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&lt;p&gt;In 1942, when the U.S. was mobilizing for the Second World War, the U. S. Public Health Service set up a program to protect the personnel of military bases in the Southeastern states from malaria. This disease had long been rampant in the area, and posed serious threats to the health of the military and civilian populations. The program known as Malaria Control in War Areas (MCWA) was created to carry out the work. The lack of space in Washington due to the war effort allowed the program to base its headquarters in Atlanta, Georgia, and closer to the work at hand. During the war years, the program was expanded to include the control of other communicable diseases. Because its work was so successful, a new organization was created around the nucleus of MCWA, the Communicable Disease Center (CDC). The date was July 1, 1946. This archive chronicles the agency’s early history from 1941-1951, including the contributions of local businessmen and Emory University. The buttons to the right will connect you to a searchable database of documents, oral histories, photographs and media. To conduct an advanced search, use the link in the blue navigation bar above. Use of this information is free, but please see &lt;strong&gt;“About this Site”&lt;/strong&gt; for guidance on how to acknowledge the sources of the information used.&lt;/p&gt;
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&lt;p&gt;Guinea worm is poised to be the second human disease to be eradicated. The Carter Center, with partners like the U.S. Centers for Disease Control and Prevention, began leading the international campaign to eradicate Guinea worm disease in 1986. That year, it was estimated that 3.5 million cases occurred annually in 21 countries in Africa and Asia. Guinea worm disease is a painful and debilitating parasite that is contracted by drinking Guinea worm infected-water. There is no vaccine or drug to prevent the disease, only behavior change through health education. Working with the ministries of health and impacted communities, Guinea worm disease has been reduced by more than 99 percent. &lt;span&gt;During 2020, only 12 human cases of Guinea worm disease were reported in Chad, a dramatic 75 percent reduction from 48 the previous year. Eleven cases were reported in Ethiopia, and one each in South Sudan, Angola, Mali, and Cameroon. As for Guinea worm infections in animals, Chad reported 1,570 (1,507 domestic dogs, 61 domestic cats, and two wild cats), Ethiopia reported 15 (eight domestic dogs, three domestic cats, four baboons), and Mali reported eight infected domestic dogs. &lt;/span&gt;The buttons to the right will connect you to a searchable database of oral histories, photographs and media. To conduct an advanced search, use the link in the blue navigation bar above. Use of this information is free, but please see &lt;strong&gt;“About this Site”&lt;/strong&gt; for guidance on how to acknowledge the sources of the information used. .&lt;/p&gt;
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                  <text>Smallpox</text>
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&lt;p&gt;Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  &lt;/p&gt;
&lt;p&gt;The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.&lt;/p&gt;
&lt;p&gt;The links above connect you to a database of oral histories, photographs, documents, and other media.&lt;/p&gt;
&lt;p&gt;Use of this information is free, but please see &lt;strong&gt;“About this Site”&lt;/strong&gt; for guidance on how to acknowledge the sources of the information used&lt;/p&gt;
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              <text>&lt;pre&gt;&lt;strong&gt;
 Interview Transcript
&lt;/strong&gt;
Interview

Dr. Mary Guinan | with Interviewer Melissa McSwigan
Transcribed: January 28 2009 | Duration 0:54:36




Melissa McSwigan:      This is an interview  with  Mary  Guinan  on  July10,
           2008 at the  Centers  for  Disease  Control  and  Prevention  in
           Atlanta,  Georgia,  about  her  involvement  with  the  Smallpox
           Eradication Program. The interview is being conducted as part of
           our reunion, marking the 40th anniversary of the program in Asia
           and East Africa. The interviewer is Melissa McSwigan.

           Now, with this interview, we are hoping to  capture  for  future
           generations the memories  of  participants  and  their  families
           involved in eradicating smallpox from Asia and East Africa. This
           is an incredibly important and historic achievement and we  want
           to hear about your experience. I have some  questions  to  guide
           you, but please, feel free to recount  any  special  stories  or
           anecdotes that you remember about events or people. So you  sign
           the legal agreement which says that you were donating  the  oral
           history to the U.S. Federal Government and it  will  be  in  the
           public domain. You will have a chance to  edit  the  transcribed
           interview and add or delete information as you see fit before it
           is made public. So at this point, I'm going to ask you to  state
           your full  name  and  that  you  know  the  interview  is  being
           recorded.

Mary Guinan:     I'm  Mary  Guinan  and  I  know  this  interview  is  being
      recorded.

Melissa McSwigan:      Okay perfect. Could you maybe start  out  by  talking
           about how your education and upbringing led you into working  in
           Public Health?

Mary Guinan:     Well-I'm not sure how my education and  upbringing  brought
           me into Public Health, but I'll tell you how I  decided  that  I
           wanted to be part of the Smallpox  Eradication  Program.  I  was
           born in New York City, a child of immigrants.  My  parents  were
           immigrants from Ireland. They were farmers. They had maybe three
           years of education, 3rd Grade education level and they  came  to
           follow  the  American  dream.  There  were  lots  of   political
           persecutions in Ireland and they were - and  it  wasn't  a  good
           time. So they met on a ship coming here. Neither  of  them  knew
           anyone here in America and they established a  presence  in  New
           York. My dad worked with the Subway, the New  York  City  Subway
           System. My mom had a job as a dressmaker I think first, and then
           she was working in a house as an Assistant to  the  Chef,  in  a
           house in New York. Many Irish women came to  America  worked  as
           servants or assistants with large wealthy  families  and  that's
           what my mother did; and they eventually got married years  later
           - five years later. The Irish were very slow at this.

