4 12 68 https://www.globalhealthchronicles.org/files/original/b4f8adb1514c501c758d789b3fe8a2d0.jpg 9c73e0db6f283f78014eba2dbb186962 https://www.globalhealthchronicles.org/files/original/b97ed4ebe8f54584b2bf7a4e730ef552.pdf 7fa570935d2cd98756f92c10e2519ff2 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> This is an interview with Deane Hutchins about his 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 Laura Harrar. Harrar: I noted in reading your bio that you were involved in private practice in Boothbay Harbor and then taught at the University of Maine. So how did you even begin to think about taking a leave of absence to join the Smallpox Eradication Program? Hutchins: While at the University of Maine, I was the Director of Clinical Services at the Student Health Center, and I what I thought was influenza. I knew D. A. Henderson [Donald A. Henderson] because he was my classmate in medical school, and I knew he'd been on the surveillance program for influenza. So I called him up and said, "D. A., are you interested in some throat washings of influenza?" And D. A. said, "No, not really," he said, "but would you like to go to Africa?" My wife and I had never talked about this. I went home that noon and talked with her and said I'd seen D. A. She said, "What did you talk about?" and I said, "Nothing in particular. He asked me if I wanted to go to Africa," and she said, "What did you tell him?" I said, "I told him I would call him back." My daughter was home from school, and she went to school and told her teacher we were going to Africa. Within 2 days, I had called D. A. back and said, "Yes, we'd like to go." I got a leave of absence from the university for 2 years. Now, universities don't like to give a 2-year release, but the president of the university had been overseas himself and knew that it was a 2-year assignment. So I got the leave of absence, and we made up our mind and, in July, we came down to CDC and were on our way. Harrar: I noted that you had a major in zoology in your earlier years. Hutchins: Yes. Zoology was just part of the premedical course that we took. Harrar: And why do you think D. A. tapped you to do this? Had you ever imagined that you would be working abroad in public health? Hutchins: No. I'd done a few surveys at the university when they had their usual food outbreaks and tracked that down, but nothing really formal about epidemiology. As I mentioned, I worked with D.A. in the same room with the dissecting tables in medical school, so I knew him well. Harrar: Had you ever imagined that you would work abroad? Hutchins: Not in particular. I'd been overseas during World War II, but nothing beyond that. Harrar: Okay. So you can blame all of this on D.A. Hutchins: Blame it on D.A. Harrar: Okay, all right. Tell me a little bit about your family at the time. Were they excited about this? Was there just the one daughter? Hutchins: We'd never considered going overseas. My wife was excited about it; all 4 daughters were excited about it. And had there been one dissent, I'm sure we'd have thought that we shouldn't do it. But we decided to go and never regretted it at all. Harrar: Would you call your family adventurous and outgoing and curious? Hutchins: I guess the family probably was curious and was moderately outgoing. They had a good time. Harrar: What was the range of your daughters' ages at this point? Hutchins: The oldest one was 14; the youngest was probably 7. Harrar: So, start with the phone call from D. A. Henderson, and tell me what happened then, how you got yourself and your family to Africa. Hutchins: Well, we started preparing to go to Africa, and come June, we packed up our Volkswagen, packed up the car, and drove to Atlanta. Ion the humorous side of things, we sent our Volkswagen bus in June to Nigeria, and we received it the next February, which was par for the course. Harrar: And so, did you need to send an enormous boatload of goods? Hutchins: Yes. We took a lot of things. We had 2 shipments. We had an air shipment of limited pounds, and then we had sea freight, in which you could take most anything you wanted. We read books to find out what we should take. Air freight got there just before Christmas, and we left in October. Sea freight didn't get there until sometime in the spring. Harrar: Was it a pretty big culture shock for you and your family? Talk to me about the language issues and some of the cultural changes that they had to get used to. Hutchins: The cultural shock hit us, I think, the worst right in Lagos, which is a capital city. From the airport into the center of the city, it's pretty raw. The smells are terrible, as you may well remember. It wasn't unusual to see a dead body on the street, and it would stay there for a day or 2. Most of the people we dealt with could speak English, so that wasn't a big problem. When we got up to Kaduna in northern Nigeria, we did try to pick up the local language, Hausa, enough so that we could say good morning, how are you, where's the bathroom, how do I get home, what time is it, and that type of thing. Harrar: Would you say that you were welcomed by the local people? Hutchins: Definitely. The local people were very nice. I never felt uncomfortable. And this was right before the Biafran War had started. But about 2 weeks before we went to Kaduna, they'd killed about 30,000 Ibo people who were living up there. So you'd go by these houses that were strictly empty and burned out, and we didn't realize the significance of it at the time, but, in retrospect, it was a little bit scary. Harrar: How did you and your wife feel about this once you got there and you realized what you had brought your family into? Hutchins: It was an adventure. I don't think we ever felt uncomfortable. There were problems like communications. We were there for 2 years, and to call the United States, you had to book the call ahead of time. Then they would call London, London would call New York, then New York would call where you were calling. One time I did get through on the telephone. You were limited to 3 minutes, but my 3 minutes were used up by the time they got through, and I could just barely hear my father say, "Hello." Then the operator said, "Your time is up." And I said, "Would you at least tell him that we're all right?" That was quite an experience. We had a telephone in our house all the time we were there. It worked just 3 months. The military government took over the country. We lived right beside the military governor, and I know our telephone number was given to him. But that wasn't too bad because no one else had telephones either, so you couldn't call anybody. Harrar: So, did your family feel isolated at all, do you think? Hutchins: I don't think they felt isolated. All of my daughters went to school in Kaduna. The second semester, my oldest daughter went to an international school down in Ibadan, 400 miles from Kaduna. The problem there was that there was just one bridge across the Niger River, and this was after fighting had started; if they'd blown that bridge, it would have been difficult to get to my daughter. Two other daughters went to a missionary school in Joss, which was an American school 150 miles from Kaduna. During the rainy season, you couldn't drive, so it was a mixed situation. Harrar: Transport, yes. And what was your exact role on the Smallpox Eradication Program? Hutchins: I was the Medical Officer in the Northern Region of Nigeria. Two Operations Officers worked with us. Harrar: So on a day-to-day basis, describe for me your activities and the range of challenges that you had. Hutchins: Well, let me tell you a little bit about our office. We lived in an ex-Minister of Finance house. This is a Muslim country, 90% Muslims. So they had a long tunnel that went from the house out to the wives' quarters. There were 7 apartments out there, 4 for wives and 3 for the concubines. Well, since the Minister had been kicked out of his house, the Ministry gave it to us to live in. We had our offices out in the old wives' quarters, which was crude but convenient. It wasn't very nice, but at least it was a place where we could sit down. Harrar: I thought you were going to say you installed your daughters. Hutchins: Well, I did have a kid come up to me and want to buy my daughter, but I told him she wasn't for sale. He was serious, I think. Harrar: On a day-to-day basis, what kinds of things were you involved in as a Medical Officer? Hutchins: I was concerned about the quality of the organization of the eradication program, smallpox reporting, and the vaccinating teams. As the reports of smallpox came in, we would investigate the outbreak and visit the various smallpox hospitals. That's about it, I guess. Harrar: Was there a strong sense of collegiality among the people working on the effort? Hutchins: Yes. We had 3 groups of teams, and each group had about 10 teams; there were 7 people in each team. So we had well over 100 Nigerians who were taught to give smallpox vaccinations. Now, most of them had not gone beyond 7th grade, but they were classified as health workers. We would teach them how to give smallpox vaccine with the jet injector and how to take care of the vaccine. We stressed very strongly that the vaccine should be kept cold at all times. We told the drivers of the trucks to turn their refrigerators off-these were kerosene refrigerators-while moving along, and when they got to the destination, the first thing they should do is turn the refrigerator back on. Well, I came across one truck one day, and it was probably 100°F or so in the sun. He'd broken down. My first reaction was to put my hand down in the freezer to see if it was cold. It was hot. So I started giving him a bad time. "But, master," he says, "you said to turn it on when I got to my destination," and, of course, he was a long way from his destination. But you could tell stories like this end on end. Harrar: What do you think were the biggest obstacles that you faced, that you had to find a way around? Hutchins: Communications, there's no question. For me to get in touch with my boss, Stan Foster [Stanley O. Foster], in Lagos was almost impossible. And to do it by courier took a long time, maybe another week or so, before you'd get an answer back. But communication, by all means, was difficult. Transportation of vaccine-getting it from Lagos to Kaduna- was also difficult. I remember one time we were having problems with this, so we had one of the Americans put it on the plane in Lagos. We got to Kaduna, and the vaccine was not there. Unbelievable. To this day I don't know where it was. And we're talking about several thousand dollars' worth of vaccine. Harrar: When you were training the Nigerians, did you also learn things from them? Hutchins: Oh, yes. Harrar: Can you elaborate on that 2-way process? Hutchins: I guess, overall, the biggest thing you learn from all developing countries is that you're not going to change them a whole lot. They've been doing something one way, and they're going to continue doing it about the same way. The first morning that we officially vaccinated, I had a schedule all made out. At 7:00, the driver is to be there; 8:00, we'd move out; at 9:00, we'd start vaccinating. Well, to begin with, the drivers didn't show up till after 9:00, and this was probably typical of where we worked. Harrar: Were there comical things that happened along the way? Hutchins: Oh, yes. Well, thievery in developing countries is always a problem. We had these kerosene refrigerators, and kerosene was worth good money. So I went out one morning, and here's this fellow with a 5-gallon can of kerosene in his hand. "Oh," he says, "I'm not stealing, I'm putting it back." I guess one of the funniest things that I remember concerned Dr. Foege [William H. Foege]. He had been in eastern Nigeria, and then the Biafran War broken out, and so they asked him to leave. He came up to northern Nigeria, where I was, and he said he would like to see some of my teams operating. So I gave him a truck and a driver, and he went out. About 3:00 in the afternoon, the Minister of Health called me and says, "Where's that Dr. Foege? You know, he came up from the east," where, of course, there was fighting. And I said, "He's up- country." And so they got the army out and picked him up that evening-they wouldn't let him break down his tent-and, under armed guard, brought him back to my house. Well, Dr. Foege is a very tall person to put in the back of a Land Rover, especially with an armed guard on both sides of him. And to hear Bill tell the story, he says, "I nudged one of these soldiers and said, 'Would you mind moving that rifle over? It's hurting my leg.'" Harrar: Can't you just hear him saying that? Hutchins: Yeah. Harrar: Oh, boy. Okay. I understand that you were involved in tracing monkeypox to humans in the 1970s. Hutchins: Yes. That was in Sierra Leone. I got a call about a case of smallpox in a small village. Well, this was after we thought smallpox had been eradicated from Sierra Leone. So I went out to this village and finally found the case. Clinically, it resembled smallpox; you couldn't tell that it wasn't smallpox. So I took a brief history and checked to see who had been vaccinated against smallpox, and this patient had not been vaccinated. I got some samples and sent them back to CDC. Well, again, communications. Two or 3 weeks later, I got a cable back saying, "This is smallpox. Look for other cases" because you can't have one case of smallpox without having another case. So I started looking. After a few days, I got another cable from CDC saying, "This is not smallpox. It's monkeypox." If you grow it out on the allantoic membrane of chick embryos, you can differentiate the 2 viruses. So I went back to the village again and took a better history, and, sure enough, this fellow had prepared a monkey to eat about 12 days before onset of his illness. This was a tribe that ate monkeys. He was the only one who had not been vaccinated against smallpox; the rest of the village had been vaccinated. This was good evidence that the smallpox vaccination also protected him against monkeypox. Harrar: Can you tell me a little bit more about the experience in Sierra Leone? How did it differ from the experience in Nigeria? Hutchins: Well, the day before we left the United States to go to Sierra Leone, WHO [World Health Organization] had reported cholera in West Africa for the first time, and so I called up CDC to get some information on it. I think I talked with Gene Gangarosa or one of the fellows in the enteric group, and they gave me what information they had on it off the top of their head. I arrived at the airport in Freetown, and reporters were there asking how we were going to eradicate cholera; like we had eradicated smallpox? Of course, I didn't have any answers for them. It's a different disease, and you can't eradicate it like that. So I spent most of my time with the cholera program that we developed while we were there. Harrar: Were there things that you learned about public health in West Africa that you have been able to apply in your career since, either in some of these international places you worked or back in Maine? Hutchins: Well, if you see an outbreak of something, you take a different approach to it. Most practicing MDs aren't really interested in epidemiology, although you became interested in it once you'd seen how it can really help. Harrar: Is there anything that you wish you could have done differently in the way the program was run? Hutchins: Well, getting back to the communications, there wasn't too much that you could do to improve communications in those days. Today, of course, it's so much different. Harrar: And how would you say that this experience had an impact on your wife and children? Hutchins: Well, having lived with a different culture, especially a black culture, my kids have no racial bias at all. I don't know if I mentioned this before, but my oldest daughter went to school with 500 Nigerian schoolgirls, and I think there were 3 other expatriates in that school. My daughter has long blonde hair. The Nigerian girls were fascinated with this, and they'd come up and they'd feel her hair. She learned a lot. And the other kids went to various and sundry schools. Harrar: So your wife wasn't one who said, "How dare you make a decision like that?" Hutchins: Well, we had a good time the first 2 years in Nigeria. We went back to the States and swore we'd never go overseas again. We were back about 3 months, and we decided, "Well, gee, we really had a good time," so we went back to Sierra Leone. After Sierra Leone, I went with the State Department, taking care of the American Embassy personnel in these other countries. Harrar: So it turned you into adventurers for the rest of your life. Hutchins: Yes. And 2 of my daughters lived overseas after they were married. Harrar: Did any of them go into health? Hutchins: Two are nurses, and one married a doctor. Harrar: So, could you comment on the problems of health workers and how you could see that getting solved today, I mean from your experience seeing the need for trained health personnel? Hutchins: I realized that you could train uneducated people to do a health program. For example, these vaccinators that we had had very little education. Sterile technique was still unheard of, and we didn't really use much sterile technique. We did not clean off arms before people were vaccinated. We told the vaccinators that if they dropped the nozzle of the jet injector on the ground, clean it off with some alcohol or something. They would just brush it off and put it back on. We did studies to see if there were any adverse effects, and there was no significant increase in infections from this lack of sterile technique. Harrar: And do you think that people can be trained who maybe haven't had an advanced education to do many of the tasks of public health? Hutchins: Yes. Especially something that's repetitive can be taught to most anyone. Matter of fact, there are places in West Africa now where they teach local people to do eye surgery. You know, it's one simple procedure, but they do it, and they have very good success with it. Harrar: I've heard it said, too, that if one wanted to really solve the problem of maternal mortality, if you could get some basic anesthesia capacity and some basic cesarean-section capacity, you could do an awful lot in field hospitals to save women's lives. Hutchins: Yes. I think there are places where they've taught the local technician to do cesarean sections. It's not that difficult. Now, if they run into problems, well, that is a problem, and they probably couldn't solve it. But 9 out of 10 go along as planned. Harrar: Better than obstructed labor? Hutchins: Yes. Harrar: Is there anything I can ask you that you haven't had a chance to speak about that you would like to? Hutchins: Well, it was a great experience. I would not recommend it to anyone if one member of the family didn't want to go overseas. As I said, I worked for the State Department Medical Program overseas afterwards. I saw some families that were sent over there and there'd be one dissenting family, and invariably that whole family was unhappy. They either had to be shipped out or would quit. Harrar: But, fortunately, you had a family full of adventurous people and curious people. Hutchins: Yes. Our kids were great, and my wife was great, and we had a good time. Harrar: Well, thank you so much. I really appreciate it. # # # </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/bSeEm8DoyLg" frameborder="0" allowfullscreen></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource interviews motion pictures moving image Date A point or period of time associated with an event in the lifecycle of the resource 2006-07-14 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/15nsh emory:15nsh Subject The topic of the resource CDC Smallpox Eradication USAID WHO Monkeypox Format The file format, physical medium, or dimensions of the resource 6459240000 bytes video/x-dv Creator An entity primarily responsible for making the resource Harrar, Linda (Interviewer); NOVA Hutchins, Deane (Interviewee); CDC; Epidemiologist Contributor An entity responsible for making contributions to the resource Centers for Disease Control Centers for Disease Control Title A name given to the resource HUTCHINS, DEANE Description An account of the resource Dr. Hutchins was assigned to Nigeria and Sierra Leone as part of the Smallpox Eradication Program. In addition to information about living conditions and training of local staff he describes the finding of monkeypox in Sierra Leone. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/cc08d72bdfcf1a8c86f92e4d2f148cb4.jpg 66d9f17414b12f7ae8b70468bfd80291 https://www.globalhealthchronicles.org/files/original/6cc2e6f67b035701fb5bad6356e2565d.pdf 25f41333f4341c7bd3cc3ca02a943bd6 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> This is an interview with Dorothy F. Hicks. The interview is being conducted at the Centers for Disease Control and Prevention in Atlanta, Georgia, on July 14, 2006. It is a part of the 40th anniversary reunion of the launching of the West Africa Smallpox Eradication Program. The interviewer is Linda Harrar. HARRAR: There's no such thing as a wrong answer here. If you don't like the way you said something, just say, "Let me pick that up again," and you can start your thought again. So don't worry; it's not a high-pressure situation by any stretch of the imagination. May I call you Dot? Is that okay? Hicks: Please do; all my friends do. HARRAR: Okay, great. How did you and your husband came to be involved with the smallpox eradication campaign? Hicks: My husband was here as an employee of the Centers for Disease Control but had been transferred to Raleigh, North Carolina. He was Chief of Venereal Disease Control as a federal assignee to the state of North Carolina. We lived in the Raleigh area and didn't have children after being married for quite a few years and decided we would like to have a family. We progressed in adopting a little boy, and Jimmy came to live with us at 8 months. And we had our order in for a little girl, but Jimmy had to be 2 years of age before we could adopt again, under the law in North Carolina. Jim didn't come home for lunch each day. He stayed at the office and went out with different people for lunch. And 1 day he came home, and he walked in the house at lunchtime and I said, "Are you feeling all right?" And he said, "Yeah, I'm fine, but I think you'd better sit down." I said, "Why? Are we being transferred to New York or Chicago?" because he knew those were 2 places where I had worked at 1 time and did not want to go back to live. And he said, "No." He said, "I've been asked to take a job in West Africa." And I said, "What are we going to do about the second child? When do you have to go?" He said, "Yesterday they wanted me there." And I said, "Let me call Josephine Kirk," who was the director, at that time, of the agency. I said, "Josephine, we're supposed to get a little girl, and Jim's being sent over to West Africa." And she said, "Well, Dot, if you would take a boy, we've got a precious little boy you could take." And I said, "But we don't even have birth certificates yet for Jimmy because he's not 2 yet." And she said, "Well, we'll work something out." And I said, "Well, Jimmy has asthma, and I don't know how that's going to affect things." And, of course, Jim told Dave Sencer [David J. Sencer], who at the time was the Director of CDC, and he said that CDC would get a waiver on it from Washington, which they did. Jim left, and I was there until the house was sold, and then he came back to go over with us. So that was how we wound up in Lagos, Nigeria. HARRAR: Okay. And what were your first impressions when you arrived in Lagos with 2 children in . . . Hicks: In diapers. We came in from Switzerland, where it was snowing. When we arrived at the airport, they actually told us on the plane that it was very hot, and we, of course, had winter clothes on. When we deplaned, it wasn't like any airport here. It was like airports used to be in this country, where you had to deplane out on the tarmac and walk in. And as we walked in, there were guards with guns, and you had to walk through them to go into their security, and I wasn't used to that, of course. It wasn't 9/11 yet, so we weren't used to this kind of security. And we got through security, and they had a car waiting to take us to a residence, which I had never seen. I had no idea where we would be going. And I was amazed, as we left the airport to head to Lagos. There were no streetlights, very few paved roads. But along the roads there were little stands that people obviously had made, and the only light was candlelight to sell their wares. So that was my first impression. I was a bit apprehensive about where we were going to be living. What are we going to be living in? I didn't know whether it was a thatched hut or what it was going to be. But when we drove in, it was a compound. The housing had been provided by the government, and it turned out to be a very nice home. Our only concern when we arrived is that we had been told by 1 of the physicians here who had been over there that they were concerned about having the 2 boys because the stairs were different than any stairs that we have here. They didn't have backing to the stairs, and with the children that small, they were concerned about when they started to crawl and get around. But we never worried, never had any problem with it. We were there when they were going up and down the stairs. And just things like that. But it was a very nice compound, the housing that was provided, and the furniture was provided. By the guidelines, you had to hire locals to work for you while you were there. They had secured a nanny for us, a cook, and since cooks do not clean the house, we had a houseboy to clean. And then, like dumb Americans going into that kind of an environment, we, in our sea freight, sent over a lawnmower. But we found out, when it arrived, that that's not what they use over there. They use machetes to cut the grass. It was little things like this. But I thank God that we had a chance to see another culture. HARRAR: I imagine you learned some things and had some experiences that you will just never, ever forget. How did you find the people of Nigeria? Were they welcoming to you? Hicks: Very friendly. They had guards. You know, we were there during the Biafran War with the Eastern Region, the oil region of Nigeria, and the military capital was in Lagos. The American wives and children were given the opportunity to evacuate, but we could not come back. And we chose, as a family, to be together, even though Jim was traveling throughout the entire 19 countries, I believe it was. It may have been 20; I don't remember. And it was an experience then that I hadn't expected. HARRAR: What would you say the impact of this experience was on your family, on the boys growing up, and on your own view of the world? Hicks: My view of the world is that we don't know how fortunate we are. I wish I could convey that to people. And when people are poor in this country, I haven't seen anything in this country, as many places as we've lived, that would be anything like living in an environment like that. When you see children that are sold from 1 client to another to work, and they'd come to our backdoor in the morning carrying loaves of bread, little tiny loaves, to sell. Precious children. And children with swollen bellies, that you thought, "Boy, that child had too much to eat," and then you'd find out that it wasn't that they had too much to eat, they weren't getting enough to eat. It's hard to convey to somebody. HARRAR: It kind of breaks your heart, I'm sure. Hicks: It does. HARRAR: Especially when you're raising children of the same age. Hicks: Yes. But both of our sons now really don't remember anything because Jimmy became very ill with his asthma overseas, after we were there for 2 years, and had been hospitalized over there around 20 or 22 times. Jim was out of Nigeria, in 1 of the other countries, and they sent a cable and told him to come back because they didn't think Jimmy was going to make it, and they decided to send us home. HARRAR: It must have taken a lot of courage for you to be the mother and try to hold down the fort at home while this was happening and your husband was traveling. Hicks: So we were there about 2 years, going on 3 years, before we left. And we couldn't come straight home by plane. They wanted us to stop in major cities in case Jimmy had an attack. He's now 42 years of age and is a chemical engineer with Solvay. And why he chose to take chemical engineering, I don't know, but he's in polymers. So he says, "Mom, we develop it on the computer, and if it explodes, we don't do it." But it's things like this. HARRAR: Do you remember how you felt when it was announced that smallpox had been eradicated? Hicks: Elated, absolutely! Jim continued to work in smallpox from here and would leave and go over for 6 weeks at a time and that sort of thing. But it was an experience that I'm thankful we were able to have. HARRAR: And did you see values in Nigeria maybe that you thought were powerful, whether it's family . . . Hicks: Absolutely family. The mothers, if they can afford to do it, keep their children, and they try to take care of them. They would feed the children before feeding themselves. You see little children laughing, and they don't realize what the situation is. They're not used to having a plate full of food. And I can remember my dad telling me, when I was growing up, that "you have to clean that plate now. There are a lot of poor people in the world." Well, we were poor, but I didn't know it until I grew up. You know, when you get to be in your 70s, you remember those days. HARRAR: And do you think that this experience really shaped your husband's career and his work that he did thereafter? Hicks: Oh, yes, absolutely. He'd been with CDC, was hired from Tampa Health Department after graduating from-am I allowed to say he's a Gator? HARRAR: Sure, go Gators! And you yourself, did you ever work outside the home? Hicks: I was teaching the Nigerian police, equestrian arts. For years, I showed hunters and jumpers and 3- and 5-gaited saddle horses. I was going to market 1 day with the boys, and I saw this Nigerian police officer-this is one of the things you may want to edit out-he had dismounted from his horse, had urinated, and couldn't get back on the horse again. So I stopped the car and went over to him, and I said, "I could make that easy for you." And he said, "How?" And I said, "You lower the stirrup." And so I showed him how to lower the stirrup and how to put his foot in it, and gave him a boost up. I was a lot smaller than him, but he got up. And so the police asked me if I would help them with training, and I was doing that. They have a polo ground in Lagos., We actually lived on the island of Akoya, which is connected by a very small bridge. You don't even realize that it's an island until you go over the little bridge and wonder what it's doing there. You think it's a drainage ditch. I was amazed at the fact that the sewage consists of open sewers. Before you could go into your own home, as a precaution, you would take your shoes off and wash your feet at the door. You just didn't go in and out when you were down in that area. There was water there, and we wound up with a boat. We used to take the boys out to this little island that the embassy had. We'd take them to a hotel that they had, and it had a little pond. The children would push their little sailboats around that. And we'd have high tea in the afternoon on Sunday. We were Christians, and we were fortunate enough, when we went over, to go to the First Baptist Church of Lagos with our sons. The first Sunday we were there, the service was in the Yorba tongue, and we knew the music, but it was sung in Yorba. I said to Jim as we were leaving, "Gosh, our sons will never understand the language, and we certainly don't understand it." Having said that, a couple walked up to us. Quite honestly, I thought we were the only white people in there, but there was another couple, an older couple, who came over and introduced themselves. They had been sent over by the Southern Baptist Convention as missionaries and had been in Africa for many years. And we found out that their residence was just around the corner from our house. So they became grandparents to our children while they were there. We mentioned to them that our children would never understand the sermon or the Bible. We read the Bible to them, but they needed to do something. And she said, "Well, do you think you-all would be interested in trying to help to formulate an English-speaking church here?" And we said, "Yes, of course." And, to make a long story short, we were able to do that. We didn't have a preacher every Sunday, so Jim would take 1 Sunday, and then there was another couple from Gulf Arabian American Oil who were Baptists, and they came, and he would preach 1 Sunday. And then there was a Nigerian man who was part of the Southern Baptist Convention but African, and he traveled in Nigeria from 1 place to another to do services, so he wasn't always there. Before we left, they had received enough money that we were in a school on Sunday mornings. A lot of the Nigerian young men who were in university chose to come to the English-speaking church because most of them had learned English when they were out of country, in the U.K. or in the United States, and they wanted to continue the language. HARRAR: Did you feel isolated when you were there? I mean, I know it was very tough in those years to-you couldn't call home easily. Hicks: No. You had to make an appointment to call home. As a matter of fact, when I was there, I received a wire through the embassy that my grandfather had passed away. It was during the Biafran situation. If I had left the country, I could not come back. And by the time I got the message, he was already buried, but I found that out only because I had made an appointment to make a long-distance call. And when I finally got through to my parents, he was already buried. So that was one of the factors. The children reached the point that, when we came back to the States, they were speaking some of the Yorba tongue. The worst part of it was our help were not all of the same tribe, and there were 3 different dialects spoken in our house, not including English. HARRAR: Were you concerned that the children, aside from the asthma, would be affected by illnesses over there? Did your family, you or your husband, ever become ill? Hicks: No, not at all. We had a physician at the embassy. I couldn't find him at the time that Jimmy went code blue, but one of our own physicians, Dr. Stan Foster, I called his residence, and the help said that he was out playing tennis. And I said, "Can you get a message to him that I need help?" Jim was out of country at the time. And Stan was a lifesaver to us to get us over. He tried to work with Jimmy at home for a short time and saw that it wasn't going to work, so he drove. And, of course, because of the war, we were stopped by soldiers for security who wanted to go through the car and all that, and Stan was able to get through to them that this was an emergency and we had to get Jimmy to the hospital. So I'm thankful for that. HARRAR: Well, that was quite an experience. I think we're all set. Thank you so much. It's really a great honor to meet you. # # # </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/_fkDd4tVoZQ" frameborder="0" allowfullscreen></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource interviews motion pictures moving image Date A point or period of time associated with an event in the lifecycle of the resource 2006-07-14 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/15nwx emory:15nwx Subject The topic of the resource CDC Smallpox Eradication USAID WHO Life as expatriate wife Format The file format, physical medium, or dimensions of the resource 4724160000 bytes video/x-dv Creator An entity primarily responsible for making the resource Harrar, Linda (Interviewer); NOVA Hicks, Dorothy (Interviewee); Spouse Contributor An entity responsible for making contributions to the resource Reunion of West and Central Africa Smallpox workers (2006 : Atlanta, Georgia) Title A name given to the resource HICKS, DOROTHY Description An account of the resource Dorothy (Dot) Hicks was in Lagos, Nigeria with her husband Jim, who was the Regional Administrative Officer for the Smallpox Eradication Program. She recounts family problems as an expatriate wife. These included attempts to medically evacuate a son. Dot also relates humorous situations that often occur while living in a different culture. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/ee0ead593395bd00bb0f24999ae89aac.jpg 9feba0e305076cbf28b12294cf45b79e Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> Interview D.A. Henderson with Paul O'Grady Transcribed: February 2009 Paul O'Grady: This is an interview with D. A. Henderson on July 12, 2008 at the Center for Disease Control and Prevention in Atlanta, Georgia about his involvement with the smallpox eradication program. The interview is being conducted as a part of a reunion marking the 40th anniversary of the program in Asia and East Africa. The interviewer is Paul O'Grady. Can you state your name? D.A. Henderson: D. A. Henderson Paul O'Grady: And you understand that this oral history is being recorded? D.A. Henderson: Yes, I do. Paul O'Grady: Thank you. I would like to start off by having you give us a little bit about your background, what lead you to a career in public health and how you started working for the CDC? D.A. Henderson: Well, I was born and brought up in Lakewood, Ohio near Cleveland. Went to Oberlin College and then to the University of Rochester School of Medicine. After internship at the Mary Imogene Bassett Hospital in Cooperstown, I was told that my deferment from the draft was at an end and I had my choice either to voluntarily enlist in which case I would be a first lieutenant, or be drafted in which case I would be a private. So, like many of my colleagues who had been deferred since, in my case 1946, and this is 1955, I decided I could volunteer. I was having difficulty making up my mind whether it was army, navy or air force. I figured I am just an intern, all I am going to do are boring draft and do physical of new recruits. So about this time somebody shows up from something called the Communicable Disease Center, which I had never heard of. They are from the public health service which I knew nothing about, but they talked about working on infectious diseases which I didn't really much care for. As I thought about it, well it might be two years and I'd learn something, and as they pointed out we don't wear uniforms, we don't salute, you don't do basic training. I go, well, okay, doesn't sound too bad. So I enlisted, in the public health service. Now, this was the Epidemic Intelligence Service which at that time was only four years old. That created by Alex Langmere at the CDC. There were, however, quite a number of applicants every year who were anxious to do their required time and service at CDC would be challenging, interesting, so forth. Well, fortunately I had done a history of medicine paper in my last year of medical school. Why had a done the history of medicine paper? Because they offered $200 and a handy subject was something about cholera in upstate New York in 1834 and there was material available in the newspapers and so forth. So I spent time creating this paper, going through the newspapers, plotting cases, doing curves. I didn't know what I was doing in terms of training but it really was epidemiology and in fact it turned out to be rather fun. I had to see what the responses of the health department were, to the various challenges. Seeing how it spread through the city and so forth. So in advertently I'd become interested in a subject which we had no courses in at all and I got drafted to the public health service. That's where I got into public health and I had no interest in public health either at that time. I was going to be in my mind a cardiologist and this would be two years out and then I go back to my residency in cardiology. Paul O'Grady: What were the major public health concerns at that time? D.A. Henderson: There was one dominant major public health problem at that time or challenge and that was polio myelitis. There had been significant cases, significant outbreaks of polio myelitis. In the 1950s, there was a great deal of fear at that time about polio. In the summers there was - they closed swimming pools, parents kept their children away from other children. If there were outbreaks there was a great deal of anxiety in the community. The National Foundation for Infantile Paralysis was a very major foundation. It was the only categorical foundation at all that time. It had been started because of President Roosevelt's, Franklin D. Roosevelt's polio myelitis and they had raised for Warm Springs, Georgia rehabilitation center. They had been extremely successful and they took some of this money and they put it into some basic research of very good quality and development of the vaccine. There was great anticipation in 1954 because they began the first major study of the Salk vaccine and there was school children across the country. I forget how many were involved. As I recall it's 100,000 plus. The results were coming up in April of that year that I was doing my internship. Very soon thereafter they began to, in April, I guess they announced the results and they began vaccination around the country with the vaccine. About this time they found that some of the lots of vaccine were not quite - the virus was not quite as dead as it should be. They began to get cases of polio myelitis, paralytic disease caused by the vaccine. So I was being inducted into the Center for Disease Control. The epidemic intelligence service Alex Langmere's group were doing the work of compiling information on the cases in trying to find out which lots of vaccine were involved and trying to determine the magnitude of the problem and then what to do about it. So we were totally immersed, as I came into the service on the 1st of July with what was an ongoing investigation into what really was the end of the largest field trial ever conducted on a vaccine and the introduction of the polio myelitis vaccine which was - had been awaited for so long. At the same time we had what was amounted to a vaccine incident which was serious with a number of paralytic cases associated with the vaccine. The question was, was it the vaccine of all companies or was it maybe one company and only some lots of the vaccine or what was it. So this was all absorbing for many of those who came aboard at that time. Paul O'Grady: And how many years were you at CDC after your - so you got a two year government required service and then you stayed on? D.A. Henderson: Well it turned out be rather more exciting than I had thought. They had a matching program. So, that those who are recruited you then submitted your preferences on a list of different positions you could have. They in turn would look at the people who are coming in, about 30-35 of us and decide which ones they wanted and they would list their priorities and then they match them up. I matched up with a position which was called assistant chief of the epidemic intelligence service which would be as they called it a go-for job kind of putting things together, helping organize a course and doing things of this sort. Well, we would have a course to a one month at that time where they taught us epidemiology and bio statistics. Basically how to investigate an outbreak and at the end of the one month you are then a qualified epidemiologist in our terms and at the end of that course I had to go off the epidemic intelligence service did to an epidemic. We were constantly being called for various epidemics. There was a big epidemic of diphtheria in Phoenix City, Alabama. I went down, I spent three weeks down there and giving vaccine, taking cultures. The patients were housed in a big Red Cross tent. I came back and here was the chief epidemic intelligence service officer packing his bags. I said, "Where are you going?" He said, "I have another job. I am going to be a state health commissioner." I said, "Well, what do I do?" He said, "I guess you are the Chief EIS officer." I said, "I have no idea what to do?" He said, "You will learn." Sure enough, then I began working in a job that certainly I was not qualified for but plunged in. With the mentorship of this Alex Langmere who was a legendary epidemiologist, a rather difficult person but demanding and just a wonderful teacher, just an extraordinary teacher. At the end of two years of this, I finished my duty. I proposed to him, you know, we are not keeping many people on. The people were getting, so many people apply. They are well qualified. All of them wanted to do academic medicine or pediatrics. Just about nobody wants public health. Now, if we offered a 5-year training program in which you do two years of training, like a residency in cardiology that I was thinking for myself, and maybe then three years with the public health service. Maybe that would be a way to attract people, then by then you will have, say then, seven years and we might get people staying longer. Well, he liked the idea and then well, he submitted it up-line to the surgeon general. He liked the idea. So, I applied for a five year training program and went back to get my residency. At the end of the - well, during the course of the residency, I found this to be frankly rather boring. I was seeing patients and some of them had some heart disease and heart failure, a little diabetes, a little gastroenteritis. A little constipation and sort of the end of the day I felt, you know, if I really hadn't been there, I wonder if it would have made any difference and was I making any difference. Am I going to be doing this for my next 40 years? Well, meanwhile I had been two years in the epidemic intelligence service which some exciting outbreaks here and there including one which was an interesting one in Argentina. There was a big outbreak of food borne disease. They were stoning the restaurant, the Argentine government was upset. They thought it was a type of food poisoning due to the Botulinum