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                  <text>Malaria Control: CDC Beginnings</text>
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                  <text>&lt;div class="landing"&gt;
&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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                <text>LANGMUIR, ALEXANDER D. </text>
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                <text>&lt;p&gt;&lt;strong&gt;&lt;em&gt;Leaders in American Medicine: Dr. Alexander D. Langmuir &lt;/em&gt;&lt;/strong&gt;Interviewed by Dr. Donald A. Henderson. A National Medical Audiovisual Center Production in cooperation with Alpha Omega Alpha. Atlanta, Georgia&lt;/p&gt;
&lt;p&gt;Dr. Alex Langmuir began by sharing that his sources of inspiration for Public Health were Margaret Sanger and Dr. George Bigelow at Harvard.  After Cornell Medical School, he enjoyed a formative internship at Boston City Hospital, trained with the NYS Health Department, and earned an MPH at Hopkins. He believed his notoriety from identifying polio in New York led him to the Respiratory Diseases Commission Laboratory.  However, he was confident that the Communicable Disease Center (CDC) offered more promising opportunities and was easily recruited.  At the CDC, he eagerly reshaped the malaria eradication program into Malarial Appraisal &amp;amp; Surveillance Teams.  Never shying from controversy, he fought the National Institutes of Health (NIH) for rights to epidemics, indicated that Gamma globulin was of little practical value, and identified Cutter Laboratories as the source of polio vaccine problems.  He also discussed salmonella outbreaks, immunization and state services, hospital infection and diarrheal disease programs, the Mortality, Morbidity and Mortality Weekly Report(MMWR), and avian flu.  He briefly spoke of EIS officers, trainings, and conferences.&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;KEY WORDS:&lt;/strong&gt; Epidemic Intelligence Service (EIS), surveillance, National Medical Audiovisual Center, Alpha Omega Alpha, Department of Health, Education, and Welfare, Public Health Service, National Institutes of Health, National Library of Medicine, National Medical Audiovisual Center, Harvard, Cornell, Boston City Hospital, New York State Health Department, Johns Hopkins School of Public Health, polio, Respiratory Diseases Commission Laboratory, Adenovirus 4, CDC, Malarial Appraisal and Surveillance Teams, Bronfman Prize, NIH, 1955 Cutter Incidence, oral polio vaccine, staphylococcus, Morbidity and Mortality Weekly Report (MMWR), Immunization and State Services, leukemia, family planning, World Health Assembly, “Global Surveillance of Communicable Diseases”&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;KEY NAMES:&lt;/strong&gt; Dr. Alexander D. Langmuir, Dr. Donald A. Henderson, James A. Campbell, Dr. Beatrice C. Seegal, Dr. David E. Seegal, Margaret Sanger, Dr. George H. Bigelow, Dr. Edward S. Godfrey Jr., Dr. Maxwell Finland, Dr. David D. Rutstein, Dr. Edward Rogers, Dr. Edward S. Godfrey, Dr. George H. Ramsey, Dr. Earnest L. Stebbins, Dr. Hollis S. Ingraham, Wade Hampton Frost, John H. Dingle, Dr. Justin M. Andrews, Dr. Joseph Mountin, Philip S. Brachman, Dr. Carl W. Tyler, Dr. Clark W. Heath Jr., Dr. Walsh McDermott, Charles “Mickey” LeMaistre, Dr. Karel Raska, Albert B. Sabin, John R. Paul, James Trask&lt;/p&gt;
&lt;p&gt;&lt;em&gt;“As I looked it over and saw the vision, there was no question, Justin Andrews took me to the mountain and showed me the Promised Land and everything he said was there…the range of opportunity, the potential was perfectly obvious, and my considerable self-confidence, even though I was depressed at the academic situation, I had no trouble going.”&lt;/em&gt; –Dr. Langmuir on being recruited to the CDC&lt;/p&gt;</text>
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                <text>The David J. Sencer CDC Museum at the U. S. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333&#13;
www.cdc.gov/museum&#13;
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                <text>6/2/1979</text>
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                <text>A black and white photograph of Dr. Alexander D. Langmuir with EIS officers Dr. Donald N. Wysham (EIS 1955) and Dr. Reimert T. Ravenholt (EIS 1952).</text>
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                <text>Dr. Reimert T. Ravenholt</text>
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                  <text>Smallpox</text>
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                  <text>&lt;div class="landing"&gt;
&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;
This is an interview with Diane LaPointe  about her activities in the West
Africa Smallpox Eradication Project. The interview is being conducted at
the Centers for Disease Control and Prevention in Atlanta, Georgia, on July
14, 2006, as a part of the 40th reunion of the West African Smallpox
Eradication Project, to mark the launch of the project. The interviewer is.

NOVA: Would you take a few moments and just describe your early life-where
           you were born and your education?
LaPointe:   I was born in Portland, Maine, and I attended Cathedral High
           School, which is a Catholic girls' high school in Portland,
           Maine.
LaPointe:   I also went to college in Maine, at St. Joseph's College in
           Lake Sebago. After I graduated, I did 1 year of volunteer work
           in Camden, Arkansas, as a teacher for the extension lay
           volunteers and then returned to Portland. My husband, Mark, was
           in the Peace Corps for 2 years before that, and he also returned
           to Maine. We each did a year of teaching in Maine, and after
           that year, we were married and then came to CDC [Centers for
           Disease Control] right after our honeymoon.
NOVA: How did Mark get involved in the Smallpox Eradication Program?
LaPointe:   He was teaching at Mechanic Falls High School in Mechanic
           Falls, Maine, and received a call from someone who was hiring
           for this program at CDC. I believe they were looking for people
           who had African experience and were able to speak French, and so
           his name was suggested by the director of the Peace Corps. Mark
           was hired over the phone. My, how things have changed, to be
           able to get hired over the phone.
NOVA: Absolutely. So, tell me a little bit about what it was like. You're
           living in Africa, you're an expatriate, and it's a different
           country, a different culture. Talk a little bit about that.
LaPointe:   Well, I'd like to, if you don't mind, start with our coming
           here.
NOVA: Okay.
LaPointe:   We married in June of 1966 and took our honeymoon. Mark had
           bought a little Volkswagen bug secondhand; it got 12 cents a
           mile. On the way down to Atlanta, our car broke down in North
           Carolina. So we put all of our belongings in a storage place in
           North Carolina-our belongings were in that Volkswagen bug-and
           took a bus down here. We left the car there to be repaired and
           came and stayed at a hotel in Atlanta.
            Mark would come over here to CDC to do his training, and I'd
           get on the local bus with the newspaper and sit behind the bus
           driver, looking for an apartment and telling him that we were
           going to be at CDC. He would tell me where to get off and point
           in certain directions. So we got a place on Briarcliff and
           started the smallpox training program here, which to me was one
           of the wonderful experiences that we've had, meeting all these
           people.
                 We had intense French training, the [unclear] program,
           where you just saw the pictures and heard the people speak. You
           never saw a written word. That's how we were trained. A group
           came from France, and we did all the training here and met all
           the people who were going to be going to West Africa. We formed
           a real feeling of camaraderie with all of these people.
NOVA: How long was the training?
LaPointe:   I believe it lasted throughout that summer and into the early
           fall. We spent all day with the French-speaking trainers, and
           sometimes in the evening, so we were really not supposed to be
           speaking English at all. It was very intense. It was wonderful.
NOVA: So, how soon after the training did you move to Africa?
LaPointe:   We went back to Maine and got together some household items and
           we flew out probably in October or November of that same year to
           Libreville, Gabon, in West Africa.
            And I do remember an experience there right at the beginning.