           I grew up in New York City and they believed in education.  They
           believed that that was the way to move ahead and they loved this
           country because of its freedom and lack of persecution for  your
           political views and they were very, very - they were very  loyal
           Americans and felt that this was really an important place to be
           and that we should be grateful-I was the middle of five children-
           we should be grateful for being born in  this  country  and  for
           exactly what we had available to us.  So  when  I  was  a  young
           teenager my dad died very suddenly and my mother had no means of
           support and we all got jobs to work our way through school;  and
           I worked my way through school and graduated from high school. I
           worked my way through college. I wanted to be a  physician,  but
           women weren't being admitted to medical school then;  and  also,
           one of the criteria for medical school was that you had to  have
           money to pay for it; and there weren't scholarships available or
           other things available to students like  me  who  really  didn't
           have the means to do that. So I decided then that I would pursue
           other things. I majored in  Chemistry  in  college  and  when  I
           graduated, I couldn't get a job because they didn't  hire  woman
           Chemists. So I was interested in - I got a job in a Chewing  Gum
           Factory...


Melissa McSwigan:      Really!

Mary Guinan:     ...making chewing gum. It was the American  Chicle  Company
           and they made Chiclets and all sorts of chewing gum. Black  Jack
           chewing gum was one of them and I was the Flavor Chemist. I  was
           hired as a Flavor Chemist so part  of  my  job  was  making  new
           flavors, developing new flavors  of  chewing  gum.  It  was  not
           terribly rewarding kind of existence, but  there  wasn't  really
           much available for women then and I try to look for  fellowships
           and I applied to many schools, to graduate  school,  and  I  was
           rejected mostly because I was a woman; and if I was accepted,  I
           couldn't get a fellowship program because they didn't give  them
           to women at that time. But at the time the Space Program was  in
           full bloom and with  Sputnik,  President  Kennedy  had  said  we
           wanted to be on the moon; that we were going to  the  moon;  and
           there were lots of became-available fellowships for  scientists.
           They wanted scientists to be  in  the  Space  Program  and  I've
           decided that I wanted to be an astronaut. So I  found  out  that
           the University of Texas was where the Space  Program  was,  near
           NASA in Texas, Clear Lake City,  but  the  University  of  Texas
           Medical Branch in Texas had a program for scientist in Aerospace
           Medicine and that the Director of  the  Medical  Program,  Chuck
           Berry - Dr. Chuck Berry, had an appointment at the University of
           Texas there. So I applied there to get my PhD in Physiology  and
           Space Medicine and I wanted to be  an  astronaut.  Of  course  I
           didn't tell anybody then  that  I  wanted  to  be  an  astronaut
           because women didn't do those sorts of things.

           So I went to Texas and people in New York said: You  won't  last
           there-about six months. You know you're a New York  person  born
           and brought up in New York. But I did, I lasted four years and I
           went to NASA. I applied - all of  my  class  in  physiology  and
           space medicine there at the  University  took  a  test  for  the
           Astronaut Program and I was the only woman who took it and I was
           the only one who passed the test. The reason I passed  the  test
           was I had 20/20 vision; and all the other people wore glasses. I
           mean that - and you also had to fit into  the  capsule.  It  was
           like the old days of being a flight attendant, you had to  be  a
           certain height and weight and not wear glasses. But I knew  that
           it was unlikely that I was going to be an astronaut, that  there
           was a great deal of competition for it. So I finished my - but I
           got to see all the astronauts,  I  took  classes  at  NASA.  The
           astronauts, you know like John Glenn  and  Neil  Armstrong  gave
           classes and talked about their  experiences  in  space.  It  was
           really exciting; I was really excited as a Scientist; and I  did
           a post doctoral fellowship; I got a Post Doctoral Fellowship  at
           the National Institutes of Health in Bethesda, Maryland; and  it
           was during the Vietnam War and I actually  had  gotten  a  place
           that was for a man who had been drafted. So I filled  in  and  I
           knew that I wouldn't really be  there  very  long  because  they
           saved the places for men who had been drafted and  had  gone  to
           war; and it was very difficult for  me  to  get  a  job  at  NIH
           because I didn't have an MD degree, and my mentor there  at  NIH
           said to me, "It would be so easy to get you a job if you had  an
           MD." You know, this is always the case, you know,  if  you  just
           did this, you know, we could get you a job.