toxin. They wanted our, what we had in the way of antitoxin to treat them. So I took off for Argentina with such supplies as we had. Paul O'Grady: When was this? D.A. Henderson: That was 1957. At the end of this I saw the secretary of health. He sort of offered "Well, let's go on a hunting trip or a shooting trip with me at my lodge." I said, "You know, I hear you have got an outbreak of smallpox." He said, "Yes." I said, "I would like to go see it." So he said, "Fine." We took off on an old Pan-Am clipper off the waters and the river on La Plata. On up to another place and we got in a two passenger piper cub and flew into a smallpox - the area where they had the smallpox and they had an outbreak of smallpox. The people were in tents in the field and so, about 30 different patients. We looked at the patients one by one, it was fascinating. And at that point, I had never seen a case of smallpox, really didn't know what it looked like. But it was my first contact with smallpox. Paul O'Grady: Was there at that point any national or international interest in trying to organize the fight for smallpox? D.A. Henderson: The international concerns about smallpox were there very, very strongly because all travelers were obliged to carry certificates indicating they've been successfully vaccinated within the preceding three years. Just about every country including our own enforced this. If you weren't vaccinated you wouldn't get admitted or they might vaccinate you on the spot. There was a great concern about importations of smallpox. It was in 1958, just about a year later after I had seen the cases that the vice-minister of the Soviet Union proposed to the World Health Assembly that they undertake a program to eradicate smallpox. That was the year the Soviets came back in to the UN family. They'd withdrawn because of the Korean War and they were - they just come back. So the proposal, they looked at this, delegates at the assembly looked at this and they really wanted to be helpful and encouraged the Soviets this time. So a year later they approved a program to eradicate smallpox. The only thing was that at - that same time the World Health Organization was deeply involved in a program to eradicate malaria. And fully a third of all staff were involved in that and all the spare money they could get together because it was very expensive, very costly. The idea of undertaking another eradication program was really not the intent of the director general. In fact the only thing he could do is say, "Fine." He really gave it very little money and a few countries then did some vaccinating and tried to get rid of smallpox. They did make some progress in this but it basically was going anywhere. That was the beginning. It was 1959 when they decided that they would undertake a global program but it really was not anything that was happening. It was seriously, it was not until 1966 that they really took it seriously. Paul O'Grady: What was the attitude of the United States government towards this program that it seemed to have gotten some impetus from the Soviet Union? Was there any political peculiarities about that? D.A. Henderson: There, clearly was an element of Cold War competition. The US was heavily supporting the malaria eradication program, both through the organization very heavily and through direct bilateral donations to the countries. So the US, you could almost say, owned the malaria eradication program. The Russians had no program at that point that they could say the same thing about. So, in a way they came in with this smallpox and said look, we got rid of it in the Soviet Union back in the 1930s when our vaccine wasn't so good, when health conditions were poor, where personnel were not well trained and we got rid of it. So, why can't the rest of the world get rid of it? So that's where they came in and then put after 1959, every year at the World Health Assembly they would really give the director general a very hard time. Why aren't you putting more money into the smallpox program? Why do you favor the malaria program? And so that went on as a continuing piece. The US really took no notice of it. It's really what it amounted to until really it came up to 1965 when a change came for the US. Paul O'Grady: Which was? D.A. Henderson: Well, in 1965 - I'll go back a little bit, 1961, Merck Sharp &amp; Dome, at that time, was introducing a new measles vaccine. It caused a lot of fever in children. So in the US, they were using it giving the measles vaccine and they gave them some immune globulin at the same time so that they wouldn't have so many reactions to the measles vaccine illness, if you will. This made little practical sense if you went to Africa. The idea of doing these two together and made life a lot more complicated. You really could not do large scale vaccination and try to preserve the immune globulin and deal with two shots to get this. So they undertook studies in Upper Volta, Benin. I am sorry Upper Volta is the place where they were doing the country. They did x number of children, 150 -200, kids reacted very well. They were no complications. Then they asked - the country minister said, could you give - do it for all kids under six years of age. So they gave them a vaccine enough for that. Then there was an organization, French organization that had a number of countries and he said, could we do it for six countries now. USAID said, "Okay, we will do it for six countries." Well, things couldn't go very well with six. I won't go into all of the complications but we got drawn in at that time to evaluating it. I sent one person over to evaluate. It was a disaster. Well, not to be deterred they decided we are now going to do 11 countries. We need from you, 11 people for six months each to help get the program started in each country. I thought, we can't do that. Really, it's - a good segment of my staff and signing people over for 6 months at a stretch is, without families and what have you, this is tough. So I thought, you know, I really have to work with AID, we really got to be responsive to them. I didn't know what to do. So I decided, all right, let's put together a proposal that we would say is sound from this public health standpoint. Why was the measles proposal bad? Well, they were going to give it for just four years and then stop. In other words AID would support it for four years and they expected the countries to continue. It cost a $1.75 a dose. The countries couldn't afford $0.10 a dose for yellow fever vaccine. So this is not good public health practice. To start a program, get the hopes of the public up and then drop it. This is terrible way to do it. Smallpox had vaccine however, cost a penny a dose. So they proposed the idea, well, suppose you take this whole block of countries, 18 countries and suppose you give, do smallpox vaccination - Paul O'Grady: And you talk about West Africa? D.A. Henderson: This is west, West and Central Africa as well called it. And so we do 18 countries. You give smallpox and develop a smallpox program there. We could get rid of smallpox in that whole area, they could then - would have as an established program for vaccination. They could continue it easily when that only cost them a cent a dose in vaccinating newborns and so forth. Then if they want to have measles vaccine added and the ministers think this is a good idea, we would be happy to give measles vaccine at the same time, but we can't eradicate it because measles spreads too easily. We couldn't get rid of it, but at least the countries would have to think through was this a good idea to do this with measles vaccine as well. Well, I think the cost - what USAID expected to spend was about five or $6 million. The proposal we submitted was about $35 million. So, I knew it can be turned down. But on the other hand I thought it was going to be a point of departure for discussion. I didn't know where we were going to find any sort of compromise on this. They just, their demands were so great that it was impossible. So I set it up through channels, through the surgeon general and very shortly USAID turned it down. We were just debating along about autumn what we would do subsequently on this. Paul O'Grady: And we are still in 1965? D.A. Henderson: This is 1965, when all of a sudden we got information that the president had decided to approve the program, the whole program. This shook everybody. My boss Alex Langmere was absolutely beside of himself. As I told him they were not supposed to accept it, that was - but the president was looking for an initiative which would be something that he could publicize that the US was contributing to a UN International Cooperation Year. There were several proposals that went forward. This I had no idea was even being considered and suddenly AID was told by the White House, fund it. All of a sudden, we are told, all of a sudden we have got 18 programs to set up in the West and Central Africa. We had never run a program outside the United States at all. Paul O'Grady: So you guys have been faced with a tremendous manpower problem? D.A. Henderson: Well, we would need about 54 people. That we are going to have to recruit. AID said that it probably would be - you can't do this under three years. They agreed finally to fund it then on November. They felt we could get it in three years. I said, no. This is wrong. It's just got too much of a delay. How about 13 months? We will have the people over there in January of 1967. They thought it was almost impossible. You've got individual agreements what every country. You have got to order the vaccine, you have got to put on training programs, you've got to recruit all the people. We did. Recruited the people, we got the vaccine ordered. We got vehicles. We had to use US American vehicles. There weren't any in all of these countries. No maintenance, no repair, so we had to set up workshops and everything else, to train our people to be mechanics. We had to lay out plans for all of the countries to get everything signed and we did. Paul O'Grady: Let's talk of, just for a second, about the attitudes of the countries involved. What was the interaction with the governments like? D.A. Henderson: Well, in November as soon as this was approved, I went over with a consultant that I had who, Warren Winkelstein, who was a good epidemiologist and spoke French, another person by the name of Dr. Henry Gelfand. The three of us went and visited each of the different countries. Fortunately a number of them were having a meeting, so we could present it to all of them at one time. They were enthusiastic. Why were they enthusiastic? More - most of them, more because of the measles vaccine because this is a very - in Africa, this is a very deadly disease. It's 10-15% death rate. The French speaking countries by and large had done some pretty good vaccination with pretty good vaccine. The English speaking countries had a lot of smallpox. They were more enthusiastic about the smallpox. But they were getting both and they were really very enthusiastic. We were coming up with vehicles. We were coming up with vaccines and consultant help but not a lot of people. It was by and large one or two people or advisors to be assigned to most of the countries with a few more in Nigeria. Paul O'Grady: And how about the Americans that were going to go over there as part of this program? Let's talk a little bit about their attitude? D.A. Henderson: Well, the Americans who were going over there, a number of the people I - some of them I had known. Basically called up and said, we have got this coming up, are you free, or would you be interested, people, contemporaries and so forth. I had a couple of people who are already serving in CDC and took them. Basically it was almost word of mouth advertising because there just wasn't very much time, and contact with people at schools of medicine and other places, infectious disease people that might know of people interested in this. People - the word of mouth, by word of mouth they learned about this and my goodness, we were able to recruit enough, so that we were able to begin the training program in July of 1966. Paul O'Grady: And people were on the ground? D.A. Henderson: Well, they had to finish up the training. We had to get all the agreements signed. I think we got all of them in to 16 of the 18 countries. We managed to put two, postpone two, but we had 16 of them by January of 1967. Meanwhile, there is a little problem. There was a debate coming up in the Assembly in May of 1966. So this is only like about 6-7 months after this approval for the whole West African program had come through. Paul O'Grady: Debate in the United Nations Assembly? D.A. Henderson: Debate in the World Health Assembly? Paul O'Grady: Okay. D.A. Henderson: Every year the ministers of health convene in May, in Geneva to look at issues of health. So they were debating the question of going with an intensified program of smallpox eradication with a budget of $2.4 million a year and an objective to complete that within 10 years. The director general Marcelino Candau, a very capable Brazilian knew that it was impossible to eradicate it. He felt you had to vaccinate everybody in the world and he was a Brazilian and he knew that there were tribes in the Amazon that hadn't been found. Or were just recently found or that sort of thing. So he knew it couldn't be done. There were a number of countries that were very doubtful of the concept of eradication at all because they were having so much trouble in malaria eradication. There were others who thought this was far too ambitious for an organization like WHO which is, where it's not, except for the malaria really it hadn't run programs or really coordinated that way operationally health programs. So it came to a debate in the assembly. The US had, as I said, been very quiet before this really in taking a position but at this assembly they were going to take a vote finally because it was very controversial, whether they went ahead or didn't go ahead. One of the strong arguments was well, the US is already committed, funds and personnel for - to take care of 18 countries. So that's a big start on this whole thing and after two o three days, three days debate, they did vote. They had about 58 votes to start the program and it passed by just two votes. It was the closest vote they have ever had in the World Health Assembly. The director general was furious and felt that the assembly had committed the World Health Organization to a program which is going to fail. It would bring the organization into disrepute and question the credibility of public health and the World Health Organization. He blamed the US for this. Well, in a way, it was true. If the US had not done this crazy thing in West and Central Africa that almost certainly the voting would not have gone as it did. So he was blaming the US. He, then, called the surgeon general in the US and said I want an American to run the program because when it goes down, when it fails, I want it to be seen that there is an American there and the US is really responsible for this dreadful thing that you have launched the World Health Organization into and the person I want is Henderson. Well, I was associated, of course, with the West African program of having gotten involved with starting it and so forth. So I got called to Washington and I was told I was being assigned to be head of the World Health Organization's Global Smallpox Program. I declined. I said, we are just starting this West African program. We have just - there is a huge amount of work and we have just barely started. The $2.4 million we got to go, we had programs in 50 countries. We don't even have enough money, $2.4 million won't even buy the vaccine we need. Trying, I had some experience in working with the World Health Organization and they really were not working well together. Each of the six regional offices were sort of wholly independent and trying to coordinate them was a terribly job. So I said, I really can't do it. I, you know, I think this is a very difficult task. I really, I think if we do a good job in West Africa, we are going to show what can be done. Maybe that will encourage the other countries but that's, I think, where I ought to stay. Paul O'Grady: Was this conversation going on between you and the surgeon general? D.A. Henderson: Yes. So I declined. He said - I said, you do not - we don't order people in the public health service to go from place to place. That we - we talk about career opportunities, and so forth and so on. It's not like the military services. He said, "Well, this is your career opportunity." I said, "And suppose I decline." He said, "You are fired." I said, "You are serious." He said, "I am very serious. I will tell you what, make a deal. You go for 18 months and if at any time during that 18 months you really feel it won't go, just send me a telegram, just put now and I will pull you out." So, I headed for Geneva to head up the Global Program. We left in October to go to Geneva, get a house. Wife and three kids, plus left half of our household goods in the storage because we knew we would be back pretty soon. Took over a program, which was a global program. This provided for headquarter staff eventually of nine of us. It never got bigger than that. So there were five medical officers, two admin officers and a couple of secretaries. That was our total staff. Paul O'Grady: Let me ask you about your own mindset at this point. You had mentioned the problems with the measles program and that malaria eradication had been problematic. Were you optimistic at this point about - at least with respect to the West African piece of the puzzle? You were optimistic about eradication's success? D.A. Henderson: This is a good question as to whether you would characterize what I felt is optimistic. My feeling was it was doable but without a full appreciation of everything, all the problems we would encounter. I must say because as I thought back on it, had I any idea of all the problems that we would face, I would have not been optimistic. You can't anticipate civil wars, floods, masses of refugees, one thing after another and bureaucratic blockage of things, countries refusing to participate. All of the difficulties you can have with this, but fortunately I was innocent of the problems, these problems that you would encounter or we couldn't anticipate, obviously, most of these. It was the fact we had a good vaccine and the vaccine we knew and I'd worked, we had done some studies at CDC while I was in charge of the surveillance program, showing the vaccine was very good. You could get virtually a 100 percent takes, using a proper technique. We had jet injectors that we had worked with and perfected these with the inventor in the US Army so that we could add jet injectors that could vaccinate a 1000 people an hour. They looked - we looked optimistic that we could do a lot of vaccination with them. So that, we had a good vaccine, we knew something about smallpox. You know that - we knew that there were a number of countries, developing countries who didn't seem to have any cases but the reporting was so bad that, little did we know that many of them just weren't reporting it. But we just - we really didn't have an idea but we thought there were large countries, free of the disease, certainly the US was and Canada was. Certainly there must be others that were involved too. So it was a feeling of technically this was doable but without an appreciation that experience would provide as to just how difficult the problem would be. Paul O'Grady: Let's take you to - take you back to Geneva. You have arrived, you had your family there and when did you start to realize that these challenges were going to present themselves? D.A. Henderson: We quickly found that we had problems. Within just the first couple of years, we ran into a number of problems. Paul O'Grady: Can you - ? D.A. Henderson: The West African program basically, Don Millar who took over from me, who had been my chief of my smallpox unit before. He was running it and he had a good administrative officer and he had some very good people in the field. My feeling was that they had to run that themselves and the only thing we could help them with, which they needed was some local costs. I think we gave them a couple of $100,000 a year to permit in some countries, purchase a vaccine, gasoline and a few other things, they couldn't get it, legally with their USAID funds. Other than that, they were on their own. So we worked at the world and saw well, we got, two countries are sitting rather at the far end. One is Indonesia, the other is Brazil. Now at that time, South America appeared to be free of smallpox except for Brazil. They had done vaccination programs in the other countries and one way or another, with their infrastructure, not perfect but they managed to get rid of smallpox. That of course was encouraging. But if we got rid of it in Brazil then they would be far away from endemic areas and indeed they could be basically the funds that we are putting into a Brazilian program could be withdrawn and we put it in other areas like Asia or Africa. Similarly with Indonesia, Indonesia sitting off where we are here and the countries nearby are free of smallpox. So the chances of smallpox being imported into Indonesia, if we got that free would be small and therefore the limited amount of funds we could use have, we could then transfer that to other countries and at least make a start in trying to get rid of the smallpox with the limited funds we had. So, that was the strategy. We almost immediately found we had a vaccine problem. The Russians had pledged 25 million doses a year and we had no idea how much vaccine we would really need. Most of the countries were doing some vaccination. The disease was so severe, it was such a problem that at least they had to vaccinate in the big cities simply because of civil disorder, with too much of this epidemic smallpox, it is destabilizing. So in all countries we are doing some vaccination and what we had - we made the assumption that most of them, already have vaccine and we have got 25 million from the Soviet Union. US is covering all the vaccine needs in their 18 countries, later 20 countries. So we got to be alright, but we - I thought we need to have some way to determine whether the vaccine is really, really potent, really good. So, I went to the Netherlands and asked if they would help in doing testing the vaccine, vaccine quality of the production that was there and then we went to Connaught Laboratories in Canada and they agreed to do that as well. So we began getting samples of vaccine from the different countries and they began testing it. Five percent of it was potent and stable. Five percent met the international standards. So we had a problem almost immediately. We couldn't afford to buy the vaccine. So I made a decision, we won't buy any vaccine. We are going to have to develop - improve the vaccine production facilities that are out there. We called a meeting of the vaccine producers from several major laboratories. From Wyeth Laboratories in the US, they were the producer here, they had one Lister Institute in London, where Netherlands were there, Soviet Union