           Mark would go off to the embassy and work with his colleagues
           there, with the AID [U.S. Agency for International Development]
           people. We didn't have a place to live yet, so we were at the
           local hotel. And this was my first attempt at using my French.
           So we would get up in the morning. Mark would go off to work,
           and I would go to the restaurant and ask for an orange juice in
           French, jus d'orange [sp.]. And I'd never get orange juice; I'd
           get grapefruit juice. So after a couple of days of that, Mark
           came back from work, and I was in tears. I said, "I can't speak,
           I can't even say orange juice in French. What am I going to do?"
           And so he went to breakfast with me the next morning and he
           asked for orange juice, and they brought him grapefruit juice.
           But he had the foresight to ask, "Why didn't you give me orange
           juice?" and it was because they didn't have any. So that  kind
           of alleviated my concern about speaking French.
NOVA: That's funny, that's funny.
LaPointe:   We had an apartment right on the ocean. I mean, for 2 young
           people, newly married, we had this wonderful apartment,
           completely furnished by the government, overlooking the water.
           It was very, very nice.
                 I was pregnant at the time. I had become pregnant right
           away. So we began thinking about where I was going to have our
           first child. Speaking with the doctor there in Libreville, who
           was a Peace Corps volunteer doctor, we had thought about going
           to Lambaréné, which is Albert Schweitzer's hospital, but we were
           discouraged from doing that. They said they didn't feel there
           were adequate facilities in case of an emergency. So it was
           decided that I would go up to the Cameroons. We knew Arlan and
           Edith Rosenbloom, who were there. So I went up there in my 8th
           month.
                 I flew up and spent my time with them and then went out to
           a hospital in Ebolowa, which was run by an American missionary
           group. I was flown there. It was a very small plane, a 2-seater
           in addition to the pilot. Beside me was an elderly Frenchman.
           Because this was out in the bush, they buzzed the hospital to
           tell them somebody was coming. And I guess I had a look on my
           face that looked as if I was going to pass out. The little
           Frenchman next to me said that he had candy with him and he
           tried to feed it to me so I wouldn't pass out. When the plane
           landed in a field, a nurse from the hospital came, with a cot,
           and I was picked up and taken to the hospital. I spent I'd say a
           week or 10 days there.
                 There was another American woman there, too, who was from
           the Cameroons. We became friends, and we hung out with the
           nurses and the doctors and played Mah Jongg.
                 Mark drove up from Gabon. It took him a while to get
           there, I guess, and he thought the baby would have been born by
           the time he got there. But when he arrived, she had not yet been
           born. So we took a walk around the campus of the hospital that
           day, and that evening our daughter Mary was born.
NOVA: I hope your daughter appreciates the trouble you went through to get
           to a hospital to deliver.
LaPointe:   I think so.
NOVA: What was it like raising your children there?
LaPointe:   Actually, it was very easy. We had help, which was something
           very new to me. We had a woman who would come every day and do
           our laundry and clean our house. I really took care of Mary
           pretty much myself, but that woman was there to help me. It was
           beautiful in Gabon. There were beaches there. So we spent a lot
           of time going to the beach and taking walks.
                 Gabon was very French. It was a former French colony, and
           there was still a large French presence there. So I didn't get
           the feel that I got later, when we went to Mali, of that African
           experience of the marketplace, because it was all French shops.
           We developed a wonderful relationship with a French family that
           lived upstairs from us. The woman took me under her wing. She'd
           take me shopping. And her 2 daughters loved my baby. So we did a
           lot together as family.
                 The thing I remember most is that all of those
           relationships you made took the place of family-although they
           certainly couldn't replace them. But they helped with that
           feeling of loss of family. They became your family.
NOVA: How long were you there?
LaPointe:   We were in Gabon probably about 2 years, and then we were
           assigned to Mali, to Bamako.
NOVA: And there was a big difference between the 2 places?
LaPointe:   Absolutely, yes. Gabon was, as I said, very French, and located
           on the water. Mali was inland, on the Niger. But the culture was
           so rich that I didn't miss the ocean-I had thought I would. But
           I got so engrossed in the culture of the people. That was a real
           experience. That was really going to Africa for me. The people
           were wonderful.
                 Our second daughter was born. I went back to the States to
           have her. We had the Rh-negative/-positive situation, so I went
           back to Maine and then came back with Michelle.
                 In Mali, we lived in a little compound. There were maybe 5
           houses, all young American couples, people with the embassy who
           lived in our area there.
                 And, again, we had help. We had a woman who would come in.
           She liked to take the children and go off. I didn't really like
           that because I wanted to spend my time with them. But she felt
           that was her job. But I enjoyed going to the market; I learned a
           bit of the language, the Bamber [phonetic] language. I liked to
           go and bargain with the women at the market.
                 We had to be careful about boiling our water, and
           filtering it, as well as washing and soaking all our vegetables.
           And if you hung your clothes out to dry, flies would leave their
           eggs on your clothes. They could get into your skin, so
           everything had to be ironed.
                 But I just had a wonderful experience because I was very
           young.
NOVA: What was your toughest problem that you faced while you were there?
LaPointe:   Sometimes Mark would be gone for long periods of time. He
           couldn't stay in the capital all the time; he had to go out and
           do his business out in the villages. Those separations were
           probably the most difficult times.
                 Another incident I remember is that when we were in Mali,
           I traveled with Mark once up into the desert. We left our
           children with some good friends. I can't remember the exact town
           we went to, but this was in the period right after there had
           been a coup in Mali, and the president was imprisoned in this
           town. There were guards around the prison. I wasn't aware that
           you couldn't take pictures. So I was out taking pictures,
           completely unaware of not being able to do that. Later, at our
           hotel, we got a tap on the door, and the local gendarme came and
           confiscated the camera and put us under arrest. We had to stay
           there at the hotel. Mark spoke to the head of the health
           department who he was visiting there, and I believe that man
           must have interceded for us and finally got the camera back. I
           think they took the film. But that was pretty frightening. So
           that's something that has stuck in my memory.
NOVA: Nerve-racking.
LaPointe:   Very much so.
NOVA: And I'm sure you were worried about your children.
LaPointe:   Right, exactly.
NOVA: Earlier, you talked about, shopping and going to the market in Gabon.
           What did you do in your spare time when you were in Mali?
LaPointe:   Much of your day was spent shopping and bargaining. I love to
           sew, so I enjoyed going to the market and buying African
           material. I used to make a lot of dresses and skirts and things
           with the African fabric. I became friends with Peggy Yates, the
           wife of John Yates, a political officer. They had 3 children, so
           we did a lot together. They had a little pool, and we didn't,
           and so a lot of our day was spent over there visiting with them.
           Or we would get in the cars and go off somewhere, find someplace
           to take the children. And then on weekends, groups of us, with
           our husbands, would get together and go out and try to do as
           much as we could around the area.
                 One particular incident I remember is when we all went off
           with the kids on a Sunday to a place near the river. It had
           recently rained, and the cars got stuck in some African lady's
           field, and she was not very happy about it. John Yates was able
           to hail some African guy with a Mobylette. So he went into town
           and got somebody to come out with a truck and chains. We all sat
           out in the field on blankets and waited until they rescued us.
                 But I think most of our day was spent shopping. I like to
           cook, so learning how to cook some of the local foods and just
           raising children and enjoying the friendship of the other people
           that we met filled my days.
NOVA: How do you think participating in the project changed your life?
