody in the household. I'm vaccinating everybody in a half-mile. And I'm searching every place in 5 miles." And then, across a cup of tea, an incredible smile. And Sabour said, "And today I found out why. I'm going in, and I'm asking for a list of visitors. They are not giving me the names of relatives who came to visit because they don't consider relatives as visitors. And so we added a list of relatives to the procedure and solved the problem." I think that this story illustrates one of the main points to get at, that a lot of us at CDC who are in leadership positions got a lot of credit for smallpox eradication, but it's these people who worked 28 days a month in the field, month in and month out for 5 years, some of them, who were the real heroes of smallpox. The other lesson to get out of this story was the importance of giving workers at the field level the indicators to assess their own performance. When they didn't meet them, they asked why and come up with a solution. There's 1 other similar story from India, which is really important. At a critical time in the program in India, things were going to hell in a basket in Bihar, and the numbers were going up. And the Minister said, "I'm sorry, no more surveillance/containment. We're going back to mass vaccination." Bill spent the whole weekend with the Minister, trying to convince him to continue surveillance/containment. But the Minister said he couldn't take the political pressure and he had decided that the only solution was to mass-vaccinate. At the Monday meeting, the Health Minister of Bihar got up and said, "I'm sorry, WHO [the World Health Organization] has recommended we continue to do this, but I can't stand the political heat any more, so we're going back to mass vaccination." In the back of the room, a hand raised. And a man got up and said, "Mister Minister, I am a poor country doctor. But when we have a house on fire in our village, we direct the water at that house and not the whole village." And the Minister said, "You have 1 more month." And fortunately over that month things got better, and so they continued surveillance/containment. Both of these examples illustrate the really major contributions that poorly paid and unrecognized field workers made. They really deserve a great deal of credit for what went on and the success achieved. Harden: But don't you think it was also remarkable that the bureaucracy and the people at headquarters were flexible enough to ask for and act on that kind of information? Many times you get bureaucracies that think they know best, no matter what's coming in. I think the synergy was quite remarkable. Foster: Yes. Well, I think that's the main difference between smallpox and malaria. When we introduced the reward for reporting smallpox in Bangladesh, I introduced a single reward. But after about 6 months, only 35% of the public knew about the reward. And then all of a sudden, I discovered my mistake. None of the health workers were telling the public because they didn't want the public to claim the money. So we doubled the reward to pay both the health worker and the public, and within 4 or 5 months, 80% of the country knew about the reward. Harden: So getting the word out, and knowing how the culture operates, also played a huge role. Foster: The Bangladeshi field staff used to say that working for the smallpox program was the best form of family planning (they were never home) because at least their wives didn't get pregnant. As you look at the evolution of surveillance/containment in West Africa to the rest of the world, it's a steady thing. .Probably the best place it was demonstrated was in Sierra Leone. Don Hopkins didn't have enough material to do the whole country. So on 1 side he did mass vaccination, the other he did surveillance/containment. Smallpox stopped in the southeastern area but continued on in the mass vaccination area. That proved surveillance/containment worked. Secondly, the legacy of surveillance/containment out of West Africa clearly was key to the success of global eradication of smallpox. Had it not been developed, it is unlikely that we would have ever stopped smallpox, in Asia especially. Harden: What about the role of the bifurcated needle? In my mind, West Africa was the jet injector and Asia was the bifurcated needle. Foster: This is not quite true. When we shifted from mass vaccination to surveillance/containment, the bifurcated needle became the preferred route of immunization. The bifurcated needle was developed to vaccinate chickens. It had 2 main advantages. It increased the amount of vaccine available 100- fold. It only took 1/100 the vaccine required by the multiple pressure method, where a drop was put on the skin and the site was scarified by pressing a needle parallel to the skin 15 times. The bifurcated needle take rates were 99% effective versus the traditional method's effectivity of 90%-98%. In Bangladesh, the bifurcated needle