were there. I think that was it. We brought them together and we talked about vaccination and developing a standard manual. Every country was using where they were making a vaccine they were using all sorts of different techniques. So let's get what we think is the best way to do it in a simple manual that I can understand. Then let us then help these countries improve their vaccine. We will, then work with UNICEF to try to get them to provide some machines so that they could freeze dry the vaccine and we would use some of the people from these consultant laboratories that we had brought together to go out and train and help develop the vaccine. That's what we did. The vaccine quality began to pickup. It was by about 1972, we had more than 80 percent of the vaccine was being produced in the endemic countries themselves and it was good quality. So we were immediately involved in trying to solve just the vaccine problem. How to administer the vaccine was the second problem. The problem was this. You have a vaccine which is a very, has a vial, it's in a vial with about 0.25 milliliters of fluid. That is reconstituted. You have one vial that has dried powder of the vaccine, another which has a quarter of a milliliter of fluid which is a very small amount. To use a vaccine, you have to put the liquid into the dry powder and mix it up. Then you had to put it on the arm. The way they did this in most of the developing countries was take like a glass rod, dip it in and then put it on the - dip the rod against the arm, tip it against the arm and a little drop would be there. Then by and large what they did was scratch through the vaccine. They had a number of scratches through the vaccine, it was an old technique which goes back more than a 100 years. In the US we did a little bit differently but it was the same principle but it was important that the US did it this way. They took and took a needle and they put the drop back on the arm and then they gently pushed the virus through the skin and the idea was that if you got it just through the skin it will grow and produce something. If you push too hard you will get bleeding. If the bleeding occurs then it washes out the virus. You don't push hard enough, it doesn't go into the skin, and so the vaccination fails. Wyeth laboratories was developing a new device which I visited Wyeth laboratories because it was the question of improving our vaccine production capabilities in the other countries and they showed me this wonderful device which they developed. A little needle about - well, tube about so long. There are two little prongs on the end. They called it a bifurcated or sort of two fork needle. The idea was you put the needle into the vaccine and you just withdrew it. Between those two prong, the little bit of vaccine would be held and then they thought you press it through the skin. In this way the amount of vaccine you could get from a vial was 100 doses rather than 25 doses. Well, I looked at it and I know how much trouble we had had in trying to teach them to medical students how to vaccinate because they were forever not getting it quite - not enough pressure to break the skin. So it wasn't growing and then a number of them are getting a little bit of drop of blood and that was thought to be bad. So I raised the question of well, suppose that we take a needle and just hold it like this and poke it like this, we called it multiple puncture. Instead of scratching or pressing it through, do multiple puncture. You are going to get bleeding. So let's see what happens. So we tried a few of these, they all got very successful takes. We took it to the field into Kenya and Egypt and did several 100 children and we did it very vigorously. There was a little drop of blood on everyone. Every single one of them was successful. So this was incredible. All of a sudden we were going to have four times as much vaccine than we thought we had or we are getting, with these wonderful needles. The needles cost us, we shortened them up a little bit and make them cheaper than we made them out of a stainless steel virtually. We could get a thousand of them for $5. You could boil them and reuse them and we ran through about a 120 vaccinations perfectly good. So we had needles very inexpensively. We had a vaccine and suddenly we had four times as much vaccine as we thought we had. Then it was a matter of bringing those into play in the different countries and this went very rapidly. So it was another development, right at the beginning which made a huge difference. It was a crazy little thing. Now the important thing, I think was is that the - the inventor of this, a man by the name of Ben Rubin received a one time, to tell you, what's called the John Scott Medal of the City of Philadelphia for the best, most important invention of a particular year. Here he was getting this and it had gone back - the award goes back to the 1700s. Marconi has received it, Edison has received it so forth. He said, "This is the most insignificant patent or invention I have ever made," and he said, "And here I am receiving the John Scott medal." And it was - it just was like inventing the safety pin. It was so incredible. So we began using that, we had - introduced the jet injector for West Africa but very soon we said, for this price we don't have problems in mechanic to repair or what have you. It's very inexpensive, much less expensive than a bio - than jet injector. So pretty soon the bifurcated needles took over the whole of the world in terms of vaccination. Well, we had a couple of the very early problems that we had. There were many more. Paul O'Grady: So tell me how the smallpox program moved into Asia and East Africa? D.A. Henderson: Well, West Africa, I want to go back to the West African program which began in '67 and they managed to record their last case in 1971. Well, ahead of schedule and under budget. Not too many programs come through like that. Meanwhile, I had a man in East Africa and he was working with the people in the different countries and helping them and strengthening what they were doing, a Russian, Ivan Ladnyi and they began to make very good progress. We, from WHO, began supporting Central Africa, not Central Africa, but Sudan and Zaire are two huge countries across the middle. This was frightfully difficult but we had some very good people, incredible people. Some national, some internationals and they began to make a good deal of progress. Brazil, I got back to say Brazil became free in '71. We had, Indonesia was a bit of struggle but they became free by 1972. In fact the whole of Africa, was free of smallpox except for Ethiopia. The whole of Africa was free of smallpox by the summer of 1973. We were only six years into the program and here we were with a good piece of the world free now of smallpox. So, in the summer of 1973, we were down to - just five countries that had smallpox, just five. It was India, Pakistan, Nepal, Bangladesh in Asia and Ethiopia. When you looked at India and that group - that bunch of countries, I think the population then was maybe about 700 million. So you look at it and you say, only four countries in Asia but 700 million people is, at that time, almost three times the size of United States. So it was not a small undertaking to deal with that. Meanwhile in Ethiopia, they were doing a malaria program. They did not want to see a smallpox program. So, the Minister of Health refused to even have me go and talk with him about starting a program. So nothing had happened in Ethiopia at all on smallpox, up until late 1970 before I managed to get into Ethiopia and lay out a plan and by various devices working through the emperor to get approval to get started in Ethiopia. So we came in the summer of '73. We had programs in all the countries and we were very optimistic that now we are on our way. The big problem, frankly, at that time was India. Huge country, a number of people talked about India being like the native, like we talk about cholera being the home or India being the home of cholera. There are some who said, well, India with very dense population, particular climate and so forth. They must have something special here that maybe is the home for smallpox. Very difficult, you will never get rid of it there. That was the general discussion that was going on. We weren't making much progress. India had started a program back in 1962, not so long after the first World Health Assembly heads said, well, let's do an eradication program. By the time they got to 1973 it really, they'd made progress some of the southern states of India but most of India, they were still recording as much smallpox as they've had 11 years before. They were discouraged and really, not sure they would continue. There was a lot of discussion about it. It was a problem saying we really have to keep going. They agreed to do so and this was the earlier 70s. They agreed to keep on going but then we met and sort of the late spring of '73 and we said, we have got to do something different. Paul O'Grady: Who's meeting? D.A. Henderson: In India, well the strategy that we had had was not working. They had done a lot of vaccinating. They were doing mass vaccination all the time, they were then beginning to do what we called surveillance and containment. Really getting much better reporting and when a report came from a village, they would go out, send a team out. Try to vaccinate and control the outbreak. It didn't seem to be working and there was a still a lot of cases and we were - they were not making progress. So that spring we decided what we needed to do was find the cases more quickly. Find them before they became outbreaks. So the decision was made that we try to undertake a village by village search throughout the whole of India in 10 days time. Mobilize the health services for an intensive 10 day search. With this we were - would employ about a 120,000 people. And the idea initially was to go to selected parts of the village in a particular pattern to try and find cases and see what you could turn up. There was a lot of planning. A lot of organization went on. We got Bill Foege from CDC, was sent over. I had asked for more help. They sent over a couple of people but India is a big place and we have a very cracked team of international from France, from Czechoslovakia, from Soviet Union, but not a lot, we were very few. So the first search was completed in October in this one state of India. We were normally getting about 500 cases a week. That first search was completed and they recorded 10000 new cases found, 10000 new cases. This wasn't even the high point of the season. This was really at the - almost the beginning of when the seasonal increase occurred. Oh my gosh! This is far, far worse than we had ever imagined. Well, it was even worse than that, because it wasn't several weeks later I found that the search teams had not done a great job and they really reached only half of the villages. So it was probably twice as bad as bad as I thought it was. They repeated the search in another two months and they got better. By about the third search they got into the point where they would do house to house. We actually had a team following and doing a sample number of the villages to make sure that they had really reached at least 80 percent of the houses. So we began gradually to mobilize this tremendous force. It took 8 tons of paper for one search. We began getting more cases. The cases were increasing. The problems were that of mobilizing the staff, of supervision, quality control. It was a really tough job. We went on and through the summer of 1974, when at that time the smallpox goes down to its low as points. Some of - smallpox transmits best like measles in the winter. Measles is a winter disease, smallpox is the same. Whatever it is, whether it's being dryer air and cooler air that does it we don't really know all the answers. But certainly the summer months are where it gets to the lowest point. So the summers and the states, northern states where this almost all the smallpox was, the summers are terrible, 120 degrees. There is not - limited amount of electricity and there is certainly no air conditioning. We were bringing in a lot of people who are on 3-month volunteer stints with their Indian colleagues. That summer it was murder. We brought them together, once a month, looked at what they had done. Reports, we viewed all of these. We had no cell phones, we had no telephones. There were no computers. I mean, this was all done by hand. They'd come in for a weekend. We'd come in for work for a day and then they had one day of rest. Paul O'Grady: Can you identify a turning point in the Indian experience? D.A. Henderson: Yeah, I will come to that. At the moment, there was a turning point but a strange one. We worked through '74 but we got started going into late '74. The seasonal pick up, picked up. There were more cases than ever, it was really a going and there were several longer term trends in the disease in India and this was a little [1:03:18 inaudible] with a longer term trend. It was on its way up and we were not having that much of an effect. However, by the time we got to around February, we realized that the search system was in place. That we had some very good people supervising this and in fact I even remember the time it was with, Bill Foege, the two of us were looking at this and wondering now, where were we at this point in time and that - but as Bill said, I am not sure I am going to put out a weekly - putting out, I guess a bi-weekly report and the curve was going up and he said, the only thing I can do that's optimistic is turn it upside down. But we felt at that time, secretly that we are on our way and they got worse. It got worse for the bad time in a way and a good time in others. India detonated a nuclear device. They had people, press coming from all over. The theme of all of the coverage, news coverage was India detonates nuclear device, smallpox - their health system is so bad that they are the world's primary country for smallpox. So here is this advanced country with such primitive health facilities that it's epidemic for smallpox. This got a lot of interest. The Indian government was not pleased. They were very upset and they began making more resources available. Higher levels in government began paying attention to it and they assigned to the program, from the Indian side, four of their very best people to work with four of our central people. We call it the central appraisal team. Well, we got over that and for India at least, when we came to the end of the last cases in May of 1975, we thought we had the last case. There was a beggar woman out on a railway platform in the far eastern part of India going into a whole area and she had infected a bunch of people going after. We had no idea what was going on. By that time by October, the Minister of Health and the Prime Minister were very excited about this. We were not confident that we got rid of smallpox. October 5 - August 15th is India's Independence Day. They were determined to announce that this was India's Independence Day and it's freedom from smallpox for its first time in history. I would say we were chewing nails at that time, thinking, oh my gosh! If they have more cases, you know, the press coverage and these people don't know what they are doing, oh god. It would have been awful, that was the last case. Meanwhile, Bangladesh was going through tragedy after tragedy of flood and famine and we had an exhausted group of really fighting to get rid of it in Bangladesh which is a story unto itself. So, on August 15th, the Director General and I, headed for Bangladesh. They only had I don't know, something like maybe 80 villages infected at that point. It was just really coming way down and we felt, my gosh! I think we are going to have - be rid of this bad disease for all the world. It was a very severe time for smallpox. That would have been in. So we are on our way to the airport and got the word, all flights are canceled. The President of the country, the really the founding father of the country, Mujibur Rahman, had been assassinated along with his entire family. Martial law had been declared. Troops were moving to the border. Floods of refugees were expected. We thought, oh my god, once more, but for some reason, the international group, was laid low. They worked locally, they kept out of the way and the expected civil war that was expected to erupt immediately did not. They went back to work and finally in October of '75 it was all done in Asia. Then we were left with Ethiopia and Somalia, subsequently Somalia. Well, if you like to hear the rest of the story I can go on Ethiopia but Ethiopia is a huge country. People look at the map and they say oh, it's about the same size as Georgia, but not so. It's equivalent to all of the states on the eastern seaboard of the United States in area. It's huge. There are very few roads or where there are roads or even roads you can drive on. It's estimated I think that, two-thirds of the population lived more than one day's walk from any accessible road, at least one day. We had just - the government had only, I think, 2000 health workers in the whole country. For a while we were working with 20 Ethiopian sanitarians, 14 US peace corps, about six Japanese peace corps and some Austrian peace corps and some volunteers who kind of wandered in. Anybody who wanted to work, we put them to work and paid them the Ethiopian per diem which if you didn't [1:09:59 inaudible] high on the hog on that one, I can tell you. Then as they were making progress, slowly but it was difficult. Some of the - first time we ran into a huge area where the people fought against vaccination. They didn't want it. Trying to solve that problem, took us some doing but finally they wanted malaria drugs and we could give them malaria drugs. We got malaria drugs to give them, provided they got vaccinated first. So they got vaccinated first and then got the drugs. Not the way you like to run a program but that was the only way we were going to stop the disease. It was a less severe decision than let's say in Asia. So there is less motivation, less concern on the part of government. Well, we got all of a sudden the emperor Haile Selassie was in charge and had been there you know, as emperor for a long time. They had a coup, military coup. Marxist military group took over. Civil war broke out, so there was fighting in different parts of the country. The emperor was, I don't really know what happened to him. I think he was killed. Then it was the US Peace Corps had to pull out as did the other groups. A number of the embassy people pulled out and for a quite a period of time the only people allowed by the military to go outside of Addis Ababa were the smallpox group. We had some pretty very good people, particularly our person who was the real leader of the program, he was a Brazilian fellow by the name of Ciro de Quadros. He had a charm and an ability to persuade that was legendary. That's why we had permission to go outside the country but that wasn't much fun because they were - we had to go to many of the provinces with military escort because it was too dangerous. So they fought through all of that. It was really horrendous and then they came to a point. Finally we got additional people in, and then finally the surgeon general of the United States came up with a contribution of a million dollars for us to get three helicopters to transport people. It was so big. That made a huge difference. Well, one of them was shot down, one of them getting up there - I don't know, we don't know what reason went into like Kenya. Another one was hit with - they threw a hand grenade at it. They were a pair of those, of those and they took one for the - we had to get at one of them with a hostage and they were captured and we had ransom notes which I've still got a copy of the request for ransom from the people dictated by the rebels, written by the helicopter pilot. While he was captured took the vaccine and got all the rebels vaccinated, so took care of that, he was thinking all the time. Finally we got to this place in Dimo, a little village way down in the desert, last case. I flew down. We thought we got a television crew down there, film this and we did and got a lot of footage of Dimo, crazy little village sitting in the middle of a desert. We had a hard time even finding it with the - by helicopter, you couldn't spot at great distance. We went back and we waited and they searched. Nothing, nothing. It went on for eight weeks. We were about ready to make a statement at the press, we are done. There was a report came in of two cases in Somalia right next door. Well to make a long story short, the Somali government, even for the all the discussions we had had with them, had been hiding cases. They knew they had smallpox. They were admitting them to a hospital in a sort of secret ward, nobody knew about. They were trying to stop it but because they were embarrassed, the only country with smallpox. They hated the Ethiopians and they hated the thought that Ethiopia was free of smallpox. They refused to believe that they were free. This went on and as they would let our people come in but they would let them go out beyond the main city of Mogadishu. The cases kept occurring but they are having trouble finding out where were they coming from, in other words, who was infecting them. Finally, there was a great discussion about this and one of them, the turning points, I think it was that a couple of turning points had happened. One being they captured a Dutch adviser who we had working with Ethiopians. He was kidnapped, if you will, with his team and vehicle and taken to Mogadishu. I think we had eight or nine of these and then the UN commissioner would intervene and talk to president and minister. This fellow Bert van Ramshorst, finally they took him. He has to see the minister. So he spent, sat down with the minister and pretty well, persuaded him that Ethiopia was free of smallpox and that there was a problem and that the - WHO would be willing to help and so forth and so on. He made a quite a persuasive pitch here. Meanwhile, Assistant Director General, Ivon Lodney indicated he would want to come down and visit the city of Mogadishu at the capital and meet with the Minister. The Director General was threatening to do the same and I think the pressure was on. Then they began to loosen up. So from then until this was about March of '77 and the number of cases, I recall are about 3000 cases finally that they had troubles because they had nomad groups moving all over the desert area, couldn't find them. Smallpox kept spreading and you couldn't vaccinate them. It wasn't that they would resist vaccination, you couldn't find them. Then the great problem was, come November, was the Hajj. Somalia is right near Saudi Arabia. Many people come from Somalia to Mecca. All we could imagine were people and they would come from through Somalia from other countries, all we could imagine was can we possibly have at this time, one of these groups infected going into Mecca and spreading it among hundreds of thousands of people and watching smallpox go like this. So there was a frantic effort in