LaPointe:   Completely. Even to this day, we have a lot of interaction with
           Africans. We went back to Africa again (not with the smallpox
           program), and the children went to French schools. That changed
           their lives. It opened their eyes to a whole different side of
           the world, the poverty, how much we have as Americans, an
           appreciation for what we have. Our daughter Michelle learned to
           speak French. She was younger and she just picked it up; she was
           so fluent in it. So when she went off to college, she majored in
           the romance languages, and that led to things for her.
                 I've done work since we've been back. I taught. I'm a
           retired teacher. But when I retired, I volunteered with teaching
           English as a second language for African women, and, as I said,
           we have a lot of African friends to this day. At our church,
           Corpus Christi, there's a large African community, and we've
           been very involved in things relating to Africa. The experience
           really changed our life completely. I don't know if we'd still
           be in Maine, if I'd still be teaching there. I don't know. I
           can't even think like that.
NOVA: What difference would it have made if families, say the spouse and
           children, could not have joined the CDC employees or the medical
           officers, the folks that were there doing the work? What kind of
           difference do you think it would have made if the families would
           have had to have stayed back home in the United States?
LaPointe:   I can't imagine. I think it would have been very difficult.
           First of all, you wouldn't be able to relate to anything your
           husband was going through. To be there together, you were in it
           together. It would have been a great loss for me, and I think it
           would have been very difficult on our family. I know we have had
           separations like that, and it's very difficult on families, the
           tensions when you get together, and the wife becomes the boss of
           the house, that kind of thing. I don't think I would have
           understood what he had been going through when he'd come back
           and talk about it. I just don't think it would have worked. I'm
           really happy to have been part of that. It was a whole new life
           for us.
NOVA: Is there anything that you would have changed if you had to do this
           all over again?
LaPointe:   I can't think of anything, really. We really enjoyed it. We've
           made lifelong friends, some of them with CDC.
                 A lot of these people [at the reunion] we have not seen
           since back then. But we have 1 friend in particular, Jay
           Friedman [Jay S. Friedman], who lives here, who we've been
           friends with him since we started here. That's 40 years. The
           Roys are another couple that we know. And some of the friends we
           made while we were living in Africa, the people at the embassies
           who had children, we're still friends with a lot of them. Our
           children became friends with their children, and they still stay
           in touch with each other. So we've developed this network of
           friends that will just keep going on.
NOVA: Wonderful. Is there anything else that you'd like to add?
LaPointe:   Just that I'm very happy that we did this. I know it's just
           made a big difference in my life, and, of course, Mark's. We
           came back here to CDC, and that was his career. I'm looking
           forward to seeing a lot of the people who I haven't seen in so
           long today. I'm so glad to have had the opportunity.
                                    # # #
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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;
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&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;
This is an interview with Mark LaPointe about his experience and
involvement with the West Africa Smallpox Eradication Project. The
interview is being conducted at the Centers for Disease Control and
Prevention in Atlanta, Georgia, on July 14, 2006, as a part of the 40th
reunion of the West African Smallpox Eradication Project, to mark the
launch of the project. The interviewer is Diane Drew.

Drew: Mark, I wonder if you could start by sort of telling me a little bit
           about your background, your education, where you grew up.
LaPointe:   I grew up in Maine. I majored in English at Assumption College
           in Worcester, Massachusetts. After graduating, I went into the
           Peace Corps in Guinea, West Africa, where I learned a little bit
           about Africa and got fluent in French, very fluent. I went
           something like 4 months without speaking English. Then I taught
           French and English in a high school in Mechanic Falls, Maine-
           French to the college-prep kids and English to the shop kids. I
           think they gave me the job because I was big.
Drew: And you could keep them under control.
LaPointe:   I could keep them under control. Just for the record, I'm 6'1"
           and about 220, and I guess they had a teacher before who they
           terrorized, even tied him up.
Drew: And that goes back a few years. That was like high school is
           nowadays.
LaPointe:   They were nice kids.
                 But anyway, during that Christmas vacation, I went down to
           see some friends in Washington. I saw Stan Shaya [phonetic], who
           was the Peace Corps doc when I was in Guinea and went on to
           become the medical director of the Peace Corps, and he asked me
           about teaching. I said I liked it but that I didn't know if I
           wanted to do it for a career. I said, "If anything interesting
           comes up, let me know."
                 And, literally, I was teaching school, and I got a call
           from a woman named Faye Hendrix at CDC who asked me if I would
           be interested in the smallpox program. Evidently, Billy Griggs
           [Billy G. Griggs] was in Washington, talked to Stan Shier, and
           told him they were wanting to recruit for the smallpox program
           in-house, but they wanted a few folks who had been in Africa
           just to sort of fill it out. So there were about 4 or 5 of us
           who were ex-Peace Corps volunteers.
                 And so, literally, I was teaching a class, and I got a
           call. In those days, a long-distance call was a big deal. So
           they said, "Hey, do you want to do the smallpox program?"
                 And I said, "Sure."
                 I was, what, 24 at the time.
                 So I drove down 1 day to Concord, New Hampshire, and
           interviewed with Leo Morris. He offered me a job. And Diane and
           I got married on June 25 and drove to Atlanta for training. She
           always teases me that I'm a cheapskate and that I earned 16
           cents a mile on my honeymoon.
Drew: Somebody that I talked with yesterday, either Jay Friedman or Betty
           Roy was in the Peace Corps, too.
LaPointe:   Both Jay and Jean [Jeannel A. Roy] were in the Peace Corps.
           Jean was in Cameroon and Jay was in Sierra Leone. Also Tony
           Masso [Anthony R. Masso]. Those were the ex-Peace Corps
           volunteers that CDC brought in. I think it was good because
           sometimes people had questions about this, that, and the other
           thing because at that time, people didn't travel that much,
           especially to that part of the world., and they could come to
           us.
            So, anyways, this is the 40th anniversary of the smallpox
           program in West Africa, and Diane and I had our 40th anniversary
           10 days ago.
                 People talked about the smallpox program, but it was
           actually the smallpox eradication-measles control program. That
           was very important because a lot of the countries, especially
           the francophone countries, had what they called the Service des
           Grandes Endemies (SGE), which were mobile health teams that were
           run by French military doctors who were assigned to Africa. And
           pre-vaccines, if you looked at data for measles, there was a
           very pronounced peak and valley every 2 or 3 years and a high
           mortality rate. And these Service des Grandes Endemies tried to
           control smallpox, but they didn't believe in eradication. And so
           in the francophone countries, you didn't have the problem with
           smallpox that you did in some other countries.
                 A measles field study had been conducted in then Upper
           Volta, now Burkina Faso, in the early '60s. And the results were
           very, very positive. So the African francophone community really
           wanted measles vaccine. There was actually a measles control
           program, which was the predecessor of the smallpox program, but
           it wasn't very well managed and it had all sorts of problems.
LaPointe:   The Minister of Health of Upper Volta came to Washington, and
           he said that his country wanted the measles program. And because
           the situation was such a disaster, a lot of CDC people-I think
           Mike Lane [J. Michael Lane] was one of them-went to West Africa
           and reviewed the measles control program. They concluded that it
           was not a medical problem, but an operational, logistics
           problem. And so that's where they got the idea of guys like us
           (I became an operations officer) going over.
Drew: It seems to have been really critical to the overall program.
LaPointe:   Yes. As time went on, although they realized that physicians
           were good, they also realized the value of good managers and
           operations officers.
                 But anyway, when AID [US Agency for International
           Development] came to CDC and said, "Can you run the measles
           control program?" CDC said that it wanted to do smallpox
           eradication too. That's an oversimplification, of course.
Drew: Sure.
LaPointe:   And so, that was that marriage.
                 And I know in the anglophone countries, especially places
           like Sierra Leone and Nigeria, they really wanted the smallpox
           eradication program, and so they took the measles control with
           it.