totally transformed containment. We could train a villager to use the bifurcated needle in 10-15 minutes. This brought ownership of containment to the village and quicker, more effective, control. It also solved the problem of getting health workers to spend nights in the infected villages, a major problem in the early stages in containment in Asia. Once you were hiring vaccinators to vaccinate their village, the barrier of the stranger was removed, and accommodations in the infected village were possible and acceptable. I think we go should back just a little bit, to 1945. After World War II, smallpox was endemic in most countries of the world, especially in tropical areas, where the liquid vaccine was unstable in the heat. So the development of the freeze-dried vaccine (you could carry it in your pocket, it didn't require refrigeration, and you could mix it up for the day and it would be good) was a big thing. New topic relevant to West African program but not to smallpox And then the initial development of measles vaccine, the Edmonston B measles vaccine, it could only be given with gamma globulin. And the vaccine was not, at that time, licensed. It had been tested in about 20,000 kids. At just about that time, 4 Ministers of Health visited the States and NIH. Harry Meyer happened to talk to them, and one of them got very excited. The Minister of Health of Upper Volta said measles was killing 20% of the children in Africa and Meyer should come to Upper Volta (now Burkino Faso) to test the vaccine there. So the first year, Harry went to Upper Volta and tested the vaccine. The vaccine proved its safety and efficacy without gamma globulin: that was a major step forward. The demand was such that the next year they vaccinated 700,000 in Burkina Faso. It was a tremendous success medically and politically. Then the United States expanded to the other countries in OCCGE [Organization de Coordination et de Cooperation pour la Lutte Contre Grandes Endemies] and that was when CDC first became involved. Probably the best story about that concerns Larry Altman [Lawrence K. Altman]. Larry's now a science writer for the New York Times. He was sent out to Mali to address problems with the measles program there. One day he sent back a cable to Washington that said, "The trucks don't keep the vaccine cold." And a cable came back from Washington, "Park in the shade." And so Larry sent a cable back, "Send trees." The measles program was a smashing success medically and politically. You had 3 parallel channels. You had the smallpox channel going on at CDC; you had Harry Meyer, who had proved the safety and effectiveness of given multiple vaccines at the same time. And then USAID and measles. USAID for some reason thought they could vaccinate a fourth of the children the first year, a fourth the second, a fourth the third, a fourth the last, and they would be done. That was totally wrong. I was talking to Dave Sencer about a phone call he got from A.C. Curtis from USAID, who called him and said, "What about a measles eradication program," and Dave said, "No, it can't be done. Measles is only control, Smallpox is eradication. Why don't we marry smallpox and measles?" Without measles, there would have been no West African Smallpox Eradication measles Control Program, no global program, and probably no eradication of smallpox. The WHO 1,000-page history of smallpox has several flaws, the major one being the order of chapters. They placed the West African chapter after India and Bangladesh. Bangladesh and India built on the lessons learned in West Africa and succeeded because of it While the marriage of smallpox and measles was key to smallpox eradication, the effects on measles were short-lived because of the lack of infrastructure to maintain vaccination. Successful control of measles has only been achieved in the last 5 years with a new strategy. It should be recognized that Jean Roy, the Operations Officer in Benin, has been a key player in this success in bringing the League of Red Cross Societies into play-resources from the wealthier countries and Red Cross volunteers on the ground to mobilize the public. It should also be said that the marriage of smallpox and measles was a major barrier between USAID and CDC. USAID felt they had been been conned. This was really the basis of a lot of the angst between USAID and CDC because essentially USAID paid the whole bill. And I was talking to D.A. last night on the phone, trying to clarify a few pieces of history, which is always difficult with D.A. When the United States first agreed to do smallpox, there was a briefing of the US delegation to the WHO Assembly. Even the secretary of HHS [Department of Health and Human Services; then, it was Health Education and Welfare] was not aware of the plan. So then the announcement went out at the assembly, from President Lyndon Johnson, that the United States would support a smallpox eradication program in