           So I applied to two medical  schools.  Since  I  was  living  in
           Maryland, I applied to  the  University  of  Maryland  to  Johns
           Hopkins; and I got rejected from the University of Maryland  and
           accepted at Johns Hopkins which tells you  something  about  the
           crazy system we have about being accepted into medical school. I
           was very grateful because I was sort of an alternative  student.
           I didn't go from college to medical  school.  I  had  done  this
           detour and had been in Texas which most people  think:  What  in
           God's name did you go to Texas for? In Texas, people said, "What
           is this New York girl doing in Texas?" So I  think  one  of  the
           presumption was I try and find a rich husband, you know, a Texas
           oil man or something and that was the  assumption-there  weren't
           very many women doing graduate work. So I went to medical school
           and I graduated from Johns Hopkins in 1972 and during that  time
           period, I was continuing my  career,  I  had  done  my  PhD,  my
           doctorate in physiology in the area of blood coagulation  and  I
           was wanting  to  continue  my  career  and  be  a  hematologist,
           oncologist, and go in academic medicine. That's what I thought I
           would want to do. Never  thought  about  public  health,  didn't
           really know about public health. I went  to  medical  school  at
           Johns Hopkins where one of the premiere Public Health Schools in
           the nation is, and took courses but really had  no  interest  in
           public health at that time.


           But I was interested in tropical medicine and I did  a  tropical
           medicine fellowship in Mexico during my senior year  at  Hopkins
           and  was  interested  in  tropical  medicine.  Then,  as  I  was
           graduating, this was the end of the 60's and  beginning  of  the
           70's and what happened during my last  year  of  medical  school
           really changed my life, in that what  happened  was  Kent  State
           happened. People were killed for demonstrating. This is  a  free
           country, our Government. The United States Government,  which  I
           was very proud of being an American and  was  very,  very  upset
           about what happened in the anti-war demonstrations that went on;
           and then these students  in  Kent  State  were  killed,  unarmed
           students, by the National Guards that had been even called  out.
           People killed and I thought: What has  happed  to  this  country
           that I live in? How  can  this  be-that  we're  living  in  this
           country where they're killing unarmed demonstrators?  Our  whole
           history of our country was revolution and fighting  for  freedom
           and doing what we thought was right.


           So what happened was I decided I wasn't sure what I was going to
           do and so in my senior year I read in  this  magazine,  sort  of
           like a  magazine  at  Hopkins  about  the  Smallpox  Eradication
           Program. That there was this idea to eradicate smallpox  in  the
           world and I thought, "Isn't that wonderful? What  a  great  idea
           that we could eliminate a scourge. It would be the first time in
           history that by the design of man or woman,  there  would  be  a
           human disease eliminated from the world  and  smallpox,  a  very
           frightening disease." But you know, I just thought that,  "Isn't
           that a wonderful idea?" I didn't really  think  about  it  much.
           Then after that Kent State and I started doing my internship  in
           Internal Medicine with the idea that I  would  go  on  to  be  a
           hematologist and do a fellowship in hematology, oncology; and as
           I was going, during my senior of medical school, I  was  on  the
           clinical service with someone who was going to be an EIS Officer
           at the CDC. I had no idea what an EIS Officer was and he told me
           that it was the Epidemic Intelligence Service at  CDC.  I  said,
           "What's that?" He said it was a  two-year  program  and  you  go
           there and you learn how to be an epidemiologist, which I  really
           didn't have any interest in. Then I saw this  other  article  in
           the Hopkins Journal Magazine. You know, they  have  an  internal
           magazine, about this Smallpox Eradication Program worldwide, and
           how our Government was participating in it, our Government. So I
           thought, "Wouldn't that be wonderful to be part of a  Government
           Program that was really doing something wonderful?" Then I found
           out that the people who were going were being assigned from CDC,
           so you had to come to CDC and somehow get a job at CDC and  then
           you could be assigned to the Smallpox Eradication Program.


           So I talked to my friend at Hopkins about this  program  and  he
           said, "Yes, it's EIS Officers who were going over there  on  the
           Smallpox Eradication Program." So I applied to the  EIS  Program
           and in 1973 I guess, I was accepted; and I came to interview and
           I was the only woman physician in my class  that  was  accepted,
           and during that time, when you are hired at CDC you are hired in
           the commission core of the public health service  which  was  an
           alternative to military service and the draft was still ongoing.
           So people would say, "We're not accepting women here because  if
           we do, another guy has to go to Vietnam. So we're not  accepting
           women." During the interview I was told this when I came to  CDC
           for the interview. So I wasn't sure that I  would  be  accepted,
           but I was. I don't know why, but I was. I was accepted into  the
           program and so I came as an  EIS  Officer.  I  was  assigned  to
           hospital infections that's in  bacterial  diseases  then  and  I
           would go -  we  used  to  have  a  Tuesday  morning  seminar  in
           Auditorium-B every week for all the EIS Officers and we'd attend
           this meeting and there'd be announcements at the  beginning  and
           every time somebody from the smallpox program would  go  up  and
           say, "We are looking for volunteers for the Smallpox Eradication
           Program." You know it was a three or  four-month  assignment  in
           India now was the part; and I applied to go and  they  told  me,
           they were not taking women. Now, Indira  Gandhi  was  the  Prime
           Minister of India  so  it's  like  to  say,  "Well,  how  is  it
           possible?" That was the first round  and  then  each  week,  you
           know, they'd have somebody and finally, Phil Brachman  was  head
           of the EIS Program and I said, "You know,  I  keep  volunteering
           and I keep getting turned down, but I don't know  why.  Can  you
           tell me what the criteria are?" So I think they thought I  might
           make a fuss because I actually had made a little bit of  a  fuss
           although I didn't think it was a big deal,  but  everybody  else
           thought it was a big deal.