terms of - they flew in vehicles, so we had more mobility and flew in all sorts of people and the government declared a national emergency and it went all out. On October 26, 1977, Ali Maow Maalin, a cook 23-year-old was the last case of smallpox. That was the end of the smallpox. We had to spend two more years working in the countries to make sure it was really the last one. Paul O'Grady: How did you find out about that last case, do you remember? D.A. Henderson: Oh, yeah. They had brought in some people at this point in time. They were moving people to an isolation camp to make sure that they would be held. There was two kids who were brought in by a vehicle from outside one of the program vehicles and they brought them in and they stopped at the hospital to inquire about where the camp was. Ali Maalin was a cook at the hospital. He was supposed to have been vaccinated but he wasn't. He had been a vaccinator, in fact but he hadn't been vaccinated. How we went wrong, - he got in the vehicle, rode for about 10 minutes till they got to the isolation camp. He got out and he came down with smallpox. Well, he came down with a rash, and as often the case the last is the worst. He was admitted in a hospital and diagnosed as chicken pox. Finally, they had discharged him with a mild case of chicken pox and it was one of the other people, friends of his, who said, I don't think this is chicken pox. It wasn't, smallpox. He was a very popular guy and he had contact with all sorts of people. So, there were everything from roadblocks to all night searches throughout Mogadishu to goodness knows what, trying to find possible other cases, but it was the last. Paul O'Grady: So do you have any final thoughts, anything you want to share about your experience with over the course of the years in the program? D.A. Henderson: Well, I think there were several things about the program that were very special and that is that we came together, people from across the world worked together very well. I worked very closely with the Russians. It was during the darkest days of the Cold War. Totally cooperative, we shared all sort of problems and they had some things that needed to be corrected and I flew to Moscow. We talked it over, they corrected them. We had people working across borders from one country to another. We had mix of nationalities out there. What was perfectly clear was that if we had a goal, we had leadership at all these levels that it became a very unique situation. Bridges were built such as you can't imagine. It formed the basis for going on from smallpox and we really convened a meeting and before the program was over, to say, the vaccination has been so inexpensive. We can vaccinate so many people in a day, so effectively so efficiently. We should be doing more of the smallpox vaccine. This was an international meeting we held and from that came recommendations for an expanded program for immunization, which was finally accepted by the World Health Assembly in 1974, even before the end of smallpox. The idea was to add other vaccines, diphtheria, whooping cough, tetanus, the DPT vaccine, measles and polio and add this to smallpox. That was adopted and then UNICEF got behind it and rotary got behind the polio side and the goal was at that time to reach 80 percent of the world's children by 1990 with these six vaccines. At the beginning, we estimated that at best about 10 percent were receiving these vaccines. So we had cases of tetanus and diphtheria. Totally preventable diseases, whole wards full of whooping cough and so forth and good vaccines out there, well, made it. So by 1990, 80 percent of the world's children had been vaccinated against these six diseases. So this was the expanded program in immunization which is going on, became in due course the eradication of polio. It served to eradicate measles throughout the western hemisphere. Measles was gone. We had so few cases of tetanus and diphtheria that it was a amazing, they were exceptionally, just throughout the whole of the Americas, they developed reporting system which I think, at the beginning we had 500 hospitals reporting once a month. The last count I looked at the reporting, they had weekly reporting from 42000 sites in Latin America. People just - it's better reporting for these diseases than it is in the United States of America. This is going on to develop the group that has convened here, have done all sorts of marvelous things and out of this came a feeling of we've done this, why can't we take on something else. They have done that with great success. So, if there is a real need for an international organization WHO, even though there is some of those like our President Bush who have not felt the need to work with other countries, this could never have been done in the United States, it could never have done by a few countries, it had to have an international organization. It showed also how much you can do if we have preventive medicine and public health vaccines. We were dealing with 10 to 15 million cases of smallpox a year, 2 million deaths a year and 10 years later we have zero cases, and zero deaths. This is pretty dramatic. Now you are seeing similar things happening with measles. Very dramatic changes and now we are talking about with the Gates Foundation supporting a lot of things, why can't we go and tackle malaria in a different way. Why aren't we doing research to get better vaccine for tuberculosis, why don't we have a vaccine against malaria? It's opened up, it's begun a whole revolution in prevention which is really something to see. Today or last couple of days, we have been hearing reports of, now, how many different fronts it's moving on very rapidly and really rethinking all of this. It has, I think, built bridges in the international field that you can't build in agriculture or education. Those are political. Agriculture, for obvious reasons, even education, it becomes quite political. With the health side, you really just don't get into political issues. It's amazing, you don't and thus it has built relationships in ways that are really quite unique across the Americas which I have spent more time with recently. There have been in other areas as well. They had days of tranquility in the Americas, where in the fighting in Nicaragua. The agreement was they would stop fighting for two days and they would and the vaccination team to go out. This has happened in Afghanistan, days of tranquility. So that even the rebel groups could be approached and could be helpful. So we got to Peru in the end of polio in the Americas, the last cases were in the area called the Shining Path, where the Shining Path was. They destroyed hospitals, they destroyed schools what have you. What the people really behind the scenes, Ciro de Quadros who was the head of immunization for the Americas had met with the commanders of the Shining Path and talked it through and got commitments from them, not to harm the health workers. Well, they went through and this is what the health workers are doing. Guess what, they searched this whole area which was so dangerous, it was a problem for the military to go into. So there, it's something that I think is unique about health here and something which gives you great encouragement for the future. Thus, I really feel quite, I feel like we have a made a difference well beyond smallpox eradication. I think, well smallpox eradication, I think has been the first step. We are now moving on well beyond that into many more exciting things. Paul O'Grady: Great. DA Henderson, thank you very much for this interview. D.A. Henderson: Yeah, you are very welcome. [End of audio 1:29:16] </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/qbfMSB8kwAs" frameborder="0" allowfullscreen="allowfullscreen"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource interviews motion pictures moving image Date A point or period of time associated with an event in the lifecycle of the resource 2008-07-12 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16rdc emory:16rdc Format The file format, physical medium, or dimensions of the resource 19266000000 bytes video/x-dv Creator An entity primarily responsible for making the resource O'Grady, Paul (Interviewer) Henderson, Donald (Interviewee) Contributor An entity responsible for making contributions to the resource Centers for Disease Control Title A name given to the resource HENDERSON, D. A. Description An account of the resource Donald Ainslie Henderson, MD, MPH, was seconded by Centers for Disease Control and Prevention to the World Health Organization in 1966 and served as the Director of the Smallpox Eradication Program until 1977. Subject The topic of the resource Smallpox Eradication Smallpox Eradication WHO Language A language of the resource English https://www.globalhealthchronicles.org/files/original/2efbfa1d712cc9a76a90691e56b3c24e.JPG c36322f058fa72125c459a2a0213fa5c https://www.globalhealthchronicles.org/files/original/51a892069f7b2a40da44fc734946c8a0.pdf 918d761c76aa457f69d77cb5705359cd Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Keywords https://youtu.be/htSQgU-L36E Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/htSQgU-L36E" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="allowfullscreen"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource DRESCHER, JOHN Date A point or period of time associated with an event in the lifecycle of the resource 2008-04-01 Subject The topic of the resource smallpox eradication program WHO (World Health Organization) Public Health Advisors U. S. Public Health Service Description An account of the resource John Drescher assigned to Niger in the Smallpox Eradication Program and later Gaya, Bihar, India talks about his experiences during those assignments. Interviewed by David Sencer Creator An entity primarily responsible for making the resource Interviewer: David Sencer Source A related resource from which the described resource is derived David J. Sencer CDC Museum https://www.globalhealthchronicles.org/files/original/0843abd88cc294f90db33766f4b7c825.jpg 734a6e2a6c9efd7069a6aa95d953dcdc https://www.globalhealthchronicles.org/files/original/3384eae5eb6f0643c7cd40f8547f017b.pdf 422a478224aa92acdf2b855c7dce12da Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong>Interview Transcript </strong> INTERVIEW Audio File: Stephen Jones Audio File Transcribed: January 30, 2009 Interviewer: This is an interview with Stephen Jones on July 11th, 2008 at the Centers for Disease Control and Prevention in Atlanta, Georgia about his role in the smallpox eradication project. With this interview we're hoping to capture for future generations the memories of participants and their families involved in eradicating smallpox. This is an incredibly important and historic achievement and we want to hear about your experiences. I have some questions to guide you but please feel free to recount any special stories or anecdotes that you remember about events or people. The legal agreement you signed says that you are donating the oral history to the U.S. federal government and it will be in the public domain. For the record could you please state your full name and that you know you're being recorded. Interviewee: Full name is T. Stephen Jones and I acknowledge that I'm being recorded and agreed to that. Interviewer: Very good. Thanks for coming in today Steve and I guess [inaudible 01.15] good place to start would be before you ever came to CDC and I'm curious about have you - did you always want to be a physician? And so think back to your early days and when you went to college and if you could talk a little bit about what you wanted to do when you were getting out of high school? Interviewee: Well I had a great interest in science and math and at the time of the Sputnik there was a big U.S. government response including setting high school students working in engineering companies and I went to work at the Salvenia Company near Boston and pretty quickly came to the conclusion I wasn't really interested in engineering. And I had always been interested by medicine and that just took over my future planning. So that's how I got into medicine basically. Interviewer: And then did you intend from the beginning to go into public health or did you see yourself more as practicing clinical medicine? Interviewee: Well when you go to medical school and you - and I was trained in medical medicine, you're in a world where all the values are academic medicine and practice. And so I knew relatively little about public health until I was an intern in nineteen sixty nine at the Stanford, [inaudible 03.01] Stanford Hospital and had to take into consideration that as a healthy male doctor I was going to be drafted into government service and probably spend a year in Vietnam. And at Stanford there was Dr. Tom Merrigan a very good infectious disease doc, talked about the communicable disease center as a potential option and knew about this program called the epidemic intelligence service. So I applied for EIS and Mike Greg was my interviewer and although it was a little bit - I applied late and it wasn't clear I was going to get in. Then I - so I was in the EIS class of nineteen sixty nine and I was posted to Alaska and had an extraordinary experience there. But finishing there I wanted to live and work overseas and I went to Guatemala and worked as a primary care doc for a year and a half. And was in the process - and was living in Texas in early nineteen seventy four and intending to probably work for LARASA as a clinician in south Texas. And then I received a letter from Lyle Conrad which was sent out I guess to former EIS officers and others and said that CDC were working in cooperation with WHO and trying to recruit people who would be willing to work for three months in India as part of smallpox eradication efforts. And that was such an extraordinary offer it took me only a small fraction of a second to make the decision that I wanted to do that. Interviewer: And were you still with CDC when you were in Texas or were you working with the... Interviewee: No, I had ended my connection to the public health service when I left Alaska and... Interviewer: Okay, and EIS. Interviewee: And EIS, yeah. I was a private citizen. Interviewer: Okay. And so you got the letter from Lyle Conrad inviting you to participate in the smallpox eradication program and about then what was the time frame in terms of how much longer before you - did you come back to Atlanta then for training or? Interviewee: No. There was no - there was nothing - I didn't go to Atlanta. I basically agreed to go and then had, I don't remember what the interval was between the letter and my departure. I went in early to mid June. I flew from Texas to the west coast and then from the west coast to New Delhi and arrived on June fourteenth of -- or sixteenth I can't remember -- of seventy four at the New Delhi airport at two or three o'clock in the morning. Was met by Bill Foege. Interviewer: And then had you ever been to south east Asia before or India? Interviewee: I had - because I lived in a developing country namely Guatemala I sort of assumed I was a seasoned, experienced international traveler or worker or whatever but I found India to be totally overwhelming at least initially partly I'm sure because it was the middle of the hot season and I was substantially jet lagged. But it was an extraordinary experience and much more challenging then central America. Interviewer: Interesting. Where did you - where were you posted in India? Interviewee: I was posted in Bihar and we had some training in New Delhi and then we traveled by train from New Delhi to Patna and it was - this was a coal fired train and I learned about how people who used to travel in trains in those days became covered with the grimy soot of the coal burning engine even though we were in first class. Interviewer: Wow. So were you part of a team in India when you went over as the smallpox? Were there others that were kind of in your cohort or? Interviewee: Yes. There was a group of something on the order of ten to fifteen people who had all been, I guess had responded to this letter from Lyle and other reasons and we were in a group that was trained and we had training from Larry Brilliant and Bill Foege. And when we got to Patna we had - we went to the field where I saw the first person I had ever seen with smallpox and Bill Foege was training us in the basic parts of identifying smallpox and doing the surveillance and containment activities. Interviewer: And was that still in the New Delhi area? Interviewee: No. That was in - that was near Patna. I don't remember where exactly. Interviewer: Okay, okay. And then what do you remember about your early days kind of getting involved with the program, figuring out who your counterparts were going to be? Interviewee: Well I - basically we had this couple of days of training in Patna and then each of us were derived - almost all of us had no prior experience with smallpox or India. We were - and we had a driver, a jeep and a paramedical assistance, a PMA who was basically a translator because most, almost none of us knew any Hindi. And we were sent off to a district to start working with the civil surgeon and the district medical officer and the - I'm now forgetting the chief administrative officer. And I was assigned to Muzaffarpur district which is one district south of the border with Nepal and at that time it was a very simple place. Muzaffarpur town had one restaurant and I stayed in one of these old British empire dock bungalows. And it was quite an experience to get started there because we were - in the beginning the expatriates were - the amount of support that we had at that point was quite limited. It was the PMA, the driver with whom you always had to have this game of trying to make sure the petrol wasn't stolen and then making connections with the local officials and then going out to the basic walks, places where the local medical officers who were in government service were providing family planning and curative services to people and finding the smallpox that was there. And there was plenty of smallpox at that time. Interviewer: You mentioned making sure that the petrol wasn't stolen. I know that Bihar has a reputation of being a I think the lawless state and I'm wondering if it was like that back in the seventies as well and... Interviewee: Well it... Interviewer: ...was it harder than some of the other places in India? Interviewee: Well the - Bihar's reputation in those days was particularly as a place that was very conservative and very quote unquote backward. And when Mrs. Gandhi in an introduction to the history of smallpox in India and eradication she said something like smallpox is a disease of underdevelopment. And in India the places which had better government services and a higher - things worked better such as all of the south, had basically eradicated smallpox already. So smallpox had remained in India was in the places which were more traditional, where there was less economic development, where there was less education. And so that was Bihar, Uttar Pradesh and West Bengal were the primary areas where smallpox was and that contributed to the pattern of where smallpox was at that time. Interviewer: How did you find out about the smallpox cases that were out in the field? Interviewee: Well, one of the things that had been instituted was a reward system so that people in the general public and health workers could earn and I don't remember what the level was when we started but it was quite low, a small amount of a number of rupees for reporting a case or an outbreak of smallpox once it was confirmed. And so that was one mechanism and the other was that there was an increasing sense among people in India that smallpox was a problem that ought to be dealt with and confronted so there was a - people had a desire to report the smallpox and also presumably to try and get some help dealing with it. Interviewer: What was the reaction of the people who were in the field in the remote rural areas when you showed up with your few colleagues to give the immunizations and to investigate the case? Interviewee: Well, you know the smallpox had been in India for a long time and was such a part of everyday life that there was in fact a deity Sheetla Maha, was smallpox and sort of infectious diseases that involved a rash but more smallpox than anything else. And that was - so there was some belief that smallpox was a blessing or came from deities but on a day to day basis when you - when we would go to a place where there was smallpox, a village where there was one or more cases of smallpox, people were very cooperative and we did a process of finding cases. We had a set of forms for listing cases and then in the beginning doing only a relatively small number of houses, the nearest houses to the home where the or the home or homes where the people lived who had smallpox, enumerating all the people that lived in those houses and vaccinating everyone and keeping track of the evolution of their smallpox vaccinations and finding out where people had - the cases had traveled and giving notifications to other areas that might be affected because someone had traveled to another place. It was a fairly easy to operate system. Interviewer: Do any of your trips back to the villages stand out as exceptional, remarkable, perhaps unique in what you encountered there or the reception of the people to you? Interviewee: Well it was - in the beginning it was all unique and exceptional and extraordinary because here I was, we were dealing with this classic killer. And I guess that the ravages of smallpox and what it could do to people and how it killed people and in particular this form known as flat smallpox where there was just a confluent rash so that people were just all pox, rash. And there was a way that you could particularly with a person who had flat smallpox there was a certain odor that you could smell that you could identify and you could almost make a diagnosis of smallpox based on that. But it was - the devastation to people and families of smallpox was extraordinary and it contributed to my feeling that smallpox was an unmitigated evil. There was no apparent good side to smallpox that I ever could find so it was a worthy adversary. Interviewer: How did they react to use of the jet gun in the little towns, any problems? Interviewee: Now you - I'll help you know the proper history. By then nobody used jet guns. We just used the famous bifurcated needle and so smallpox being historically present in India and a huge problem there people were very familiar with vaccination and vaccination had been done by a variety of methods. So vaccination itself was not really a problem. I mean there was some - there are many schools or ways of medical care including ayurvedic and homeopathic in India. And the people, the practitioners of those types of medicine at times had opposed vaccination for one reason or another. And I can remember having some sort of a debate with a homeopathic doctors about smallpox vaccination. But there were always people - there was always a small number of people who refused to be vaccinated and one of the rules of the expatriates was to help convince