West Africa. Later, the smallpox/measles marriage took place. Clearly, Dave Sencer was a key actor in this. D.A. told me last night-which I didn't know-that that press release about smallpox was written by Bill Moyers. That was the international Year of Cooperation, or something like that. And smallpox eradication and the US contribution fit this like a glove from 3 perspectives: science, development, and politics. Harden: You have mentioned the 2 women who were professionals the West African Program. Neither of them is here for the reunion, but could you talk about who they were and how exceptional they were? Foster: Yes. Two very different people. Vicki Jones, young, free spirit, guitar-playing, and Margaret Grigsby, an older, African- American woman professor at Howard, very prim and proper. I remember we had some issues insuring that there was a proper latrine arrangement for her when she went to the field. And it was difficult in the area that Margaret was in, in terms of getting cooperation. Margaret was great. She had her heart and soul in the program and bonded well with her African colleagues. I do remember the first outbreak I went to in the western region. They had isolated the smallpox patients in a cocoa farm, and the only people who were allowed to go there were those who had the scars of smallpox. This is very, very interesting. On the other hand, you have the smallpox cult, Shapona cult, where if you didn't want to get smallpox, you paid the priest. If you got smallpox and didn't want to die, you paid the priest. And if you died, the priest got all of your worldly possessions. So they couldn't lose. There are historical accounts, in the 1800s, of priests actually infecting people who didn't pay up by putting smallpox scabs on sticks going into houses. Actually, I remember the last African outbreak I visited, in Togo. A couple of the traditional healers were there trying to pick scabs. Fortunately, the scars were from a vaccinial modified case, so it was not likely that there was much virus left. Harden: What did Africa teach you about yourself and about public health? Foster: We were young; we were bright; but we were not bright enough to say we couldn't do it. I mean, that was really important. In other words, there was never a sense that we couldn't succeed. It was a totally different story in Bangladesh. But we learned as we went along. We had pretty good government response and fairly credible civil service. At least, we were paying per diems and that sort of thing, kept people working. It was a well-oiled machine. I mean, we had something like 80 Dodge trucks in Nigeria. We had lots of spare parts. I think the last one I saw running was in the late '80s. Harden: What kind of impact do you think the whole West African program had on the global eradication program? Foster: Had West Africa not succeeded, it's doubtful that the global program would have succeeded. I have no question in my mind that it laid the foundation, and one of the great injustices in the smallpox book is that the West Africa chapter is put after India and Bangladesh. This is extremely unfortunate and historically incorrect because a lot of the lessons learned out of West Africa laid the foundation for what went on in Asia, and Ethiopia, and Somalia. Harden: Indeed. Is there anything you would change if you were running the program all over again? Foster: What we did then, we couldn't do now. Harden: Say again? Foster: What we did then, we couldn't do now. Harden: Why? Foster: I mean, it was pretty much an expatriate-run operation- money-driven, technology-driven. We did not have the proper amount of deference to local culture and societies and governments. Harden: I wondered about that. Foster: It was pretty much a technology-driven program. It was marvelous in terms of the teams we had. Some of the Operations Officers, Dave Bassett for one, George Stroh for another. George was driving from Jos down to the South when his motor mounts broke, and his motor fell out of his engine. He put the motor back in and drove home. I mean, just that kind of ability, to react in the field. So that was important. In Asia, several things were key. One was that the monthly meetings were incredibly important. People came in, they gave their reports, they shared the successes, they shared their failures, they got drunk, they sobered up, they got their money, they went back to the field. And most of them spent 25-28 days in the field. And as I look at CDC people going in the field now, they don't do that much any more. Harden: Are there any final things that you want to say? Foster: The challenges of West Africa were nothing compared to what it was in Bangladesh, especially in the floods of 1974, when the 2 remaining areas of infection were totally flooded out and people went into motion. We went from 89 infected villages in October of '74, to 1,500 the following May. We were all depressed. We lost it. A