           When I applied to the EIS, I was accepted, but  we  had  to  get
           three references from physicians who knew us, and they  sent  me
           the reference sheets that had to be completed and it was:  "Will
           you please rate this  candidate  on  his  background  on  his  -
           whatever he does and is he a leader?  Is  he  going  to..."  You
           know, there wasn't a parenthesis with "she" and so I  sent  back
           the forms, I said, "I'm sorry. I'm a woman. Do  you  have  forms
           for women?" and apparently that caused some issues here  at  CDC
           before I arrived, so  they  figured,  "Oh,  oh-this  is  trouble
           coming." They wrote back and said, "We do not discriminate,  but
           we don't have any female forms." So, they crossed out  the  "he"
           and put "her" and "she" in the  appropriate  spots.  So  when  I
           came, I think that there was an idea that maybe -  feminism  was
           just sort of coming into existence. It really didn't exist until
           later; it was funny. So there was this worry I think so finally,
           they said, "You're going. You're going to India." So I  went  in
           December of '74 through early May of '75.

Melissa McSwigan:            Okay. So that was about  six  months  that  you
      were in India?

Mary Guinan:     Probably less-somewhere in there.

Melissa McSwigan:            And what was your exact role while you were  in
      India?

Mary Guinan:     What our roles were was that we  would  be  assigned  to  a
           district, some district area that - and you did surveillance for
           smallpox, looked for smallpox cases and then if you  found  one,
           you quarantine the case and then surrounded it with  a  ring  of
           immunity in a five or 10-mile  radius  around  because  smallpox
           spread locally;  and  this  have  been  demonstrated  in  India,
           actually Bill Foege who really was a person who worked this  out
           and really is probably one of the  people  responsible  for  the
           eradication of  smallpox.  Because  he  was  in  Africa  and  he
           probably told the story and you've heard it, but they would have
           a shortage of vaccine and they tried to figure out how to use it
           appropriately and they theorized that smallpox  spread  locally.
           So what you need to do  is  to  surround  the  populate  of  the
           infected person with a ring of immunity and then it won't spread
           because it only  spreads  from  person  to  person.  There's  no
           environmental reservoir  for  smallpox.  Humans  were  the  only
           source of smallpox; so you would find that  -  that  was  funny.
           Anyway that's what we had to do and we would be assigned. When I
           arrived at my destination, we first went to Geneva. On our first
           assignment, we'd go to Geneva and we met all the people who were
           being assigned; and I went with Walter Einstein from CDC who you
           probably will be interviewing too. He and I were both  from  New
           York City and we were assigned together to  Uttar  Pradesh;  and
           then we were assigned to go to Uttar Pradesh.

           So we were in Geneva and then we were sent to Uttar Pradesh  and
           there were still smallpox  in  Uttar  Pradesh.  There  were  two
           provinces in India, Uttar  Pradesh  and  Bihar  that  still  had
           smallpox. So it was like a competition between Bihar  and  Uttar
           Pradesh; who would come first down to smallpox zero?  What  we'd
           do is, we would go out into  the  field;  we  would  go  and  do
           surveillance. You were  assigned  a  driver  and  a  paramedical
           assistant and then you were given all  these  traveler's  checks
           like in Rupees because you had to hire people, and  you  had  to
           pay them. Then I would go to the bank and cash these  checks  so
           I'd have lots of money to pay people to immunize. You had to get
           vaccinators. You had to get people to work  for  you.  I  didn't
           realize what the whole system was in India, but since my  driver
           and paramedical assistant had been working, and  my  paramedical
           assistant was Shaffy[0:22:56] Mohamed, he was a Muslim,  and  my
           driver was a Hindu, and they spoke different languages actually.
           Shaffy spoke English perfectly, but his native language is  Urdu
           not Hindi, so that we had this three way thing going  on  trying
           to communicate with Urdu, Hindi and English. I didn't speak  any
           of either, but I learned to read the Hindi symbols  so  I  could
           read the road signs and they were very small - rarely was  there
           a road sign, but if there were, the driver couldn't read,  so  I
           would phonetically sound the symbols so I could tell  which  way
           the direction was pointing.  I  would  say,  "Kahnpour[inaudible
           23:44]; that way, okay  this  is  where  we  want  to  go."  The
           paramedical assistant acted as your interpreter, your  cook.  To
           find a place to stay, we were  issued  Tenson[0:24:10]  sleeping
           bags and these mattresses. You know,  thinking  about  India,  I
           thought it would be very hot and didn't bring any warm  clothes,
           but Uttar Pradesh is up North near Nepal and it got  very  cold.
           It was three degrees (3º) centigrade when I arrived at the Delhi
           airport and it was cold. So I had made a quilt, so I would  wrap
           it around me because I didn't have any warm clothes. We would go
           out and we would offer a reward; we'd go like to a  village  and
           the paramedical assistant would get up and say to the villagers,
           they had never seen a foreigner before so I was a  great  source
           of interest to people like: look at  me,  this  is  incredible..
           This is an area of Uttar Pradesh which was 99% illiterate.  They
           had never seen a foreigner before nor heard of America; and very
           often if we went to a Muslim village the women wanted me to come
           into their house because they didn't come out; they lived  in  -
           it was a part of their practice.