people that they ought to be vaccinated. Interviewer: To follow up on one of the comments you made, one of your roles was to convince people that they needed the vaccine. How did you go about doing that? Interviewee: And I was going to extend on that. It became a - it was clearly something that as an expatriate, as somebody from obviously outside of India that the expatriates had a particular possibility of being influential with people that were declining to be vaccinated. And I remember I had many, many, many conversations with people who were declining to be vaccinated. And I remember in particular at least once and I'm sure it was many times, a sign of respect was to touch someone's feet or shoes and I did that multiple times in trying to convince people to be vaccinated. And another thing that you did was to vaccinate yourself so I in the process of a few months in India was - I was - I had vaccinated myself hundreds of times as a way to show people that it was a trivial thing to be vaccinated, a minor process. So those are some of the things. Interviewer: How did your relationship with the translator? Do you - it sounds like you always went in the field to the villages with your translator. Interviewee: Yeah. Interviewer: And how did that develop over time? Interviewee: Well, it - many people - obviously because of the history of India as being part of the British Empire there were many, many people who spoke good English and in particular the government servants and medical officers and all were fluent in English. So it was possible to function a lot without a translator but it was also essential to have somebody who could help you with Hindi. In the end I got to be moderately competent with Hindi and perhaps over estimated my ability to communicate and understand. And it was an important relationship. Your PMA was - the degree to which the PMA was interested, aggressive, concerned, involved was a big deal, while if you had a more passive PMA then expatriate was much less effective obviously. So it was a very important relationship and... Interviewer: When you went out in the fields, excuse me, when you went out in the field did you go for several days at a time from village to village or were these more long days in the field and then back to your headquarters in the evenings? Interviewee: Well, headquarters didn't really exist in those days. We had - I had a room in a dock bungalow which was basically a - if I remember it was a single living space with a bathroom and that was all the office we had. It was very low key and not very well supported in the beginning and as I stayed in Muzaffarpur for probably something on the order of five months and then gradually we got additional resources and we had more staff, more vehicles. We had local young medical officers from India who joined in and medical officers from other parts of India and so it became a much more elaborate operation and a much bigger team as those resources were added and they made a big difference. And so I couldn't tell you exactly when we ended smallpox in Muzaffarpur nor exact - we had - when I arrived it was - there were probably a hundred outbreaks and within four or five months it was essentially taken care of part of which was the weather and the fact that we got into the poor transmission season. But the surveillance and case finding and then containment activity was a very effective tool for slowing and then stopping the spread of smallpox. And what happened is as the number of outbreaks dropped the amount of work that we did with each outbreak could be increased substantially and to some extent that was measured by how many houses we would include in the containment activity. So in the beginning it was a relatively small number of ten or fifteen or twenty and as we got more resources as there were fewer outbreaks it became fifty, a hundred, hundreds of houses. Interviewer: That you would go out and vaccinate at the reporting of one case? Interviewee: We would put a number on and then the houses and household would receive a number and there was a regular thing in which we put the number of people in the household written on the side and the vaccination status of how many of them had - cause you had to - you vaccinated and then you went back to see that - you had a vaccination take and monitored that. So that was part of the containment activity. Interviewer: How long after did you return then? Interviewee: Well, it would be - depending on what was going on you might stay in the local area if you have the time and there were other dock bungalows and other places that you could stay around the district. But when you have a hundred outbreaks you can't visit them, each of them for very long and the typical way that we worked at that time as we were in the field for probably twenty five days out of the month. And then we went to Patna for a couple of days of state level meetings in which we reported on our progress and heard from our colleagues about what was going on and had people like Mahindra Dhata or M. I. D. Sharma from the Indian health side and Bill Foege and Larry Brilliant and others from the WHO side inspire us not that we needed much inspiration. Interviewer: So were you pretty much working seven days a week when you were out in the field? Interviewee: When you're living in the country side in India particularly in nineteen seventy four, there was nothing. There were - I suppose there was some cinema but there was nothing to do and one of the things that always struck me about smallpox is it was an awful disease and it caused tremendous suffering. And so there was a kind of a feedback loop of encouragement or inspiration and so that - because as you could see that if you worked hard then you could reduce the number of cases of smallpox and if you worked even harder you could do that sooner. And then as you got the number of smallpox cases went down then you were sort of getting to the point where you were going to have local control, local eradication and you knew that that was part of a grander plan of eradicating smallpox in Bihar and in India and in the world. And so you had a feedback loop to keep you working harder and harder and harder or at least continue to be putting in tremendous amounts of effort because you were working toward an extraordinary goal of taking this killer disease and getting rid of it, 100% gone. It wasn't a - you didn't have to work - you didn't have to suffer for small gains. You could... Interviewer: Like you could see your - the results of what you were doing? Interviewee: You could see the results and you also knew that if you and everybody else worked hard that you were going to definitively get rid of smallpox. It wasn't something that was done by half or where you settled for a partial victory. We were headed to a 100% eradication which is an extraordinary achievement and in part why smallpox for me was the most - was the peak of my personal - my life and my professional experience. I mean it was an extraordinary one for that part of it and for a number of other things. Interviewer: Right. So you had mentioned that you saw this drastic decline in the smallpox cases in India and I think earlier you mentioned you also spent time then in Bangladesh. Is that about the time then - were you transferred or did you ask to go to Bangladesh or how did that happen? Interviewee: I actually - David Sensor was in India and I'm afraid I can't give the - this was I believe January of nineteen seventy five. And I remember riding on a train with him and I believe with Bill Foege and there was a discussion about - at that point it was clear that India was headed for success and the program in Bangladesh was in deep trouble in terms of having many outbreaks of smallpox. And I was one of the first people to go from the India program to the Bangladesh program as part of the beginning process of helping the Bangladesh program transform itself into what was the sort of India model I guess you would say. Interviewer: Were there differences in the composition of the teams or what were the differences? Interviewee: Well they - I believe this is the case and I'm - this is my impression. India, the India program was a transformed approach, a new approach because earlier in Asia in Pakistan and Afghanistan and other parts of and I think also in the Africa programs although I'm less clear about that, the model was a relatively small number of expatriates who were WHO employee, full time WHO employees, perhaps a dozen or so. And in India what had happened is that there was - it was such a large scale problem that the program model that evolved was the one that I sort of described where first you bring in some significant number of expatriates for short time work and then you amass resources and you have lots more money and government commitment and you provide lots and lots of vehicles. You provide - you pay for more local staff, you recruit the young Indian medical officers so that you have a huge, in the end you have a huge operation that was a sort of - I mean it was a parallel organization to the government and the local government, the government in India and the local government in the states and districts where you worked with a specific purpose. In the Bangladesh program was one where they were working with the old model and they were I think hoping that they would be able to show that the program in India was sort of overkill and that they could achieve smallpox eradication with a relatively small intimate group if you will of expatriates and WHO employees. And I believe that they had been offered resources but felt that they didn't need them. Interviewer: Did you have local counterparts in Bangladesh as well? Interviewee: Oh yeah. Interviewer: And was it - I'm sure a car and a driver and a translator. Interviewee: Yup. Interviewer: Others in addition? Interviewee: That was the pattern everywhere and the - in Bangladesh we had a - there was a different sort of type of expatriate. There were more people with young volunteers who were not medical officers and who came from a wider array of countries. There was more Americans in the India program and we had a lot of - substantial number of people from the U.K. and elsewhere. One of the aspects or the fascinating things of smallpox eradication work in India and Bangladesh was the fact that there was these many nations, people coming together from around the world whether it was the Soviet Union or France or the United Kingdom or the United States or Czechoslovakia or Poland or whatever working together in a team. So that was one of the extraordinary parts of working on smallpox eradication. Interviewer: Steve as we come to a close about this and you had mentioned a little bit about this before about how working in the smallpox eradication program really had a huge impact on your life and how you think about public health. Could you talk just a little bit about that before we close? Interviewee: Sure. I mentioned this aspect of smallpox eradication as this extraordinary in the sense of there was really nothing like the experience you could have of working on a killer that had existed for centuries and centuries and centuries and by your hard labor contributing to getting rid of a plague in the generic sense of it. And that - that's a life experience and I also in that process of work spent or got to know a lot more people from the CDC. And when I finished in Bangladesh in the summer of seventy six it was quite a challenging thing to think about coming back to the United States and changing from this sort of single focused monomania working on smallpox eradication to coming back to a quote unquote real world. And part of what I did was to gain time to get perspective by getting a masters in public health but I was just committed to work on public health. I was intoxicated by the experience and it was clearly something where you could have a huge impact. And my connections - the first work that I did after school of public health was to work on - with the immunization program in the Pan American Health Organization. And then I came back to CDC while working with that program and I was totally committed to public health and had no interest in clinical medicine whatsoever anymore. Interviewer: Thank you. It sounds like - I appreciate you being part of this oral history project and... Interviewee: It's a pleasure. Interviewer: ...just sharing your experience working with the smallpox program in both of those countries, around India and Bangladesh. It just sounds like it's had a tremendous impact and I know that you went on to have a very long and productive career in public health before retiring from CDC. So thank you again. Interviewee: Thank you. </pre> Player html for embedded player to stream video content <iframe src="https://www.youtube.com/embed/LJpf8xW7E_w" frameborder="0" width="560" height="315"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource JONES, T. STEPHEN Description An account of the resource Dr. Stephen Jones describes his experiences in the smallpox eradication program in India and Bangladesh Creator An entity primarily responsible for making the resource Jones, T. Stephen (Interviewee); CDC; Epidemiologist Date A point or period of time associated with an event in the lifecycle of the resource July 7, 2008 Format The file format, physical medium, or dimensions of the resource 8705880000 bytes video/x-dv Language A language of the resource English Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16s0t emory:16s0t https://www.globalhealthchronicles.org/files/original/52f2fe7a1b88eca98b1bb96b4fa0657f.jpg a5dcccaf247dbb132b20c5d1a2897d6a Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> INTERVIEW Audio File: Craig Leutzinger Audio File Transcribed: January 23, 2008 Interviewer: I am Hailey [inaudible 00.10]. I am helping David Sensor to collect oral histories of workers who helped to eradicate smallpox. This is Craig Leutzinger and he'll be talking to us today and we have a couple of questions for you Craig. Craig will you tell us a little bit about yourself, about your background? Interviewee: I joined CDC in nineteen seventy and... Interviewer: Go back before that Craig. Interviewee: Oh, even before that. Well, I was raised in Southern California. I went to the University of California, Riverside. I anticipated going to Air Force pilot training but I failed the physical. So, I was looking for work and eventually saw an ad for the U.S. Public Health Service Syphilis Eradication Program and I answered that ad and after several months they offered me a job in Baltimore. So, went to Baltimore and started my career with CDC doing syphilis contact tracing. Five years later I was with the STD program in Washington D.C. and they were asking for people who might be interested in participating in the smallpox eradication program. At that particular time they were looking for people interested in going to India or Bangladesh and I asked to be considered and I was picked to join a team that went to Bangladesh in May of nineteen seventy five as I recall. Interviewer: And was it your first time out the country? Interviewee: Other than Mexico, yes. Interviewer: And what kind of training did they offer you? Did the CDC give you any advice or training program or anything? Interviewee: It was pretty fast. I think we - there was about a dozen of us and we came from all over country and we were in Atlanta for I think no more than a day. We got some minimal briefings and then flew to Delhi via London, spent one day in Delhi mostly acclimatizing ourselves. We didn't get any training that I recall. Then we thought we were - when we arrived the day after that in Dakar we thought we were going to get some training before going to the field but the leaders there had decided that we would better getting on the job training in the field. So the very next day we split up and went to various districts in Bangladesh. I went with one other... </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/oOaqAXluACU" frameborder="0" allowfullscreen></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource interviews motion pictures moving image Date A point or period of time associated with an event in the lifecycle of the resource 2008-04-03 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/15p7d emory:15p7d Subject The topic of the resource Bangladesh Smallpox Eradication WHO CDC Format The file format, physical medium, or dimensions of the resource 7444440000 bytes video/x-dv Creator An entity primarily responsible for making the resource Kensia, Haley (Interviewer); Emory College Leutzinger, Craig (Interviewee) Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of Southeast Asia and East Africa Smallpox Workers (2008 : Atlanta, Georgia) Title A name given to the resource LEUTZINGER, CRAIG Description An account of the resource Craig Leutzinger, went to Bangladesh in May 1975 as an Operations Officer. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/8ed421437307be9c17df32152ef60233.jpg c075e9419d43a4b71404b398c01b823a https://www.globalhealthchronicles.org/files/original/603d0d6cdad868fcd0961665b7c7a66b.pdf f35b1062812f33f24b46fd45acce0df4 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> Interview Dr. David Pratt with Interviewer Elisa Koski Transcribed: January 2009 | Duration: 0:31:56 Elisa Koski: This an interview with David Pratt on July 11, 2008 at the Centers for Disease Control and Prevention in Atlanta, Georgia about his role in the Smallpox Eradication Project. The interviewer is Elisa Koski. With this interview, we are hoping to capture for future generations, the memories of participants and their families involved in eradicating smallpox. This is an incredibly important and historic achievement and we want to hear about your experience. I have some questions to guide you, but please feel free to recount any special stories or anecdotes that you remember about events or people. The legal agreement you signed says that you are donating the oral history to the U.S. Federal Government and that it will be in the public domain. For the record, could you please state your full name and that you know you are being recorded. David Pratt: Sure. My name is David Pratt and I am aware of the fact that I am being recorded. Elisa Koski: Thank you so much. Thank you for being here today and being willing to share your experiences. I'm going to start with a question about your childhood and how you grew up. Could you briefly describe for me your childhood and your pre-college education and how you became interested in Public Health? David Pratt: Sure. I grew up in a small town in Massachusetts, Newbury Port, Massachusetts and did my primary grades in Newbury Port and had nobody really - I shouldn't say nobody, I had two aunts who were nurses and I think they perhaps had influences. Nobody in my direct family though, neither my parents, nor my grandparents were involved in healthcare in any way. So perhaps it was my aunts' influence that got me interested. Elisa Koski: How did you become involved with CDC, and particularly the Smallpox Eradication Program? David Pratt: Very interesting question. I went to medical school at Tufts in Boston and while I was a medical student at Tufts there were people in infectious disease who were Fellows in training in infectious disease and one Kenny Ratson had actually been an EIS Officer; and I was a medical student while Ken was a Fellow and in discussions back and forth about a variety of questions and interesting topics he shared with me and with the other medical students what it was like to be an EIS Officer. So I became really quite interested in that. At the same time at Tufts Medical School, Jack Geiger and Count Gibson were running a family medicine program and they were doing some very interesting things with Social Medicine in Bolivar County, Mississippi and in Housing Projects in South Boston. So the complete picture of what Public Health could be like from the social, economic and cultural aspects to the infectious disease aspects, really increasingly got me interested. So following my medical school experience with Ken Ratson and Community Medicine, I applied to become an EIS Officer. Now at that time, we have to remember that the Vietnam conflict was ongoing and choosing a career in Public Health was also ethically more comfortable for me at that point in my life. So it was a wonderful way to serve the country, it was an exciting area to learn and be a health professional, and it was an exciting time. Elisa Koski: Thank you. How did you specifically end up in India, you mentioned a little bit, prior to this interview as we were being introduced, that you actually had an option? David Pratt: Right. When EIS Officers in my cohort came to CDC we had a choice of what kind of assignment to take. There were assignments here in Atlanta and there were assignments in the field with State Health Departments; and I chose to actually take an assignment with the Hawaii Department of Public Health. That group was doing routine State- based Public Health, but in addition, we were doing some vaccine development, specifically an intranasal vaccine with measles. It was clear for the group of people who came in when I came into the EIS that there were going to be opportunities, international opportunities. One was an opportunity in Nigeria, the Biafran famine was ongoing and huge amounts of migration of Nigerians ethnically diverse moving across the country and a great deal of hardship and despair over that, and EIS officers were given an opportunity to go and actually do assessments, surveillance, measurement around the famine. The alternative option was Smallpox Eradication. When we came to CDC the West Africa campaign was largely victorious and a very clear strategy had been laid out by Henderson and others and so those two options were available. Ultimately I chose to turn down an offer to go to Nigeria and accept the offer to go to India in 1974. Elisa Koski: What influenced that decision, why would you have rather been in India? David Pratt: I think two things really. One was the - I think even then I understood the magnitude of what we were going to try to do. I also thought that the work in Biafra, though important, and doing the assessment of the famine, and the impact of famine on the health of those children was important, I thought it was also desperately sad, probably tougher going and I thought that the chance to have an opportunity to play a role in the eradication of a disease was very significant and exciting and India also interested me a great deal. As a resident at the University of Michigan, I had a medical student who talked in very interesting terms about work that he had done in India and so I was intrigued by his descriptions, I was intrigued by the challenge and the opportunity and decided that when the call came from Lyle Conrad here at CDC that it was a good thing to do. Elisa Koski: Can you tell me a little bit about your role when you arrived in India? David Pratt: I think as a slight - to step back just a bit - it took a fair bit of convincing in my own life circumstance, I just had an infant son born way away from family, so my wife - and this is our first child, so she was there