                 But anyways, I think we talk about smallpox eradication .
           . .
Drew: And kind of forget the other . . .
LaPointe:   Yes. And many Africans were more concerned about measles than
           smallpox.
Drew: Because they were losing a lot of children to that.
LaPointe:   Oh, yes. We would hear stories of measles just decimating the
           pediatric population of a village. And you'd hear stories about
           a woman who had several children under 5, and measles would come
           along and all of a sudden she had none. So I just feel, for the
           record, that it's important to state that for many countries
           measles control was more important than smallpox control.
                 Some of the French military physicians would ask me,
           "What's this eradication stuff? We've been controlling smallpox
           for years." There was always the debate whether smallpox control
           was adequate. Plus eradication is such an absolute. And so
           physicians in the French military community would say, "Well, it
           gets down to nothing. There's a little flare-up, we send some
           people out and vaccinate, and it calms down again."
Drew: So they were skeptical about eradication?
LaPointe:   Well, you know, they thought eradication might be too
           difficult. But I think that was one of the beauties of the West
           African program: they showed that if you can pull off the
           eradication program in West Africa, with all the problems there,
           there was a case to be made that it could be done globally.
Drew: So some of the lessons learned, then, during that period probably
           applied in subsequent countries.
LaPointe:   I think the biggest lesson was that, although mass vaccinations
           were good, CDC questioned whether you really needed them for an
           eradication program, especially with a disease like smallpox
           that, over time, especially in West Africa, proved not be as
           infectious as people thought it was. Originally they thought it
           was going to be an urban disease, and actually it was a rural
           disease.
                 That's another thing: they talked about search and
           containment strategy, but many of these countries had what they
           called firefighting teams. If there were an outbreak someplace,
           people would go out and vaccinate. So it was sort of a
           containment strategy. It was haphazard, ad hoc. But the notion
           that you would run mass vaccinations and just do the whole
           country, and if there were an outbreak in an area where you
           weren't vaccinating, it was left unattended-that's not true at
           all. You got some vaccine and went out and did what you could.
Drew: So, even when there were mass vaccinations, even then there were
           containment strategies?
LaPointe:   Yes. They had these strategies. If there were an outbreak
           someplace, you just wouldn't sit there and say, "No, we're doing
           mass vaccinations. We're not going to go out with that." So I
           think that what Foege [William H. Foege] did is that he
           institutionalized that, sort of codified it for the campaigns in
           the subcontinent. Am I straying?
Drew: No, no. Please don't worry about that. I feel that you and the others
           I've talked with are the ones who have the stories, the
           experience, and from my conversations with Dr. Sencer [David J.
           Sencer], I think the interest is in trying to gather the heart
           of your experience. So maybe tell me about where you were and
           what the living conditions were like.
LaPointe:   Well, we came down to Atlanta, and we had our training from
           July through November. And as projects agreements were assigned
           in countries, then you'd get the go-ahead to leave. Diane and I
           went back to Maine in mid-November and just waited for the word
           to go. We were assigned to Gabon and got there in late November
           of '68.
Drew: So, you celebrated your first Christmas together in Gabon?
LaPointe:   Yeah, we did. And Gabon was an interesting country because it
           was very rich and underpopulated. At that time, the official
           census was something like 450,000. It's a country that has
           always had a problem with its demography because the birth rates
           weren't very high. Some people attributed it to a lot of
           untreated gonorrhea.
Drew: I'm not that knowledgeable about Gabon.
LaPointe:   It's on the equator, very wealthy. It had a little bit of oil.
           It was one of the smaller members of OPEC [Organization of the
           Petroleum Exporting Countries], which was just started when we
           were there. Gabon had uranium, manganese, a big iron-ore
           deposit, and wood (because it was heavily forested), and it was
           very much controlled by the French. My counterparts were mostly
           French. My direct counterpart was a Frenchman about my age, Alan
           Gourdon [phonetic], and we got along pretty well. We had a good
           time together. The head of the Grandes Endemies, that mobile
           unit, was Jean Montinazo [phonetic], and the dean of the medical
           community was General Gee Sholiak [phonetic]. These people, even
           to this day, have stayed in contact; I saw them last about 3 or
           4 years ago when I was in France. The Grandes Endemie was very,
           very prominent. Gabon was very interested in measles control
           because it hadn't had a case of smallpox since '63, and it was
           '66 when we were there. But the SGE bought into the notion of
           mass campaigns because the vaccines for smallpox that they used
           really weren't that good.
                 The experience was good for me because I worked with the
           French. I think I got to understand them and I got very involved
           in the community. If Diane or I made a mistake in French, the
           neighbors would tease us and correct us. And so we got to be
           pretty close friends while we were there. that are still
           entrenched with, the parents, the kids, and the grandchildren
           have visited in the States, and we've visited them.
Drew: Which is a great side benefit.
LaPointe:   Yes, it was.
                 But they were very fixed in their ways. I think a lot of
           the things that CDC was promoting-epidemiology, surveillance and
           reporting, using data as a tool to control disease-were used for
           their records, more for their archives than to really help
           control disease.  So there were these continual little-I can't
           say they were squabbles, but debates-about how you're going to
           do this stuff or improve surveillance.
Drew: Kind of maybe not being altogether on board with CDC's way.
LaPointe:   Well, no. At that time I think the CDC was the new kid on the
           block, and people really didn't know much about it. That was
           CDC's first overseas project. By contrast, the French ran
           institutions, like the OCEAC [Organization de Coordination pour
           la Lutte contre Endemies d'Afrique Central], which is the
           medical community in Central Africa, that did training (it was
           based in Yaounde, the capital of Cameroon, and people would go
           there for their training and almost eschew training elsewhere).
           And the French had the same thing up in the OCCGE [Organization
           de Coordination et de Cooperation pour la Lutte contre Grandes
           Endemies] countries and Bobo-Dioulassou.
                 I worked in the smallpox program, and I also had several
           other African assignments right up until 3 years ago, so you can
           see things over a period of 40 years. And what's interesting is
           that these organizations are now pretty much passé.   At the
           time the role  of the paramount trainers and policymakers in
           that part of the world had fallen on hard times because the
           French don't support them as much, Now, people realize that WHO
           training, CDC training, and training in the tropical institutes
           in Holland and in Belgium are all very worthwhile. So I was
           working in Gabon in sort of the heyday of the French dominance
           in that part of the world.
                 So, I think in terms of getting the teams trained and
           building a warehouse and a cold room and things like that, I was
           busy. But I thought the real action was in West Africa.
Drew: So in some ways, your assignment was a little more low-key than some
           of the others?
LaPointe:   Well, it wasn't a high priority, I guess, because of the small
           population of the country, for 1 thing. And the infrastructure
           of some of places-the roads were abysmal, especially in the
           rainy season. I remember taking something like 36 hours to go 40
           miles.
Drew: Amazing.
LaPointe:   And we had to dodge trucks and this and that. People chided us
           about not having a winch on our vehicles to pull us out of the
           mud/
                 Once, we had had to rebuild a bridge because our truck
           went through it. We took the jack and got a 2×4 or something
           like that from the bridge. I jacked it up and found a hard spot,
           in about 5 feet of water, and jacked it up. We took turns doing
           that. It was miserable. I was young then; I could do that.
           American ingenuity born of necessity,
                 But those are the sorts of adventures we had in Gabon.
           It's such a different place. It was newly independent-I think it
           got independence in '63. And there wasn't much of an
           infrastructure.