           So they always wanted me to come in to their house, their little
           mud hut, but they wouldn't allow  my  paramedical  assistant  in
           because he was a man, so I would go in there  and  we  would  do
           sign language. They couldn't understand; you know: Where were my
           babies? What was I doing there?  I soon found  out  everybody  -
           most of the women were pregnant, they had babies every year  and
           while I was there, there were several  babies  that  were  named
           America because they heard this word America. They had no  idea,
           they didn't have a concept of another language or another place;
           and if they asked my paramedical assistant  where  I  was  from,
           he'd say, "Oh, she's from the capital, Lucknow" Because they had
           no concept of another country and languages  but  they  couldn't
           understand why I  couldn't  understand  them.  So  it  was  that
           interesting. We would go to the village and we had these picture
           postcards that showed cases of smallpox and we would  say,  "Ten
           Rupees to anyone who can show me a case of smallpox" and it  was
           increasingly - 10 Rupees was a lot of money then for the average
           person. So if there was smallpox in the village they would bring
           you to the person. Very often it was chickenpox,  not  smallpox;
           or something else. It wasn't smallpox; and you were supposed  to
           be the expert, not having ever seen a case of smallpox,  it  was
           like strange to think that you were going to be the  expert  and
           tell whether this was smallpox or chickenpox. Of course we  were
           taught at all of these training sessions how to  do  it.  So  we
           heard about a report of smallpox in a village that was  supposed
           to be free of smallpox. So I was sent there out of my  district,
           my district was Kanpur, but this was outside of my  district,  a
           place called Rampur Madras. So I went there and I looked at  the
           case and it sure looked like smallpox to me; and at that time we
           took a culture of the lesions and put them in a little vial  and
           a mailing case. Then I mailed it off to  Delhi  and  they  would
           either confirm, because they wanted to culture every case to see
           if it was really a case; but  it  would  take  weeks  and  weeks
           before the results came back. I declared it as smallpox  and  so
           we started our immunization. There were vaccinators who actually
           worked in all the villages. There's this infrastructure in India
           where they have these people who are vaccinators; and they could
           be hired. So my paramedical assistant would  just  let  out  the
           word and people would come and want to work for you  because  we
           paid very well. So what we would do, we would pay  the  people's
           family to be guards at the door. This is  a  mud  hut  in  these
           villages and then we would pay a family member to be  the  guard
           at the door and the only people - they'd have to vaccinate them.
           Anybody who went in or out of the house had to be vaccinated.

Melissa McSwigan:            So this is the door  of  the  house  where  the
      smallpox patient was?

Mary Guinan:     Yes, the smallpox case. So here's  the  case:  this  was  a
           young man and nobody knew where he'd gotten smallpox from and he
           was a Brahman. The Caste System was a part of what was happening
           in India at the time although it was banned, it was outlawed, it
           was pretty much the practice. Everybody recognized  -  when  you
           went into a village the first thing people asked was what  Caste
           you were; and since I was an outsider, they weren't  quite  sure
           how to treat me, and so the Brahman didn't want me to touch him.
           You see this young man, they are Brahmans; but I interviewed him
           to try to find out where he got smallpox because he had to  have
           gotten it from another person, and where he had traveled; and it
           turned out that he had travelled to a village somewhere, I'm not
           sure where; where he had received the services of  a  prostitute
           for his inauguration into his, you know, Right of  Passage,  but
           of course, this was not something that anybody could know about.

Melissa McSwigan:            Right.

Mary Guinan:     And it was not something that I would  be  able  to  track.
           You know, to find out that case. In fact, they were  very  vague
           about where the village was and how it was. So we  just  decided
           then to employ a member of the family, it was a father, to be at
           the door and  then  we  paid  a  vaccinator  to  stay  there  to
           vaccinate. We paid the parents money to keep the person  in  the
           house-keep the young boy in the house and  to  get  food  so  he
           wouldn't come out until we declared him to be non-infectious. So
           we went about, and I found out that when we go to  the  villages
           surrounding it, we didn't have maps, it wasn't like  you'd  say,
           "Okay let's draw a five-mile radius around this and try and find
           some maps to figure out what the radius was or how you could  do
           this." So, we got these rather rudimentary maps and  we  started
           going to the villages to try to vaccinate.  We  found  out  when
           people would come - we had a jeep, they were Mahindra &amp;amp; Mahindra
           jeeps I think is the name of them, and they were provided by the
           Indian Government, the jeeps; and when the jeeps  came  and  the
           only time the villagers ever saw a jeep come  in  was  when  the
           Family Planning person came and there was a  big  initiative  in
           India at that time to reduce the  population  and  to  introduce
           birth control, and they used to pay the men to have a vasectomy,
           gave them a portable radio was one of the  gifts  that  the  men
           would get.