wonderful guy, Rangaraj, was my deputy; he was the first Indian physician parachutist. He had fought with Stillwell in Burma. And every morning, he would say, "It's going to be all right. Hang in there." Every day, he was like that. There was no rationale for that. Later on, when I was working in Somalia, I had a beer with Rangaraj 1 night, and I said, "Ranga, how could you have been so optimistic?" He said, "I didn't think you had a chance in hell in winning, but when I fought with Stillwell in World War II, I learned that if you ever thought you'd be dead the next day, you would be dead." So it was his military training and his optimism that enabled us to keep going, during incredibly difficult times. When I walk into an HIV/AIDS village today, I feel Ranga's hands on my shoulder. "Hang in there it will be all right." Harden: And eventually, to win. Foster: Yeah, and eventually to win. And Ranga was incredibly important. And there were lots of people like that. In Bangladesh, we had 22 nationalities on our staff, and they were they best. I mean, they were family. We were all 1 family. The monthly meetings were key. Then surveillance got incredibly better, and we were able to track things. And we used money. We paid $25,000 in rewards starting at $2.50 per report of an infected village and increasing to $50 as the number of infected villages in Bangladesh decreased. And we learned. For example, when we started in Bangladesh, we were having trouble with containment until we started hiring people from the village. The reason we were failing was because health workers had no place to stay in the villages. Once you started hiring villagers to do the work, you had a place for your health workers to stay. And so there was a tremendous lesson. </pre> Player html for embedded player to stream video content <iframe src="https://www.youtube.com/embed/0m-qj2HereE" 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/. 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 2006-07-14 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/15nd0 emory:15nd0 Subject The topic of the resource CDC Smallpox Eradication USAID WHO Combating Childhood Communicable Diseases (CCCD) Format The file format, physical medium, or dimensions of the resource 9738000000 bytes video/x-dv Creator An entity primarily responsible for making the resource Harden, Victoria (Interviewer) Foster, Stanley (Interviewee); CDC Contributor An entity responsible for making contributions to the resource Centers for Disease Control Title A name given to the resource FOSTER, STANLEY O. Description An account of the resource Dr. Stanley Foster traces his early years and interest in international health. Describes his recruitment into the EIS and subsequent assignment to Lagos, Nigeria as the Epidemiologist for Nigeria in the Smallpox Eradication Program. Following that he was assigned to Bangladesh's smallpox program and then became the Project Director for the Combating Childhood Communicable Diseases (CCCD) project at CDC. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/4dc6ef937719dd6fa6d83fd77f250dc9.jpg c4add24234d15f08afd1581c7c14dd6e Omeka Image File The metadata element set that was included in the `files_images` table in previous versions of Omeka. These elements are common to all image files. Bit Depth 8 Channels 3 Height 178 Width 184 https://www.globalhealthchronicles.org/files/original/683280d25992d65aedc92146052f9d32.pdf 8cb9282c57c5ecde06ed0cd89986795c 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. Duration Length of time involved (seconds, minutes, hours, days, class periods, etc.) 1:04:45 Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310210147%3Fsecret_token%3Ds-71EQF&amp;color=ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false" frameborder="no" scrolling="no" width="100%" height="166"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource FOSTER, STANLEY O. Description An account of the resource Dr. Stanley O. Foster, EIS Class of 1962 provides descriptions of the working relationships he had with other people and organizations during the smallpox eradication efforts in Africa and Asia. Interviewed by Karen Torghele 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 November 2, 2011 https://www.globalhealthchronicles.org/files/original/494db00f7ff2cef243a4442f4dbd7fb7.JPG 58342c3c80fc4962be2cabc80ca9c96c 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> Media Powerpoints, Recorded lectures, movies, training films, and interviews Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/wSEhCAzQOys" 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 presentations (communicative events) motion pictures moving image Date A point or period of time associated with an event in the lifecycle of the resource 2008-07-12 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16s92 emory:16s92 Subject The topic of the resource Smallpox Eradication CDC WHO MOH Bangladesh Format The file