                 Now, once they have some money from OPEC and started
           building their own . I haven't been back there. It's sort of
           like a forgotten country on the continent because it has such a
           small population.
                 I have a friend who was the ambassador there. We were
           talking about the demography of Gabon, and he was saying that,
           even today, they have the population up over a million, but
           nobody can count the people. They must be counted 3 times. And I
           remember when I was there, the population count all of a sudden
           went, with the stroke of a pen, from 450,000 up to something
           like 600,000. And the ambassador, a wonderful man named David
           Bane, called me and he said, "What do you think?" and I said,
           "According to all of our figures, there's been no change." And
           my theory was, is, that they would count people twice. They
           would count them in the village and then, as they moved into
           town, they'd count them in the town. But there's no way in the
           world that they had that increase.
                 The president who took power when I was there is still in
           power.  He must be the longest-serving head of an African state.
Drew: What's his name?
LaPointe:   Well, when I was there, his name was Albert-Bernard Bongo. He
           became a Muslim about 20, 25 years ago, and now his name is Omar
           Bongo. When I first got there, the president was Léon M'ba, and
           he was sick. He was in Paris, and the cabinet used to fly to
           Paris about once a month and have signatures and this and that.
           It was sort of a tempest in a teapot. There were several people
           vying to be vice-president, knowing that Léon M'ba was going to
           die. Léon M'ba died in the summer of '68, and Bongo, somehow,
           was appointed president. The country, as I've said, was
           dominated by the French, and there was a fellow named Jacques
           Fokka [phonetic], and he used to come in. He was some sort of a
           political henchman of de Gaulle and the people who ran the
           ministry. The French community had great trepidation because he
           could fire people. So I think he and some other people decided
           that Bongo was their man, and so he's been in power ever since
Drew: That's amazing.
LaPointe:   Yes. He's been around about 38 years, and he's still a
           relatively young guy.
Drew: He must have been very young.
LaPointe:   Oh, yes. He was in his early 30s or mid-30s.
                 So, after that, we headed up to Mali. Our older daughter
           was born while we were in Gabon. Diane is talking about that in
           her interview. She had Mary in a missionary hospital in
           Cameroon.
LaPointe:   So we went up to Mali, and that was different work. I had been
           the only CDC person in Gabon. Up in Mali, I was working with Pat
           Imperato, the CDC epidemiologist in Mali, that was different,
           just the opposite. Gabon was firmly in control of the French,
           whereas Mali had socialist notions, Marxist notions. A lot of
           the people we worked for were confirmed socialists and Marxists
           because those were the people who supported African
           independence. They bought into the philosophy that the riches of
           Europe come from exploiting Africa.
Drew: In Mali, were you dealing with migrant people with cattle and stuff
           like that?
LaPointe:   Yes. In Mali,  Pat did a study called the Tranjo Mas. In Mali
           there was a whole series of movements, depending on the season.
           During the rains, the cattle herd stayed stationary because they
           had adequate pasture, plus people liked to stay home during the
           rainy season because it rained a lot. The nomads liked to go way
           north during the rainy season to get away from the mosquitoes;
           and so the Tuaregs would go way up almost to the Algerian
           border. The hill cattlemen would stay in south-central Mali. The
           fishermen would stay in their village. And the Sauri [phonetic]
           stayed up around the Niger River. As the waters dried up, the
           northern nomads would come south to follow the grass. And then
           the southern herds of the [unclear] would come. And right in the
           middle of the [unclear] delta or the Niger was something called
           Lake Dabo.
                 And I remember Pat and I went up there, and he felt it was
           like a National Geographic special because all these folks would
           come together to Lake Dabo. They all had their little turf. You
           would meet people, try to vaccinate them, and find out if they
           had any smallpox. That's how we did surveillance.
Drew: And you were also doing measles vaccination?
LaPointe:   Yes, and then other things. Mali had a big yellow fever
           outbreak, and so we were doing yellow fever vaccinations. We had
           Russian oral polio vaccine, Sabin, and they were like little
           bits of candy. We used to go crazy because the vaccinators
           thought they were candy and would start eating them.
                 We were funded for measles and smallpox, but yet when a
           crisis would come along, we were a viable operation. We had as
           many as 30 teams.
Drew: So you had the manpower and the structure and so forth to be
           flexible?
LaPointe:   Yes. One of the great lessons, I think, in public health, is
           that most of our vaccinators were not trained, except by us. I
           mean, they called themselves nurses, but they weren't. They were
           people we recruited. Some of them were illiterate. But they
           formed teams and they did a great job.
                 I don't think they've gotten enough credit. We talk about
           some of the people who went on to become very prominent in
           public health, but a lot of that work was done by teams of
           people, men mostly, with primary school education, if that.
                 We're getting away from Lake Dabo. I just want to finish
           up on it because it's a fascinating story. All these folks would
           come together. Then, when the rains came, they would just
           disperse and go back to their cycles. And so we had to move
           quickly. After 2 or 3 rains in the delta, the Niger became just
           a morass; it was bottomland clay. If you didn't get out, your
           vehicle might just stay there, and that whole area, during the
           rains, would become an inland lake.
Drew: So you could wind up being trapped if you didn't pay attention?
LaPointe:   That's right. There were places, during the dry season, where
           you could drive across the Niger if you found a ford. But then,
           as the rains fell heavily in places like Sierra Leone and
           Guinea, the headwaters of the Niger, the river would be a half a
           mile wide at the height of the rainy season. They had steamboats
           that would only navigate the river for 6 months a year. But we
           rode a boat because we had the idea that we could drop off
           vaccine at these small, isolated villages, and we wanted to see
           how it was done. It's sort of impractical, but it was great fun.
            So in places like Mali, you really had to be attuned to the
           rainy season because the whole dynamic of the country could
           change.
                 When I got to Mali in '68, we survived a coup, the
           military overthrow of Modibo Keita, who was a socialist. That
           was a little hairy because on the ride down to the bakery to get
           some bread, I saw soldiers all over the place and machine guns
           and stuff.
Drew: Did you know ahead of time what was going on?
LaPointe:   No, I didn't, and I said, "What are all these soldiers doing
           here?" Duh.
                 We had just arrived. I left Gabon and went up to Mali, and
           then Diane came after, when Mary was just about a year old. We
           settled into a little transient apartment, from which I could
           walk to work. And the nurse came by and said, "There's been a
           coup," and I went and told Pat, "There's been a coup." We had to
           stay in the house for about 3 days.
                 I remember we were going to go take a walk, and it wasn't
           too far away. Some small-arms fire opened up, a machine gun, tat-
           tat-tat-tat-tat-tat. So that changed a lot because the
           socialists-their party was called the Union Sudanese-were very
           hostile to Americans. They were against the war in Vietnam
           because it was against one of their socialist brothers
                 After the coup, the military took over, and things became
           easier for us. The Minister of Heath was a guy named Benny
           Chenny Fofona [phonetic], who was a good friend of Pat's.  They
           had done some fieldwork together. And he was very good. Well,
           the other guy was okay, but he was under political restraints.
Drew: Sure.
LaPointe:   So I think, in Mali, when the military took over, there was
           sort of a honeymoon. That was a time in Africa when there were
           lots of coups. I think people in the smallpox program went
           through half a dozen in places like Nigeria, Dahomey, Togo, and
           Mali. And so that changed, and, of course, after a while the
           military abused their power and became crooks.
            I don't know if anyone's talked about the last outbreak of
           smallpox in Mali, which was in 1968, October-November. We had
           gotten reports that there was smallpox in an area over near the
           Upper Volta border. We looked at the maps and we talked to
           people, and the only way that we could get in there was to go
           through Upper Volta, through a town called Watagere [phonetic],
           and come in the back.