Melissa McSwigan:      Mmh!

Mary Guinan:     And then were these - the Family Planning people  had  told
           us that they had to meet every month. They had to have  so  many
           vasectomies and so  many  tubal  ligations  and  they  were  not
           terribly receptive people so they saw this jeep coming and  they
           thought it was the Family Planning people and they all ran away.
           So nobody would be there. So we said, "We couldn't find  anybody
           to vaccinate, everybody disappeared." In India, you know, people
           would disappear and then reappear;  it  was  so  incredible  the
           number of people; when you go to India, all you  see  is  people
           everywhere. There's never any privacy. You  go  out,  you're  on
           this road and you're there in this  wheat  growing  and  things,
           this farm area and you go, and if  something  happened,  if  you
           broke down, my driver would just shout out, and all of a  sudden
           people would appear and they'd come out  of  the  fields,  there
           were people everywhere. They'd sleep in the  fields,  they  were
           there, but you know, with the  heat  they'd  be  hiding  in  the
           shade.

           So the whole idea of us  being  Family  Planning  people  caused
           problems for us to be able to do the immunization.  So  what  we
           decided to do was to do a survey of the town,  to  get  all  the
           names, and this was something that we understood what the people
           used to do that gave - what the politicians used to do  to  give
           resources to a town or village. They would take a census of  the
           village, and the village then - and  then  take  the  census  of
           everybody who lived in each house in the village and maybe there
           were 50 or 60 or 70 houses in the village  or  less,  and  there
           usually would be sometimes 10 or 15 people living  in  that  one
           room mud hut. So we would just go  in  and  say  we're  doing  a
           census; and we'd go to the village Elder and  talk  to  him  and
           tell him first that we were going to do the census; and then  we
           would tell him after we did the census when we had all of the  -
           then we would ask the Elder if we could  vaccinate  the  village
           and why. If the elder agreed then, we could  go  and  start  the
           vaccination.


           So we would go, but we knew how many  people  were  there.  They
           would all sort of list all these children and  you  always  knew
           that there was a child every year, so if you had a  one-year-old
           that look like one,  you  would  look  for  the  baby  somewhere
           underneath, hidden in blanket somewhere there was always a baby.
           So we would find a baby. It was just amazing, we would  ask  how
           old people were and they didn't know how  old  they  were.  That
           wasn't a concept to them, the children how old they were. So  we
           would just guess at their ages, and then we would vaccinate them
           and vaccinate each village until we completed the circuit.  Then
           I'd come back every once in a while to make sure that the  guard
           was at the door.  We  had  these  surprise  inspections  because
           people  didn't  really  understand  what  we  were  doing.  They
           thought, you know: Okay, they're going  to  give  me  money  for
           this, I'll do it, but then when I was out of sight,  well  maybe
           not understanding why they needed to keep  this  person  inside,
           they might not, you know - So we would come  back  regularly  to
           check every two or three days. Sometimes there wouldn't  be  the
           guard at the door and we say, "Okay, where is the guard?" and we
           had the guard and the vaccinator had a book in which  he  listed
           all the people he vaccinated so we'd know who  were  vaccinated.
           So that was my first start, and it was smallpox and then I  kept
           finding more smallpox cases.


Melissa McSwigan:            So that was your first  case,  but  there  were
      more?

Mary Guinan:     That was my first case, and then as we  went  from  village
           to village, I'd find another one and declare it  then,  I  would
           culture the lesion and send it off to the post office  and  this
           is a big thing to do, to find a post office that would take this
           and send it off to Delhi. You'd never know if  it  would  arrive
           there or not, because sometimes they didn't have stamps  at  the
           post office so you couldn't buy stamps and it was a  complicated
           system that you had to try and figure out  how  to  ensure  that
           your specimen got sent. So I kept sending them off and  then  we
           kept moving around from village to village; and the  person  who
           was in-charge of Uttar Pradesh  at  the  time  of  the  Smallpox
           Eradication Program was Don Francis and he would come to  visit.
           He came down to visit me about a month and two into it. I  lived
           in a mud hut outside and my paramedical assistant would try  and
           find some place for me to live, that would have a  shelter;  and
           sometimes we did and sometimes we didn't. It was  very  cold  at
           night. But there were all  sorts  of  things;  there  were  rats
           around that really used to scare me.  They'd  come  in  and  run
           around at night and the Indians always respected life.  So  they
           never killed anything. The Hindus didn't kill  anything  and  so
           there would be rats.