format, physical medium, or dimensions of the resource 9056160000 bytes video/x-dv Creator An entity primarily responsible for making the resource Foster, Stan (Speaker); CDC; Epidemiologist Contributor An entity responsible for making contributions to the resource Reunion of Southeast Asia and East Africa Smallpox Workers (2008 : Atlanta, Georgia) Title A name given to the resource FOSTER: BANGLADESH Description An account of the resource Dr. Foster discusses the Bangladesh Smallpox Eradication Program Language A language of the resource English https://www.globalhealthchronicles.org/files/original/e1c18afedacb87edf4a9b2915a19473e.JPG 5b8895f58592b571e06589f4d4dd0cff 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 src="https://www.youtube.com/embed/fO5wY6PUheA" 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 FOSTER: CDC'S ROLE IN SMALLPOX Description An account of the resource Stan Foster details the history of CDC's involvement in the Smallpox Eradication Program. Source A related resource from which the described resource is derived David J. Sencer CDC Museum at the Centers for Disease Control and Prevention https://www.globalhealthchronicles.org/files/original/2655c4909f801e4df01314f9dd140477.JPG 18b4405be8e5f728aac76ad5492e7609 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> Media Powerpoints, Recorded lectures, movies, training films, and interviews Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/P9oTcphpyh0" 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 presentations (communicative events) motion pictures moving image Date A point or period of time associated with an event in the lifecycle of the resource 2006-07-15 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/15n3r emory:15n3r Subject The topic of the resource CDC Smallpox Eradication USAID WHO Reunion Format The file format, physical medium, or dimensions of the resource 1370280000 bytes video/x-dv Creator An entity primarily responsible for making the resource Foster, Stan (Speaker) Contributor An entity responsible for making contributions to the resource Reunion of West and Central Africa Smallpox workers (2006 : Atlanta, Georgia) Title A name given to the resource FOSTER: SEMINAR CONCLUSIONS Description An account of the resource Questions and comments at the close of the seminar sessions. Dr. Stanley Foster moderates and adds closing remarks. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/b04b03270535ff5b78ba27646749f06c.JPG 5b8895f58592b571e06589f4d4dd0cff 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> Media Powerpoints, Recorded lectures, movies, training films, and interviews Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/Lh8iDGuSQ3s" 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 presentations (communicative events) motion pictures moving image Date A point or period of time associated with an event in the lifecycle of the resource 2006-07-15 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/15mp0 emory:15mp0 Subject The topic of the resource WHO Legacy of Smallpox Eradication Reunion CDC USAID Smallpox Eradication Format The file format, physical medium, or dimensions of the resource 2195400000 bytes video/x-dv Contributor An entity responsible for making contributions to the resource Reunion of West and Central Africa Smallpox workers (2006 : Atlanta, Georgia) Title A name given to the resource FOSTER: SMALLPOX LEGACIES Description An account of the resource Dr. Stan Foster details the challenges and legacies of smallpox eradication and measles control in West Africa and in Bangladesh. Topics include surveillance and containment, and the Expanded Programme on Immunization. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/8ccb83bae923fa23433b4de020234b64.JPG 18b4405be8e5f728aac76ad5492e7609 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> Media Powerpoints, Recorded lectures, movies, training films, and interviews Player html for embedded player to stream video content <iframe src="https://www.youtube.com/embed/J9ZkmXPKTZA" 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/. Type The nature or genre of the resource presentations (communicative events) motion pictures moving image Date A point or period of time associated with an event in the lifecycle of the resource 2006-07-15 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/15mmq emory:15mmq Subject The topic of the resource USAID Smallpox Eradication CDC WHO Reunion Format The file format, physical medium, or dimensions of the resource 1539360000 bytes video/x-dv Contributor An entity responsible for making contributions to the resource Reunion of West and Central Africa Smallpox workers (2006 : Atlanta, Georgia) Title A name given to the resource FOSTER: SMALLPOX SEMINAR DISCUSSION Description An account of the resource Comments from the audience following the seminar. Commentators are Tom Mack, Tim Miner and John Noble. Language A language of the resource English