                 That was a big expedition. It was like a Frank Buck
           movie. We had people carrying Ped-O-Jets on their heads. We must
           have recruited about 20 people or so. And we walked up to. We
           met Tom Leonard (CDC operations officer) over in Watagere
           [phonetic] with his counterpart. And Dave Asteen [phonetic] was
           there. I think he was in Burkina Faso or Upper Volta. And we all
           went up there, to this little canyon that had something like 5
           generations of smallpox.
                 And that was interesting because everyone thought that
           smallpox spread lightning fast in West Africa. Mike Lane had
           done a survey of the outbreak in nomads and found out that they
           had 3 or 4 generations of smallpox. And we saw that, too. People
           with scabs. That's one of the things you would look at, their
           faces, because after the scabs, they'd have pock marks. But if
           the scars were of recent origin, they'd still be pink. So we did
           these surveys. We just walked around looking at people's faces,
           and if the scabs had recently fallen off, their faces were so
           pink, that was at least a 30 percent attack rate.
                 I remember we walked up there, spent the morning,
           vaccinated everybody, and did all the things that we were
           supposed to do, and that was the last outbreak in Mali. We had
           scares after that, outbreaks of chickenpox and this and that,
           but that was the last smallpox outbreak.
                 After that, we still did the mass campaigns because we
           hadn't finished up in the desert area. Looking back on it, it
           was great fun.
                 But the Dodge trucks used to break these front axles. I
           used to be amazed at our mechanics. They could set them up with
           spare axle housings. Somehow they're out in the middle of
           nowhere in 115° to 120°F heat, and they would take off the axle
           and sort of put the snap where the housing was, and they'd
           reassemble it.
Drew: Didn't it take a certain amount of brute strength too?
LaPointe:   Well, it would take a lot of patience, some strength, and then
           some ingenuity. Again, we talked about the vaccinators being
           good, but some of these drivers were exceptional because they
           always brought the vehicles back. And they could repair them. I
           mean, I would go up and watch them and, looking back on it, I
           have the greatest admiration for the work that they did.
Drew: These were Africans?
LaPointe:   Yes, Malians. And the same in Gabon. Some of these drivers were
           amazing. You know, these muddy conditions. I have a picture in
           my mind of a driver-his name is unknown to history-but we were
           coming down a slope, and the car fishtailed, and we were going
           toward a relatively small village. And it was in the rainy
           season, and in Gabon, the rainy season was just gumbo. It was
           terrible. And this driver, somehow he downshifted, fishtailed,
           and just straightened us out just as we hit the village. If he
           hadn't done that, there would have been a serious accident.
           Those were the days before seatbelts and air bags and all that
           stuff.
            These guys were great drivers. And they used to compliment me
           on my driving because, up in Maine, I knew how to drive in snow,
           and if you can drive in snow, you can drive in mud. So I knew
           how to downshift and go with the flow. Most of the time I didn't
           like to drive there, but just in case there's an accident or
           something, for practice I'd do it every now and then, and they'd
           always comment. So I could admire how well they drove in mud,
           because if they were in Maine, they would have been able to do
           the same thing on snow.
                 But I don't think that these folks get the credit that
           they deserve.
Drew: So there's really kind of this whole foundation of getting the job
           done.
LaPointe:   Yes. We stood on their shoulders, you know.
Drew: Were they primarily informally trained?
LaPointe:   Oh, yes. These apprentices would be assigned to a driver, and
           it was exploitation because things that, teach my kids to drive
           was an afternoon, and then sort of a white-knuckle drive. But
           they would learn rudimentary mechanics and they could fix
           things.
                 In that part of the world, they added water to a lot of
           the fuel; they were constantly tinkering. And these guys did a
           marvelous job.
Drew: How old were they, about, on average? Young adults?
LaPointe:   My age.
                 I was in Mali in 2003 and spent a couple of afternoons
           with some of my old drivers.
Drew: That must have been kind of neat.
LaPointe:   It was wonderful, wonderful.
Drew: Were they French speakers?
LaPointe:   They knew greetings and phrases..
Drew: But they were fluent in French?
LaPointe:   They could say simple phrases like, "Where's the chief's
           house?" or "I want to eat," or "I need some water." But that
           would get me to someone.
                 The problem in that part of the world is that, in Gabon,
           for instance, they must have 40 dialects among half a million
           people. I remember driving along with my driver, who was a Fang.
           He would be fine translating in that area, which is up at the
           Cameroon border. But we'd go down to southern Gabon and someone
           would speak in a dialect, and I'd say, "What's he saying?" and
           he'd say, "I don't know, I don't know." The situation was like
           with a romance language. You know, like if you understand
           Spanish and French, you can sort of follow a little bit
           Portuguese or Italian? But with the local dialect, absolutely
           zero, not even the same language.
                 The same in Mali. You had [unclear] in the central part,
           and you'd have 15 languages. And so to master one might be
           great. Then you go to another part of the country . . .
                 I remember when I was in Senegal the last time, I was
           talking to some Senegalese in French about why they should have
           a national language, saying, "Well, you'd be like Belgium,"
           because the Walloons and the Flemish are always fighting about
           language superiority. It's very political. You know, language is
           political, even in this country now.
Drew: Oh, yes.
LaPointe:   And the thing is if they did that, I was telling him that
           Senegal would have to be like a Scandinavian country. When
           Scandinavians learn English, it's not fun and games. They take
           it seriously because it's their lifeline to the rest of the
           world. You meet Scandinavians who speak very good English; they
           start in grammar school. So, anyway, I said, "Well, if you guys
           want  French as a national language, first of all you'd have to
           appease all the other non-French speaking. then you've got to be
           serious about a language. So French is, maybe people don't like
           it. They're always figuring out official language and the
           language of instruction.
Drew: Because that's the association with colonialism?
LaPointe:   Well, you know, they speak French well and they love it, but
           when push comes to shove, it's still foreign to their African
           culture. But they also realize that they have to have that
           because how else can someone, say, from Mali speak to someone
           from the Congo? They need a common language. And so it's French.
           And they realize that, because if you chose a native language,
           which one would you choose? And so the subject is fraught with
           politics.
                 When we went back to see the driver, we always spoke in
           French. I mean, I would fool around and say, "What's the word
           for this?" and "What's the word for that?" He was a Bambara
           speaker. And we would play around with it. But when push came to
           shove, if you really wanted to talk, it would have to be in
           French, so that was the language you stuck with.
                 It was nice going back to Mali. I saw my counterpart, who
           was sort of administrative counterpart if you needed travel
           orders or some formality or process type thing. He and I were
           about the same age. I saw him, and he's retired..
Drew: And he is a Malian?
LaPointe:   Yes. His name's Sisoko [phonetic]. In his retirement he formed
           a service to solve small problems for civil servants. He doesn't
           get paid for it. But it was fun because I went in and he was
           talking, and he just lit up, jumped over his desk, and gave me a
           big hug. There must have been about 25 Malians there, and they
           go, "Who the hell is this guy?" Then he told them who I was and
           what I had done. And so it was good going back. We talked about
           the old days.
Drew: Did Diane go with you, too?
LaPointe:   No. I was working.
                 The last time I was in Africa, I managed a 10,000-
           household survey for UNICEF and managed, activities in Mali,
           Senegal, Ghana, and Benin. I went to Mali 3 times. So I made
           time to go around and see as many people as I could, and the
           word got out that I was around. It's nice seeing people again,
           going back, oh, I guess, 38 years.
Drew: Did you and Diane have other children?
LaPointe:   Yeah, we had Michelle.