           One morning, there was a rat in my purse and I  told  my  driver
           there was a rat in my purse and he just opened the purse and let
           the rat out. Okay! So Don Francis came down to visit to see what
           we were doing because they wanted to make sure, you know  I  was
           new, of what you were really doing and actually, I was  a  woman
           and they weren't sure women could do those things at that  time.
           So Don came down and he said, "Listen, this place  was  declared
           free of smallpox and you are sending off all these sample saying
           there's smallpox. Are you sure these are smallpox?" I said,  "As
           sure as I can be. I certainly - all I can say is, to the best of
           my  ability  I  call  them   smallpox."   "Sure   they   weren't
           chickenpox?" "I think they were  smallpox,  it's  a  possibility
           that they were." He said, "Are you sure because you're causing a
           big sensation here. The leader, the Indian Public Health  leader
           in the area was very upset because he had declared his districts
           free of smallpox and I was saying it wasn't. So  that  caused  a
           little political problem. Anyway, it was miles and it would take
           them several hours to come to where I was, and they  went  back.
           Then as I moved toward the other villages that were infected  in
           this area, we had difficulty crossing  the  rivers.  There  were
           three rivers - parts of a river that  intersected  the  villages
           and each time I would have to cross the river; and  it  was  too
           deep for the jeep to cross it, so I decided  the  first  day  we
           came to this I said, "I'm going to  wigan[inaudible0:41:35]  and
           wade across" because the water was the water is about up to here
           maybe at my waist, and we're  going  to  wade  across  with  the
           supplies and everybody would wade across. So I always wore pants
           because showing your legs is not something that the Hindu  women
           or Muslim women do, so I had made a  series  of  Muslim  outfits
           like pants and a long shirt, a Kurta, I think it was called  and
           that's what Muslim women wore. The Hindu women wore  Saris,  but
           the pants were much easier for me to work in and I  always  kept
           my head covered. I had very long hair then, it was a braid and I
           decided before I went to India that I would dye my hair black so
           I wouldn't look so conspicuous.

Melissa McSwigan:            Did that work?

Mary Guinan:     No. Well, you know, when the  white  roots  started  coming
           out, they thought I was going grey; and it got  streaked  as  it
           went, and I'm pretty tall; so I was taller than what most people
           saw, so I stuck out in the crowd no matter what. So I decided to
           roll up my pants-now I tell you that showing legs isn't  a  good
           thing in India, and there was nobody around, but after I  rolled
           up my pants and started going across the river, a big crowd came
           out and there was a huge crowd, and I had rolled up my pants and
           I'd walked and crossed to the other side  to  get  the  supplies
           over, the vaccine, needles and things. Then we went and did  the
           thing and on return I realized that I'd caused some sensation so
           I just didn't roll my pants up, I just  waded  across  and  word
           travelled fast, who knows how, but it went to Delhi; and  people
           were saying, "Oh, I heard you went to..."

           Once a month we would have this meeting and Bill Foege  would  -
           Bill Foege was the head of the Indian  Smallpox  Eradication  at
           the time when I arrived, and he would come  up  from  Delhi.  He
           would go to each of the districts once a  month,  and  he  would
           come to Uttar Pradesh one day a week and then we would all  come
           in from the field, there were number of us; and he was the first
           person that we would talk with, and we'd take showers, I mean  I
           might not have showered in weeks and weeks. So you would stay at
           the hotel and meet friends, and they would  tell  you  what  was
           happening, and they'd show you how many cases of smallpox  there
           were and how they were decreasing and how close we were to zero-
           coming to zero in India; and that UP was winning from Bihar.  We
           were ahead of Bihar. So that was a monthly meeting  and  when  I
           was coming into town, we would stop at the railroad station  and
           I would know whether Bill Foege was there or  not  because  Bill
           was very tall, he's 6'6", and they would  always  know  when  he
           came from the railroad station. He was here. So they'd tell  me,
           "He's here." So I would know he was at the hotel.  People  would
           know you were with the smallpox program and they'd let to  know,
           I mean, word would travel fast and anything I did was  reported.
           People knew what I was doing and all. That  was  interesting,  I
           didn't do that again.

Melissa McSwigan:      How would you - let me interrupt you  for  a  second.
           How would you say that this experience that  you  had,  the  six
           months that you had in India, how would you  say  that  affected
           your career after that?

Mary Guinan:     Well, I became a believer. I believed  that  this  was  the
           way to go. I decided that I was going to have a career in public
           health because it was so successful. I mean, I couldn't  believe
           it, what you were doing and all the things you  were  doing  and
           all the problems you were having, and you would come,  and  it's
           working. It's actually working, so you were reinvigorated to  go
           out in the field and keep doing what you were doing because  you
           can't really see the results and you often see the  errors  that
           are made  and  sometimes  things  slipped  through  the  cracks,
           somebody didn't guard the patient, and did they possibly  infect
           someone else and you had a whole trail of smallpox moving about.
           You're always worried about that, but it worked. So I decided to
           work in public health-that changed my life.

Melissa McSwigan:      Did you keep travelling after that?  Did  you  go  to
           other countries as well?

Mary Guinan:     Yes, I've been probably all over the world.  I've  been  to
           Asia: Thailand and China, Japan; and Central and South  America.
           I guess the only place I  really  haven't  been  is  to  Eastern
           Europe. So it was the - during that time it was the Cold War  so
           there were lots of difficulties getting in and out of countries.
           But I came back and then I left CDC after  my  EIS  program  and
           then was recruited back to CDC, and then I worked at CDC for  20
           years then retired. I was part of the First Aid Task Force so  I
           was a trained Virologist and that's how my career evolved.