Drew: And this was while you were still in Africa?
LaPointe:   Yes. Diane went back to Portland, Maine, where she had family,
           because Mali really didn't have the facilities. Mary had been
           born in Ebola. In Cameroon, there was a Presbyterian hospital.
           When the physicians went on furlough, they usually went to do a
           residency someplace, so they were all board-certified. We were
           young and maybe a little foolish, but things went well. I drove
           up from Leeperville [phonetic}. We drove across the border. It
           was about another 100 miles to where she was. And everything
           went well. But Mali just had no facilities that were as good as
           the ones in Cameroon. So the option was to go up to Europe or
           the States, and we opted to go to the States, and it was best.
           So off they went. Anyways, they're doing well.
Drew: If you'd been in charge of the program, are there things that you
           would have done differently?
LaPointe:   I think the biggest thing that they did is that they left us
           alone. Don Millar [J. Donald Millar] was very good that way. If
           you showed some initiative, and even though you broke every rule
           in the book, he'd say, "You're a naughty boy, but God love you!"


                 Once I was way out on the tip of Gambia in a small
           village. We were driving out for the smallpox program, and our
           vehicle didn't really have any air-conditioning; it would all be
           dusty and red. And one of the Malians said, you know, "In the
           smallpox program, we're not white or black; we're red."
                 And so this time we went up there in an air-conditioned
           vehicle and people had their laptops and their phones. There
           seems to be this phenomenon where people land someplace and
           [unclear] airplnes, it seems that everyone has a cell phone and
           wants to call someone up here. .
Drew: It always makes me laugh how quickly they adapt to the new
           technologies.
LaPointe:   As soon as they say you can use your cell phone, it's . . .
Drew: Everybody and their brother.
LaPointe:   It seems like most people do that, and it's the same
           phenomenon. We were with some UNICEF people, and they rented an
           air-conditioned van. There must have been 15 of us. And these
           guys were calling their offices and had their laptops and all
           this and that, and yet it was a practice run. And we went out to
           the village, and the village hadn't changed that much. I was
           thinking that when we were there for the smallpox program, the
           last thing in the world we'd think of when we were visiting a
           village was to call Atlanta. Now they have cell phones, and many
           people call their local offices, regional office.
Drew: Checking their voice mail.
LaPointe:   Yes, all that stuff. And I remember they did some sample
           interviews. We were looking at the forms and walking around in
           the village. There was absolutely no-or very little-change in 40
           years. But then I picked up a form and really looked at it, and
           it noted that a 23-year-old woman had had 6 pregnancies and half
           the kids had died. She had no education. So, I just grabbed a
           sample of every woman who was 23 or 24-I forget the exact age-
           and all had pretty much the same type of history. And I was
           thinking, we have the technology, and yet nothing's changed at
           the local level. It's disappointing in a way. And I can never
           figure out why. If people want to change, they leave the
           village. Change doesn't come to the village. A person has to
           leave the village to change. And so the villages' populations, I
           suppose, really don't grow that much because people want to
           leave.
                 But I think somehow the modern technology might lead to
           micromanagement. I mean, why do you have to call your boss and
           say, "I'm here at the village and I'm shuffling around." I
           really think it's a distraction. Or your boss tells you stuff to
           do. Among other things, if you don't want people telling you
           what to do, you don't call them up and ask them for advice, and
           especially a superior.
Drew: And if you don't want to be told no, you don't ask.
LaPointe:   That's right. And I think with the smallpox program, the
           program was CDC's first overseas project, and we were all young.
           People didn't really defer to headquarters. I think sometimes
           when people who have been out in the field come back to
           headquarters, they have their own values and start to impose
           them on people. I supervised people overseas. I think one of my
           biggest chores was to keep my mouth shut and not say, "Well,
           that's not quite the way I'd want to do it." And I just think
           that the smallpox team was a good team.
                 I consider Billy Griggs a friend and a business associate.
           But he understood his role. He really didn't interfere with the
           daily stuff. But he knew how CDC worked and how CDC should be
           supported in the field. He never went to the field. I think
           there's a tendency now for people to travel too much. Some
           travel is good. But I think Billy was a key to that success.
                 I don't think he liked to travel. Once, I asked him, "How
           can you not travel?" And he said, "Well, I know CDC, and if
           people need something, I can get it at CDC."
                 And that was a very valuable thing. I don't think people
           have given it the credit that it deserves. If you needed
           something, they'd find it. And with Millar, if there was any
           doubt about the central office or the field, he always supported
           the field because these guys knew what they were doing. Now a
           lot of things have become very institutionalized, and I think
           there's too much process.
                 I went to a 30-day evaluation conference, again in 2003
           when I was doing that stint for UNICEF. Everyone was talking
           about input. There was no output type of thing. And I think an
           eradication program, process is good, but the bottom line is
           eradication; your feet are really to the fire. I mean, it's an
           absolute term. You have the disease. I suppose it's like
           pregnancy. You either are or you're not.
                 But I noticed when I've gone out and talked with the same
           people, they spend a lot of time on emails. I remember once I
           went to Guinea for something in the '90s, and there was this kid
           who went along. He did something at CDC. He came up to me, and I
           said, "Well, here's where I'm going to be if you ever want to
           link up, just show up."
                 And he said, "I love to do it, I'd love to do that."
                 And I was there 10 days, going to the ministry and clinics
           and talking to people, taking notes and doing my evaluations. I
           saw this guy a couple of days before I left, and I said, "I
           never saw you. What happened?"
                 He said, "I can't get out of the office." He said,
           "Everyday, a window opens up in the heavens and dumps a whole
           screen full of stuff, emails from Washington, the AID office. I
           have to answer them." And he said, "I get all caught up, and the
           next day at 3 o'clock, I get another dump."
                 I asked him, "How often do you get out of the office?"
                 He said, "Never."
                 See, in the smallpox program, people were never burdened
           with that stuff. You had your reports and you sent them in.
Drew: Well, one of the things that I find happens is almost like a
           Pavlovian response. An email shows up, and we're often geared
           toward, "Oh, I must respond to it right now."
LaPointe:   And then, nowadays, with phones. When we were in Mali, I think
           we got 1 or 2 phone calls. Big deal. In those days, you'd have
           to go down to the "Ministry of Telephones," etay tay [phonetic],
           as they called it. Post Telegraphic and Telephone, something
           like that. And you'd say, "Well, we want to call Atlanta at 3
           o'clock tomorrow," or whatever. And then we'd go down there and
           somehow the call would go through Paris, and we'd get our call
           through. And we could hardly understand it half the time. Why
           bother? Now, with the phone systems working so well, people call
           headquarters everyday just to say, "Checking in."
                 When I was going overseas. I always liked to go to the
           schools and see what was going on because my wife was a teacher
           and teaching is sort of our family profession. My grandmother
           was a teacher; my dad was a teacher; my wife is a teacher; and
           Michelle, the one who was born in Mali, is teaching, doing
           research at Stanford as a postdoc. I always liked to see the
           class size and this and that. We'd see class sizes of 60-70, and
           hear kids come in speaking an African dialect, trying to learn
           something in French, or English in the anglophone countries. I
           also like to talk to people in the offices, especially at
           UNICEF, ask them, "How often do you get out in the field?" And
           they say they can't. They take emails and telephone calls.
Drew: Somehow that just seems wrong.
LaPointe:   It does. I remember when I did some work for the Carter Center
           in Guinea. I went out to Niger, and the place I was in had a lot
           of Guinea worm, at one time perhaps more Guinea worm than any
           other place in West Africa. They had put up a little sort of
           rest house office so that the director could go out there. He
           had young kids. And he told me, "I go out in the field. I bring
           my wife and kids and work for a couple weeks."