Melissa McSwigan:      It sounds like you faced a lot of  challenges  before
           you went for the Smallpox  Eradication  Campaign.  Particularly,
           you've talked a lot about being a woman and how  that  presented
           some obstacles as far as getting into school and so on. Did  you
           find that  in  this  particular  campaign  that  being  a  woman
           affected the work that you were doing? You talked a  little  bit
           about when Don Francis, I think you said, came to visit you, how
           they kind of doubted maybe your effectiveness?

Mary Guinan:     Well, they were worried. You know, as I  would've  been  in
           Don's place. It turned out they were all smallpox. But  I  think
           it did affect the people - I think it helped me  a  lot.  People
           were much more trusting of a woman than a man in that  situation
           when I'd go into a village.

Melissa McSwigan:            That was as far as the Indians were  concerned?



Mary Guinan:     Yeah, as far as the Indians were concerned. Because  I  was
           such a curiosity to them; and also, people helped me  a  lot.  I
           told you about these rivers.  We  had  problems  traversing  the
           rivers and the only way to get across was a boat, a camel or  an
           elephant. So there were always camel drivers and we  would  just
           wait until a camel came along then I would rent  the  camel  and
           then we'd get across; and how I got back  from  over  the  other
           side; we'd hope another camel would come or somebody would  show
           up with a rowboat and would row us across. We'd pay them to take
           us across. So one day, while we're working in the village,  this
           local Raja Saab they call him came, and he said, "What  are  you
           doing?" And I told him what we were doing and he  said,  "That's
           wonderful." He said, "Well, since you're having this difficulty,
           I have an elephant and I'm going to give you an elephant so  you
           can have this elephant to go across the river." So  I  got  this
           elephant. I mean elephants swim and their wonderful. Camels  are
           nasty and they want to bite you. It's really  difficult  getting
           on a camel. They'd turn around and bite you; and  the  elephant,
           very sweet and there was a Mahout, an elephant  driver,  and  he
           said to me, "When the elephant swims over this  river,  he  will
           take you up in his trunk, so you won't get wet" I said, "No. No.
           I'm not doing that. I'll get wet-it's okay if  I  get  wet."  So
           when we would go across, he would take the Mahout. The  elephant
           would take - it was a female, she would take the Mahout  in  her
           trunk and carry him over, and swim to the other  side  and  then
           I'd go; and then we'd come back and then somehow somebody  would
           call an elephant. The elephant would come and then take me  back
           to the other side.  Of  courts  Don  Francis  heard  about  this
           naturally, and he came saying he wants an elephant ride. He came
           down, he says, "I want my first ride." So  he  got  an  elephant
           ride. So I'm not sure, I think this man, because I was a  woman,
           he thought I needed help in getting across and so, he gave me an
           elephant. I gave it back to him. I didn't take it home.

Melissa McSwigan:      That would be kind of hard to fit and  you're  carry-
           on luggage I'm sure. What would you say is  the  most  memorable
           moment that you have from your time in India with  the  smallpox
           program, the memory that sticks out the most?

Mary Guinan:     Well the memory is - and the first is  the  cultural  shock
           of going to a country  where  you  don't  know  the  morays  and
           learning them it's a bit of a  - it was  one  of  those  culture
           shocks that it would take years to  adapt  to,  you  take  these
           small steps. But I think that the most exciting thing  was  that
           it worked and that these monthly meetings that we would  go  to,
           we would learn that it was working. It was just - and that whole
           idea that this is actually going to work. I mean, it's  actually
           going to work was intoxicating. So that was the  most  wonderful
           thing about - and the thing I remember, it was effective.

Melissa McSwigan:      Well, is there anything else that you would  like  to
           add, to tell future  public  health  professionals  like  myself
           about the time and the program and so on that you would like  to
           share?

Mary Guinan:     I don't think so. I don't know  what  I'd  say  except,  an
           opportunity like this where your Government was doing  something
           and you have an opportunity for public service, it's  just  -  I
           don't know that I got any better satisfaction of  anything  I've
           done in my lifetime, than feeling like I  participated  with  so
           many other people  from  other  nations  to  do  something  that
           improved people's lives and you had an opportunity,  I  mean  it
           was a privilege to have that opportunity, so  I  feel  that  our
           government who was doing what I thought, such  terrible  things,
           but somewhere there was someone doing this wonderful  thing.  It
           was in these rickety old buildings at CDC that nobody ever heard
           of  then,  CDC  wasn't  in  the   spotlight,   and   all   these
           Quonset[0:53:41] huts out in [inaudible  0:53:43],  that's  what
           people were living in. I mean this is CDC and it was  these  old
           Government buildings, but these people  planned;  imagine,  they
           planned as  well.  They  were  part  of  the  planning  of  this
           momentous event, and I feel very privileged to have been a  part
           of it. So it was that sense  of,  I  guess,  if  you  have  that
           opportunity to do something that's outside of anything you could
           possibly do as an individual, do  as  a  team,  then  that  will
           surely be one of the greatest satisfactions in your life.

Melissa McSwigan:      Well, thank you very much for  your  time  and  thank
           you for sharing your stories.

Mary Guinan:     Okay.


[End of audio - 0:54:36]
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