                 I saw him about 6 months later, and I asked, "Are you
           spending enough time in the field?"
                 He said, "I can't get out of the office. I have calls, I
           have emails, I have meetings," and this and that.
                 And I said, "Well, how about the field?"
                 And he said, "Well, I just can't get out there."
                 Well, the thing is, is that you can, but you have to tell
           your people and say, "I'm sorry, we're not going to reply to
           emails," and this and that, and you go out to the field for 2
           weeks.
                 In the smallpox program, you were expected to spend 50% of
           your time out in the field. Now, we were younger then, but even
           so, those roads, I swear to God, it was like someone beat the
           hell out of me because of the rocks and the bouncing around. The
           smallpox program was really field oriented. I just wonder if you
           had the same program today, with modern technology, would you
           spend all your time answering emails and phone calls and not go
           out in the field?
Drew: You wouldn't be as productive ultimately.
LaPointe:   Yes. Looking back on it, Atlanta pretty much left you alone,
           and they supported you. And CDC at that time, I think, was more
           flexible.
Drew: They were a little less bureaucratic.
LaPointe:   Well, I think technology leads to bureaucratization. It's just,
           if you have the ability to communicate, you communicate. You see
           people yakking away on their cell phone, and you think, before
           cell phones, what did these people do? So, I don't know,
           technology is a mix, a double-edged sword.
Drew: I think it is. One of the phenomena that I find fascinating is how
           frequently you'll see people who are not present in their
           present space. In other words, they're constantly emailing,
           calling. They're interacting with something that is far away and
           they're not, in a sense, fully present. I can't tell you the
           number of meetings that I've been in where you'll have everybody
           and their brother with their Blackberry on the table.
LaPointe:   My son-in-law works for Microsoft, and he said the same thing.
            In Gabon, General Sholiak [phonetic], who now is [unclear], and
           I got along very well. I think he had kids my age, and everyone
           else would be bracing and saluting because he was the general
           and they're all captains. And I'd say, "Hey, General, how are
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           remember him telling me he went to Gabon for the first time in
           1937, and he said he got off in Porjantee [phonetic], which is
           on the [unclear], took a Dogon canoe, went up to this hospital,
           and stayed there for 10 months. And sometimes he'd get a pack of
           mail. So he was almost lamenting telephones and e-mail. I don't
           know what the solution is. Computers are wonderful, but they're
           a terrible distraction.
            You know, the Africans say that-I'll translate it from the
           French-
Drew: No, say it in French.
LaPointe:   In French, they say, le feast. It's a French expression that
           means that success is the son of everyone in the village, and
           failure is his mother's son. And so the smallpox was a success,
           so everyone bought into it.
            When I did the first draft of the smallpox history, I remember
           that everyone who was remotely associated with the smallpox
           program, took some credit. "Well, I did this," you know, or "I
           recruited this" or "We did that."
            Before I close, one cautionary tale. In the mid-'90s, I was in
           Cote d'Ivoire. They were having an AIDS meeting, and I was
           staying at a hotel with someone who was going to a dinner for
           the AIDS workers. And Kevin DeCock who is now, I think, the head
           of WHO, HIV/AIDS, he was saying that it would be wonderful if we
           could eradicate the disease, that then we could be like the
           smallpox people, who had these orgies of self-congratulations.
           And so I said I had been in smallpox."  He said, "I didn't
           realize it was smallpox." I said, "We're everywhere."
            So success does generate things like that. If the program had
           been an abject failure, it would have been sort of swept into
           the outback someplace. We're lucky.
                 You know, areas where we worked in Mali, I don't know how
           the hell we did this, but I took Diane. We went way up in the
           desert. Now you can't go up there.
Drew: In terms of safety?
LaPointe:   Safety. The Tuaregs were on the warpath. They were pacified or
           brutalized, I don't know what the word is. But the area that I
           went up to in 1970, which is way up Keydal [phonetic], had a
           shootout out about a month ago between the Tuaregs and the army,
           with casualties. Sierra Leone, Guinea, Liberia are pretty much
           semi-failed states. Could we work there now? It's very iffy to
           be in the desert areas of Niger. When I was in Chad working for
           Guinea worm eradication, sometimes we were out with armed
           guards, guys with AK47s.
Drew: And that's so qualitatively different-on so many different levels
           from what you're describing about your relationship with your
           drivers and nurses.
LaPointe:   You know, I went to a meeting once during the smallpox days,
           and my counterpart opened up his briefcase, and he had a gun in
           there, a pistol or something. And I said, "Geez, I didn't
           realize you were packing." And he said, "You were the only guy
           in that room without a gun." And he said, "I'll get you one."
                 And I remember once we were in southern Chad and we went
           out to a village, and the district officer wanted to go. It was
           like an old Western. I mean, he reaches in and he gets a gun and
           sticks it in his belt, and takes a rifle out of the closet.
           Other people got shotguns, and off we went. I don't think we
           could have done that.
                 We were lucky. It was an era where, if you looked at the
           history of Africa, it had the infrastructure of the colonial
           age, which, in many instances, has disappeared or hasn't been
           maintained. You had a lot of political people who were
           socialist. That's a bad word in this country. But they did have
           a conscience about health, and they supported it. If my memory
           serves me correctly, they dedicated something like 10% or 12% of
           the national budget to health. Well, the economies are stagnant
           now, and populations have doubled.
                 I remember reading something about 40 years ago about the
           demographic history of India. I remember talking to Pat about
           it. I said, "You know, when you have population growth in this
           part of the world, these populations are going to be more than
           double in 40 years," and they have.
            But now Africa has stagnant economies, and so the per capita
           income for social services has gone from what I described down
           to 35 cents. Now, many of these countries can pay people, and
           that's about it. Everything else is dependent on foreigners or
           other things.
                 And so we were lucky in a sense, is that we had-
Drew: It was like you were in a perfect sort of a window.
LaPointe:   And then we had CDC just starting out and they didn't know how
           to boss people around. They let us alone. Everyone was young.
           You realized you had to spend a lot of time in the field. You
           had infrastructure that was still workable.
Drew: Yes.
LaPointe:   And political stability in a sense. You could go almost
           anywhere in the country without safety concerns. But recently,
           when I went to Chad, the ambassador gave me hell. He said, "What
           are you doing down there?"
                 I said, "Well, that's where Guinea worm is."
            "That's dangerous. You're not supposed to be going there."
                 I said, "Well, what am I going to do?"
                 And so we were lucky. As Napoleon said, he liked lucky
           generals, and we were lucky generals
Drew: Mark, thank you so much. I really enjoyed this interview
                                    # # #
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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>Centers for Disease Control</text>
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                <text>A black and white photograph of Ali Maow Maalin, a Somali hospital cook and health worker from Merca, the last person known to be infected with naturally occurring Variola minor smallpox in the world.</text>
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TO: Dr. Don Francis &#13;
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FROM: Dr. L. Montagnier of the Pasteur Institute &#13;
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                <text>The U. S. National Archives and Records Administration at Atlanta, 5780 Jonesboro Road, Morrow, GA 30260       www.archives.gov/atlanta</text>
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          <name>Player</name>
          <description>html for embedded player to stream video content</description>
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            <name>Coverage</name>
            <description>The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant</description>
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Death Rates from leading causes of death in persons aged 25-44 years, United States, 1982-1994. AIDS death rates steadily increased to become, in 1993, the leading cause of death in this age group.</text>
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            <name>Creator</name>
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                <text>CDC/NCHS/National Vital Statistics</text>
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