to take care of a child by herself when I trotted off to India. We knew communications was very poor, telephonic communication was virtually non-existent in the areas that we were going to be in and telegrams were iffy. So I had to really convince my wife that this was of great enough significance to allow me to leave her and my son to go and do this. So the context was socially challenging for me personally, but I thought very important. So the routing that I took was basically from Hawaii over through Thailand, from Thailand up to Delhi and then when we got to Delhi we were met by the WHO people at the regional office in Delhi and began a briefing. I think it's important to explain, or share, how dramatic the arrival in India was for us in 1974. The gulf in terms of economics and in terms of the way the place looked from where we had come from, that is Hawaii and mainland United States, was incredibly different. The smells, the sounds, the beggars at every stoplight, the crush and the throng of millions of people it felt like, was very different and for a while the truth is, I think we were stunned, literally stunned and it took us a while to kind of catch up with the fact that we were in a brand new environment, very different than the West. So there were going to be lessons to be learned about the economics, about the sociology, about the psychology of this new terrain that we were entering. So those first few days were very challenging I think for all of us. Elisa Koski: Of course, there was the challenge with your wife and son. Did you encounter any other challenges when you first arrived, housing, food and water, anything that you can recall like that? David Pratt: The WHO team in New Delhi arranged to pick us up at the airport which is always interesting and hasn't changed too much in India, getting through the airports; and they brought us to our hotels. They had things pretty well arranged, the logistics, pretty well arranged for us. The hotels were certainly comfortable, not lavish, it wasn't anything we expected and I think they built a very nice routine, a briefing routine for us in Delhi before we went to the field. The food of course was very different than what I was used to in Hawaii, but I always have been sort of an omnivore and interested in different cuisine, exotic cuisine, so that was fine with me. I was good with that. I think where it got interesting is when we went by train across the North of India, a group of us all together, to go to our duty station which was in Bihar. Now at the time I really didn't realize that Bihar was among the poorest States of India and that the poverty that we'd witnessed in Delhi was going to be compounded by the kind of misery that we would see when we got to the Bihari regions across the Ganges River to the North. So it got more interesting rather than less interesting as we went further and further to our duty stations. Elisa Koski: Can you describe to me a little bit about what happened when you arrived in your duty station? David Pratt: Okay. Elisa Koski: What was your role? How did you interact with your team? David Pratt: I was assigned to two areas, two States or two regions inside Bihar. One was called Sarn; (S-a-r-n), and the other was Siwan (S-i-w-a-n). The stepping off point for those assignments was in Patna and you may remember from Lord Jim, the name of the boat in Lord Jim is the Patna, ill fated boat-Anyway we went to a hotel in Patna, where we had a further briefing on Bihar and our duty station and then very interestingly took ferries across the Ganges River. There were some wonderful lessons about the ferries. It turned out that moving a WHO jeep across the Ganges River was not as easy as simply pulling up and buying a ticket. It turned out that if you pulled up and bought a ticket, everybody went around you and the reason everybody went around you was because there was another payment being made that was invisible beyond the ticket, so it's called baksheesh. So if you didn't understand that if you really wanted to get that ride across the river, it would be the ticket plus some baksheesh, you would wait a long time at the ferry dock. So cross the river by ferry and then got to Chapra which was the area that was my headquarters for those months that I served in that region. Elisa Koski: Can you tell me about the smallpox situation when you arrived? David Pratt: There were lots of outbreaks going on. I think at the time in my region, there were 18 or 20 outbreaks that were in the midst of being dealt with, controlled; contained. A wonderful experience for me as I reflect on it; was the first day in my region. We went by jeep to an outbreak at a village, we went into a mud hut in the village and a woman presented me with her infant covered with smallpox lesions. I picked the child up as you would to examine anyone; the child was pretty miserable and had still persistent fever in spite of a fairly well developed rash, and the thing that really struck me was at that moment I was betting that my immunization was sufficient to keep me healthy as I went forward in the program. So it really was a challenge; you know, how deeply do you believe in immunization, how profound is your faith, and so it was obviously pretty profound. I examined the child and on we went. I mean, I am recognizing that the case fatality rates are 25%. So it was a huge gamble really that things were going to work. I mean, we all knew the history of the immunization, that it was robust and successful, but when it's you, with a child at home, and so forth, and you are beginning an assignment, you'd rather not get a dreadful illness in the middle of India. Elisa Koski: Of Course. Can you describe to me a little bit about the progression of your assignment there, from your first day onward; how did things move forward? David Pratt: From that day, seeing that outbreak that very first day, it was right at the tail end of the monsoon, humidity was very high, day time temperatures were routinely 40 degree Celsius, 104 - 105 degrees, and taking notes, which I tend to be a compulsive note taker; was very challenging because perspiration would run down your arm onto a pencil right on to your notepad or onto your notebook. So I had to find clever ways to do note taking that wouldn't saturate my books, and so on and so forth. So it was very, very warm, very dusty; when the monsoon ended the dust began. But it was still raining during the time that we first arrived. The Indian Public Health people said that searching, trying to search through the monsoon was nuts and yet the people we relieved had done it and had done it successfully. So we had in some ways bucked the standard wisdom about it and had gotten off on a really good foot. So I was turned over to a region that was well done, well maintained. I stayed in a place that was called the Circuit House. The Circuit House - they were they were also called Dak Bungalows. They were locations where the British mail people went when they delivered the mail around the country. It was basically a squat toilet, there was a shower that was heated by a tank on the ceiling, a little desk, no screens on the doors, we had bed nets that we used and I had monkeys as my neighbors who would come in on my porch and actually come in my room if I wasn't very careful. So I had good neighbors and the accommodations were decent, in the day it got very hot, but at night it cooled successfully; and I didn't realize, but my colleagues, my Indian colleagues assured me that the mosquito nets served a dual purpose, not only would it keep the malarial mosquitoes from biting me at night, but it was also good as a preventive measure against Cobras and Kraits and Russell's Vipers which were snakes that potentially could bite you in the night because you were warm. So they would sense your warmth and come up on your bed. So I had no problem with that, but my Indian colleagues frequently slept on the cement floor in our building covered with their dhotis and mosquitoes would bite right through the cotton. It was extraordinary to see the situation that they were in at night. So the living situation was in the Circuit House or Dak Bungalow. In the morning I had a chowkidar, the servant of the bungalow; he would bring tea to me from a tea stall down the road and one morning I had my tea delivered by this little man and my Indian Epidemiologist counterpart saw this occur and was horrified, because it turned out that the man who delivered the tea to me was an untouchable and that's unacceptable. They were unclean so to bring me food was sort of revolting[indiscernible0:17:11] and being outside the caste system there was no issue for me but there was like a little confab and they discussed it and explained that really you shouldn't do that. I continued to have tea from the chowkidar the day after that, it just wasn't an issue with me, but it was my first banging into the whole issue of caste was right there in the Circuit House that day. Elisa Koski: Okay. How close were your field assignments to the Circuit House? Were you were working right in the surrounding villages or did you have to travel a lot? David Pratt: No, there was a fair amount of travel. We had jeeps and drivers and on an average day, we would probably work 8 or 10 hours driving and you would go from outbreak to outbreak, District Health Officer - you would visit with the District Magistrate, you would meet with the various people who were critical to you being able to get the project done. So there was a great deal of traveling around. We all had drivers and I have to say that the Indian, Dr. Chakravarty who was my counterpart in Chapra was an extraordinary guy, very bright and could accomplish things that clearly I could not accomplish. He spoke the language; he knew how to influence in very effective ways, so he was critical. I would begin the morning by going to his home and his wife would serve me another cup of tea, we would lay out the day and then we would just simply start going; and routinely we'd leave his house probably at 10:00 o'clock and not return until 8:00 or 9:00 o'clock at night - that evening. He never stopped for lunch, I don't know what the guy ate, but he never stopped for lunch, so we just kept going. Sometimes we'd stop actually on the road and our driver would buy in the market cow dung, these dried patties of cow dung, light them on fire and then buy cucumbers and cook cucumbers in their skin and we would eat those as kind of a snack, a break on the road with tea. So extraordinary things, and cow dung was routinely used as fuel. In the mornings in the villages you could smell the cow dung burning as people began to make tea and food for breakfast. Elisa Koski: Very, very interesting. How were you received when you arrived in these villages? David Pratt: Interesting. I am 5'6" tall and they would say the big saab. "The big saab is here," which I always thought was hysterical or they would say, "The American saab is here in the village." So it was a respectful term - the fact that an American would come that far to Bihar to work on this issue was felt to be extraordinary by the Indians. So in many ways there was a great deal of respect. It was beneficial as well that I was outside the caste system because I was allowed to make mistakes and gaffes that an Indian couldn't make, and I could perhaps ask for things that an Indian couldn't ask for and get away with it. So I was well received, respectfully received, and I tried to work carefully with the people, the Indian health professionals that were with us-it was intriguing, when we were there - when my group was in India, Daniel Patrick Moynihan was the Ambassador to India and he indirectly told the American EIS Officers who were deployed in the field never to speak to the press. Only allow the Indians to speak to the press and don't make any derogatory comments at all. So we were well schooled and well prepped about what not to do, what not to say in the country. So we really counted on our Indian colleagues and counterparts to do a great deal of the PR and the outreach and the commentary that Ambassador Moynihan really prohibited us from doing. Elisa Koski: You mentioned earlier that you were perhaps more socially free to have some indiscretions or make some mistakes that Indian people would not have been allowed. Can you describe any particular instances where you ran into a problem or where those mistakes weren't accepted? David Pratt: Yeah. There were times when people would flatly refuse you because you didn't quite look right and I remember specifically one outbreak, a woman became very upset when I personally asked to be able to immunize her, and I think I was bucking probably the male-female divide, Eastern-Western divide, so that was an instance where it was very clear that I was not welcome in that circumstance. But that was the minority. The thing that was interesting, another key learning for me in the villages, is the villages were frequently broken up into tolas [0:22:07] or sections. There was often a Hindu section, there would be a Muslim section and then there would be a section for tribals [0:22:12]; and it was always humorous to me that when you spoke to the different leaders of the different tolas, they would make derogatory comments about their counterparts, and it frequently went something like this. "Oh, you will never get them to be immunized, they don't know anything. They are sort of ignorant." It was intriguing how each of them made similar commentary of the others, but at the end of the day they all allowed us to immunize them; and the strategy was frankly to invite the village headman to be the first recipient of vaccine when we were doing containment. So if the opinion leader in the village would allow you to immunize him, then all things seemed to flow from that. So if he got it done, well everybody would line up behind him and we would be able to do a good job. Elisa Koski: Of course. I would like to talk a little about how your entire experience in India really influenced your life and impacted your career in public health subsequently? David Pratt: You have to realize that this was sort of like winning the grand slam in tennis at 29 years of age. Where do you go from here? You know, it was an extraordinary event and as the years went on and the true eradication was proclaimed, and so on and so forth, it became even more spectacular in my career. So what do you do? What is your follow on act? It's like a first novel, if it's a success, it's a huge challenge. I think that I took a lot of important lessons from the Smallpox Eradication Program. The first one is that sometimes naiveté is a wonderful asset. You know, we really didn't know how extraordinary what we were going to do was, and we went at it anyway assuming that it could be done. So I think that was of importance, the naiveté; and the other thing that goes with it is a comment that Colin Powell makes and he says that - General Powell's comment is that, "Optimism is the most important force multiplier" and I tried to remain - the optimism that I brought to the table I thought was powerful in allowing us to get my region - and by way by the time I left my region we were smallpox free. All the outbreaks had been contained and I left an absolute pristine area, I should say the Indians and I as their assistant, left a pristine area, and I was always outwardly very optimistic although as I read my diaries, I read that there were times when I was very pessimistic that we would get the job done. But ultimately when I spoke to our searchers and spoke to students and spoke to people in the villages, I was always kept that very optimistic view. That's one. I think a second big one is the fact that it is sometimes really simple stuff that makes a huge difference. For instance, the logistics, knowing where to get gasoline, knowing how to keep your jeep serviced so when you had to go to an outbreak you could keep going. Having sufficient Rupees to pay the people who search, just really nuts and bolts of good management were critical to succeeding in India and in the rest of my career they have been critical elements as well. Simplicity too; I think part of our success in the Smallpox Eradication Program had to do with the fact that we were using proven technology for the vaccine, we were using a strategy and the tactics to deploy that strategy that had been proven in West Africa and basically what we did was execute, execute, execute. Just this kind of diligence of doing it every day, following the book, compulsively filling in all the things that we needed to get the job done. Atul Gawande who was a writer, an American health writer, talks about the power of diligence and improving quality in care. Well, it was sure true with smallpox, diligence really paid off. Which reminds me of a point where things were not looking so good, in early October in fact, it was October 5, 1974, I know from my diaries-we went to meet with Bill Foege - Dr. Foege in Patna, and we were explaining how it was going and the answer was: "Not so great" and we were really working hard. I mean: we were doing 10 and 12-hour days, lots of driving around and very bumpy roads, the infrastructure in India was tricky, and we met with Bill and he said, "Not good enough, you are going to have to do more." So we were saying - Jason Weisenfeld[inaudible name0:26:57] and l were working in the region together, and we'd say, "Phew, okay we can do it Bill, but we are not sure how much more." So we went back and tried to think; how do we do this in a fashion that is more efficient, more effective as well as putting in more hours. That was extraordinary. So I think those were the real key takeaways, simple things logistics, good management, proven technology and diligence. Just doing it, recording it, measuring the heck out of it and continuing to execute every day. Elisa Koski: How about in your personal life, I mean you mentioned that prior to going you were quite torn of leaving your wife and son at such a critical time and those obviously had to play into some of your future decisions as well? How did this experience in India indicate your personal decision to continue on in Public Health? David Pratt: Yeah. That's a great question. Actually I didn't continue in Public Health until much later. Well, I'll explain. I was invited to move from India to Bangladesh and then ultimately it would be a move from Bangladesh to East Africa where the smallpox was finally eradicated, Jason Weisenfeld and so forth, his team; and it was pretty clear that I was not going to be able to continue with the effort. Several reasons: I had an infant son at home; I had a commitment to continue my training in internal medicine. My father had had a heart attack, my mother-in-law died while I was deployed in India. I mean it was social catastrophe. So it really probably took me 24 months before everything was kind of right in the world, in my little world back home after I got back. So I made a conscious decision at that point to do something that was going to be less travel and more like traditional clinical medicine. I continued to drift towards Public Health in spite of that and ultimately did a number of activities in clinical care that drew upon the public health model to allow me to get the good vibrations back again about public health, and then ultimately when I retired from being a medical director with a large Fortune 500 company, now I have gone back - actually go back fulltime into Public Health, which is a wonderful place to be. Elisa Koski: Excellent. In conclusion, I'd just like to offer you the opportunity to share anything that we perhaps didn't cover, that I didn't touch on, anything very poignant about your time in India, people, places that you would like to add. David Pratt: Yeah. A couple of things: Number one is that I was a grunt in a huge campaign and it was my wonderful opportunity to be at the right place at the right time with wonderful leadership, Indian, International, American-It was a tremendous experience for me to work with D.A. Henderson and with Bill Foege, Mike Lane, Nicole Grasse, and a gentleman named Yallaporka[inaudible 0:30:02], who was an Indian expert, a smallpox expert. So it was a privilege, first of all, to do that work. I played a minor role in a great pageant of strategy and tactics and so forth, and I am grateful for that. Another thing that was very clear is that it was the Indians who did the job in India. We frequently, I think, perhaps take more credit - the EIS types, but at the end of the day; the day by day, grind them out, hard, hard work was done by the Indians and we need to salute them for the extraordinary job that they did. Bright, bright people very hard working, deeply committed and it was an honor to work beside them and with them. I think that the Public Health model that I learnt in the Smallpox Eradication Program of assessing a situation, trying to decide how do you do the greatest good with the smallest number of resources, in the shortest period of time, served me again and again and again, whether it was organizing programs for farmers in Upstate New York or whether it was thinking about field engineers deployed by General Electric in Nigeria, the same thinking that I learned and was underscored in the India Smallpox Campaign served me again and again. So it was a wonderful learning experience for a young man, it laid a foundation, an infrastructure for a career that has been very rewarding, and I look back on it fondly as both formative and instructive for the rest of my life. Elisa Koski: Excellent. Thank you so much for being willing to share your experiences with us and for speaking with me today. I wish you the best in your future endeavors and as you continue on with your medical training. David Pratt: Thank you, it was my pleasure. [End of audio - 0:31:53] </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/P7eiWFStW5A" frameborder="0" allowfullscreen></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource interviews motion pictures moving image Date A point or period of time associated with an event in the lifecycle of the resource 2008-07-11 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16rhs emory:16rhs Subject The topic of the resource WHO Smallpox Eradication CDC India Format The file format, physical medium, or dimensions of the resource 6891960000 bytes video/x-dv Creator An entity primarily responsible for making the resource Pratt, David (Interviewee) Koski, Elisa (Interviewer) Contributor An entity responsible for making contributions to the resource Centers for Disease Control Title A name given to the resource PRATT, DAVID S. Description An account of the resource Dr. David Pratt, MPH., MD., was an epidemiologist assigned to Bihar State in India for the Smallpox Eradication Program. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/c73bea9d83eca7bbab115323daa40148.jpg ba711561aa5b45b01f26d22e674d51e3 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Player html for embedded player to stream video content <iframe src="https://www.youtube.com/embed/6WWGg3Gt7pg" frameborder="0" width="560" height="315"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource presentations (communicative events) motion pictures moving image Date A point or period of time associated with an event in the lifecycle of the resource 2008-06-11 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16rm6 emory:16rm6 Format The file format, physical medium, or dimensions of the resource 8910120000 bytes video/x-dv Creator An entity primarily responsible for making the resource McSwegin, Melissa (Interviewer) LaForce, Marc F. (Interviewee) Contributor An entity responsible for making contributions to the resource Reunion of Southeast Asia and East Africa Smallpox Workers (2008 : Atlanta, Georgia) Title A name given to the resource LAFORCE, MARC F. Description An account of the resource Dr. F. Marc LaForce describes his experiences as an epidemiologist in Bangladesh in 1973 Subject The topic of the resource CDC WHO Smallpox Eradication Language A language of the resource English https://www.globalhealthchronicles.org/files/original/39ed46c91bdb1476732b08e5f2e4c3e6.JPG 32687499f0714d9ee0066f9c36569ca1 https://www.globalhealthchronicles.org/files/original/e0f226bf37f678c446589add4fd0fc1e.pdf 0f1d2df5de2ded7fa0b2ae8b01ef0733 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> This is an interview with Jeannie Lythcott on July 17, 2006, at the Centers for Disease Control and Prevention in Atlanta, Georgia, about her experience and involvement with the West African Smallpox Eradication Project. The interview is being conducted as a part of a reunion marking the 40th anniversary of the launch of the program. The interviewer is David Sencer. Sencer: Jeannie, do you want to tell me a little bit about your early years? Where were you born, what were your parents like? Lythcott: I was born in Leeds, in Yorkshire, England, and I was born in Leeds because my mom had to go to the hospital. I was the only 1 of her 5 children who had to be delivered in a hospital. We grew up in a little village called Rye Hill, partway between Leeds and Sheffield, a coal-mining town. My dad was the only child of coal miners, and he won a scholarship to go to the local grammar school, but his parents wouldn't pay the fee-what would be maybe a dollar, now-to go to that school. And so he was down in the mine at 14. He took himself to night school. He was drafted in World War II. He got in the Royal Signals Corps, and when he got home, he went to college on a program for servicemen. He became a science teacher and grew to become the headmaster of the only school in which he taught. So education for Dad was absolutely prime. Mom had gone to the local high school, and so they were both incredibly bright folks, and with 5 children. I was born in 1939, at the beginning of World War II, and some of my earliest memories are about gas masks and being evacuated. You know, bombs were dropped on Leeds. I grew up speaking Yorkshire, and our teachers spent a good 12 years trying to have us approximate the Queen 's English. This is how Yorkshire sounds. I'm going to give you a Yorkshire toast: [toast in Yorkshire, which Dr. Sencer can't understand] About 6% of students went to university in those days. I applied for and was accepted to Majesty University. Because our family was so poor, I got a scholarship from the government as a result of the 1944 Education Act. The government paid every penny for me-bus fare from home, food, everything-to go to university. If that had not been the case, I couldn't have gone. I taught in England for a couple of years and then decided that I wanted to go around the world, knowing somehow that my experience of education was limited by the British system. So my thought was that I would teach in former British colonies, where some things would be recognizable. And at that time, David, I was going to end up this grand tour of the globe in America, that being the far end of the spectrum. And after that, I was going to go home and become headmistress of a school for girls. I began in Ghana. I arrived in August of 1962. George Lythcott and his 4 teenage children, ages 12 to16, had arrived in Accra with an American team the month before I got there. He was there as Deputy Director of a medical research team to help Ghana build a national health institute manned by Ghanaian scientists and molded after NIH [National Institutes of Health]. We lived very close to each other. I met the family on September 9, about a month after I arrived, and we became very, very close very quickly. It's amazing. George had to go back to the United States in October or November of that year. Three of the children, Ruthie, George, and Mike, were in boarding school in Achimota, so they would be taken care of while he was gone. The youngest one, Steven, was going to a day school, an American international school. So I went to see George the night before he was to leave for 9 weeks to go back to the United States. His household goods hadn't yet arrived from America. We were relative strangers, you understand. I sat there in his house helping him to pack his bag, and he kept giving me money. He gave me 3 blank, signed checks just in case anything happened to his children. I mean, his trust in me from the start, it was amazing when I think about it. And so we worked side by side. I was there to teach physics, chemistry, biology, and mathematics to girls who were given a scholarship. They were bypassing secondary school and being prepared for a degree nursing program, which was unusual in 1962. So that's what I was doing there, and continued to do, until December 1965. Kwame Nkrumah [the first Prime Minister of Ghana] had fallen into disfavor with the American government, and as a result of some of the things that had happened, the United States decided to pull out most of George's team. There were 22 scientists of different disciplines there. The United States decided to pull most of them out as a political statement, but the Ghanaian scientist with whom they'd been working made a plea to the American Ambassador at the time to say, "Can't we keep a scientist-to-scientist relationship?" And so George stayed with 1 technician. But I had upset the Ghanese government, so my contract was not renewed in 1965. Sencer: How did you upset them? Lythcott: In the summer of '65, those who taught in this pre-nursing program said that, for the first time, they were willing to leave as a group (they were very close friends) to go on vacation because they felt that they could leave the college in my hands. We were on vacation, and they felt that they could leave the administrative details to me and they would come back at the beginning of school. Around this time, we had administered an entrance exam to over 2,000 girls from all over Ghana. We had announced in the newspaper when the exam would be given and when we would announce the results. And those results were to be given on a specific date, maybe September 28 or something. While the women were gone, the Minister of Education in the government called up the college and wanted to know whether his niece had been accepted for the pre-nursing program. And so my reply was that the exams had been scored, but we hadn't done the final analysis, and as we had reported in the paper, all of the results would be available at the same time to the public on September 28. I had the good sense to write that in a letter to the director of the college. But he didn't like what I'd done; he just didn't like it. But I stood my ground. So I wasn't expelled from the country, but my contract wasn't renewed. I'm not sure of the details of how this happened, but I ended up working for NIH in Ghana for 6 months on the Burkett's tumor project. I was responsible for getting the tissue samples, getting the osmium tetroxide, and we did 2 other lab manifuplations and then. I hand-carried the samples in dry ice to a plane at midnight to get to Washington, D.C. So that was my last 6 months in Ghana. And then, in November or December of '65, George met D. A. [Donald A. Henderson] in New York somewhere, and they'd talked about the smallpox program. So, in January and February, I think, he was roaming around the 20 countries to be in the eradication effort, getting the agreements signed. We got married in Ghana on January 17, 1966, in an incredible ceremony. So there I was. George headed off to get these agreements signed. We came back to Atlanta in that summer to help get the team oriented to Africa.. So those are my beginnings. Let me tell you 1 other thing. It relates to where I am now. When I was at the University of Manchester, I had applied, on the basis of recommendation from my professor, for a Ph.D. program in Saskatoon, Saskatchewan. There was an interesting morphological problem. There was a weed in the prairies; when you pulled up a plant, if you left any little piece of root, each root had the possibility of making a whole new plant. So the weed was noxious from that point of view. They wanted somebody to study that plant from a morphological perspective. So I got the scholarship. It paid for everything, but I couldn't afford to get there. The professor said he made every effort to try to get me there and found a scholarship from the Dreyfus Company, $1,600, $1,700, something like that. It was a scholarship for post-university work at any college or university in our dominions or colonies, but it stipulated that it was for a male student. And they said they were so happy if somebody would try to change it, but it would take them 5 years. So I went into teaching. Sencer: You got married instead. Lythcott: Yes. I met George. That derailed my whole plan. Yes. Sencer: You came here in '66 for the training course? Lythcott: Yes, yes. Sencer: Was this your first experience in the States? Lythcott: No. My first time in the United States was 1968. We'd been married in '66, and I was still a British citizen. We found out that when an American official was part of the diplomatic corps, marries an alien overseas, and is returning to post overseas, that the residency requirement for US citizenship is waived, which makes good sense. Also, you can be naturalized in any court that's meeting. So in 1968, I took all of the steps to come in on an immigration visa. I had studied up the kazoo. We found out that the federal court was meeting in Washington, D.C. I was in New York, pregnant, so I went up for the day to Washington, D.C. to take this exam. I took the oath, in a very moving ceremony. It came time for the exam. Well, I had studied. This judge sat there, and he said, "How many arms of government?" "What do we call this form of government?" Then the next question was, "So tell me what you know about the Executive Branch." And in all seriousness, I said to him, "You mean everything I know?" And he looked at me, over the top of his glasses, and he said, "Well, why don't you just start, and I'll tell you when to stop." Well, I started, and I had this down. It was like unpacking the files from memory, you know, and so on and so on I went. He didn't ask me another single question. It was amazing. Sencer: So, in the smallpox program when you went back after '66, George had traveled around getting the agreements signed. Lythcott: Right. Sencer: And then what happened? Lythcott: Most of the agreements were signed, but not all, when we came back for the training program here in 1966. Nigeria was still the very difficult one. And if I recall, 50% of the population was in Nigeria, and I don't know if 50% of the smallpox cases were there also, but without Nigeria, this program made no good sense. Back then, CDC had a program in Atlanta for the families while the guys were going through their training. There were some cultural events for children. So George went off for a week to Nigeria to get the agreement signed. But when he got there, all of these hostilities between the north and the east had just erupted, and nobody, but nobody, was interested in thinking about a smallpox eradication-measles control program. So it is my understanding that he did everything that he could. And people would check in with him. It wasn't easy to make long-distance calls back in those days. You could hear the ocean, I think, in the background. You had to book your call 3 hours ahead of time. And so, when we knew a call had been booked, I would actually be in the hallway, waiting. D. A. and Billy and various people would be there, and I'd just wait in the hall outside for messages. George was an incredibly social person; he had people skills up the kazoo. It's funny, because at the same time, he was also very much of a homebody and a loner. He would say often things like, "I don't care about anything else, just as long as I've got you and my baby at home." But when he was out there, he had people skills up the kazoo. And people found themselves talking to him easily. He adored women, and women adored him. From his days in Ghana, he knew about the underworld, you know, those CIA [Central Intelligence Agency] spies, and so on. Actually, the CIA tried to recruit George, and George came home and told me about all of it. But he told some of the things that they knew about him and about me, and I said, "I don't think you need to be a part of that." So he gave it up, although it would have meant a whole lot of money, which would have been helpful with 4 children. But he was used to that, sort of thinking, where messages can be passed back and forth that can ameliorate situations before they erupt. He was used to that sort of level of conversation. So George was at a cocktail party in Lagos He'd been there about 6 or 7 weeks. And nobody knew much about the new young leader of Nigeria, General Yakubu Gowan. As president of the federation, he was in the middle of Yoruba country, but he was from the Jos Plateau. So he didn't have his own people, his own tribe, around him. So it must have been very tenuous for him in the beginning. And so it was hard for George to find connections with him because there weren't many in that milieu. So George was at this party, chitchatting with the wife of one of the Yoruba diplomats there whom he'd come to know. And George said to this lady-it was very serendipitous-"He's such a handsome young man. And he's not married, I hope. This is the army," some conversation like this. And the woman leaned over and she said, "Oh, no, he has a girlfriend." And so it was through that contact that George then arranged an introduction with. the girlfriend [I believe mistress would be a more apt term. djs] And so George told the young woman about the smallpox program, what it would mean to children in all the 20 countries, and that if Nigeria didn't sign, there would be no program. He gave her that understanding, and she went to the President the next day, and there it was the signed agreement.. Yeah. Sencer: As you say, he had people skills. Lythcott: Oh, he did, he did. Sencer: Did you do much traveling with George, or were you a homebody? Lythcott: I did some, but not much. Once the civil war erupted, we were told by the American government that they were not requiring dependents to leave but that if we left, we couldn't come back. So I actually did very little traveling. I went to Abidjan, to that meeting. And then little Julie was born in November of 1967. Sencer: Where was she born? Lythcott: In Lagos, Nigeria. Sencer: Which hospital? Lythcott: It was a Nigerian hospital on the mainland. She was delivered by midwives at the hospital. George brought my mother from England to visit us, so she came for about 3 weeks, the first and only time she ever flew in an airplane. So, of necessity, we were home. Sencer: You want to tell us some of George's printable exploits? Lythcott: One that I didn't tell the other night was about Colonel Labusquiere leader of OCEAC [Organization de Coordination pur la Lutte contre Endemies d'Afrique Central]; he was a formidable character. As I remember it, he wasn't at all persuaded that the Americans had any role in the OCEAC countries; he thought that the French were doing just fine, thank you very much. In the case of smallpox, I think he was absolutely right, but measles control was something he would gladly give up. But as George used to describe him, the Colonel was just puffed up with national pride. Any notions that Americans were going to be coming to help them were just impossible. So we were in Lagos, and we got a call that Colonel Labusquiere, his wife, and his mother, who was traveling with them from France to visit them in Cameroon (I think that's where they lived), were going to have to lay over in Lagos, Nigeria, because there was something wrong. They couldn't fly all the way. I don't know what it was. But they were arriving in Lagos, and of course they would stay with us. And I was in a panic now. What are we going to do? So we've got Labusquiere, this formidable character. As far as I knew, he spoke very little English. And his mother was coming too. Sencer: Right. Lythcott: So I put the word out among the wives of those who worked in the regional office-Bonnie Flanders [Bonnie Jean Flanders], Ilze [Ilze Henderson], and Dotty Hicks [Dorothy Hicks] and so on-that if anybody, anywhere, had any French literature-magazines, books, anything-that I could at least put in their rooms, to let me know. One of them came up with a magazine, and I got the guestrooms ready. And you know how they did things in 1966. So I put the magazine down on the bedside table for the mother, and just flipped it open to a page, and placed it next to a little vase of flowers. It turns out the page depicted a vineyard, and this was their property. So completely serendipitous! There it was. The next morning, the mother said, "How did you know?" So they come, we're struggling through, in French. You know, the astonishing thing about George was that he didn't speak other languages, at least not at this point. He would have a few words here and there, but that was a tribute to his people skills as well. It was all eye contact and body language. Anyway, we're struggling through dinner. I think Ilze and Rafe [Ralph H. Henderson] came. I was struggling with my French. I hadn't used it in a long, long time, but it seemed to be okay. And we were getting through. It was a kind of a nice occasion. So the next morning, at breakfast, we got up. I mentioned that I hoped that they had spent a pleasant night, and so on. And all of a sudden the colonel begins speaking in English that is much better than my French. That old son-of-a-gun. Sencer: Yeah. Lythcott: And so he said that it had been a wonderful visit, and he said the first thing that he needed to do was to toast George because in one 24-hour period, this man had caused his mother and his wife to fall in love.. And that's when the conversation about the vineyards came up. He thanked us for the evening and how they appreciated us trying to put this together. And George always thought that was a turning point in that relationship. You have all of the other stories about the passports and things, I'm sure. Sencer: Well, we don't have them in your words. Actually, I don't think those were recorded the other night, about filling in his passport. Lythcott: George was traveling with Jay Friedman [Jay S. Friedman]. I think they were trying to go into Abidjan. George realized, as he's going up to passport control, that this [unclear]. "I still have these passports. Maybe I should send those to CDC. That would be fun, wouldn't it?" with all the extra pages stuck in, and so on and so on. And so he looked and found that his visa had expired the day before. What was he going to do? Somebody else goes through, and then George comes along. The passport officer was a young woman. So George said to her, in his own inimitable style, "Hello, honey. How are you doing? May I borrow your pen?" And so she said, "Here's one." So she took out a pen, gave it to George, and on the desk right in front of her, he drew around the outside edge of the visa and changed the date. So the date was, I don't know, tomorrow. So if it said the 17th, he changed it to the 19th or something, right there. And he gave her his passport, returned her pen, and she said, "Fine, thank you very much. Have a good day, big boy." Another time I think he just ripped out the old page of his passport with the old visas that were attached and put it in his passport. And then there was the time, it was Julie's first birthday, so November 28, 1968, George had been at a conference with a whole lot of other people in Congo Brazzaville. I'm not sure why, but George didn't get on the plane to come to Lagos as we had thought. But he had let me know that he had invited 3 Russian physicians to Thanksgiving at our house. This was a big deal because George cooked the turkey. George could cook like you wouldn't believe. He put it on a spit on the grill outside. And I was allowed nowhere near this machine. So I expecting George home, and he didn't come, and about 10 o'clock in the morning, the 3 Russian physicians arrived. And I'm panicking a little bit. I have the turkey all dressed, it's all ready to go, but I haven't heard from George. It's Julie's first birthday. I knew he was going to be there if he could. And nobody seemed to know what had happened to him. Finally, about noon, totally unexpectedly, George breezed in through the front door, dropped his suitcase and his coat, and went right into the kitchen and said, "Is the turkey ready?" and I said, "Yes." And so I followed behind him, and he said, "Did the Russians come?" I said, "Yes, they're outside by the pool." And he said, "Oh, by the way, your brother said to say hello." My brothers are both in England. It made no sense to me. But later, as I got the story, he had persuaded the people in Congo Brazzaville that he absolutely had to get to Lagos, Nigeria, he just had to. And so they entered into this whole problem-solving with him. You know, that was the art, that he got people to problem-solve with him. So they said, "Well, we can't get you to Lagos, but we can get you to Rome, and maybe you can get home from Rome." Know this. This was all on the ticket from Congo Brazzaville to Lagos, so there was no extra charge or anything involved here. And so he got to Rome, and the same spiel, and he tells a story and, of course, he's been talking to the stewardesses on the plane. It's like he's got the whole world looking out for him. They sent him to London in time to get the flight-BOAC, I think it was-from London to Nigeria. While he was in London, he called my brother. Oh, man. Sencer: What were some of your high points in Africa, besides having Julie? Lythcott: Well, that was definitely the high point. I think the only big conference that I knew about was the one that we had in '69 in Lagos. It must have been in the spring. Most of the photographs that I sent are from that conference. I remember 2 things about that conference. One is that George was bound and determined to have a diplomatic coup, which was that all of these contiguous countries would finally agree that a smallpox outbreak could be attended to by the smallpox vaccination team that was closest to the site, regardless of which side of the border the team was on. And this was huge. So that from Nigeria, you could go into Niger, and vice versa, for the purpose of containing smallpox. And they reached that agreement at that meeting. So that was a high point for George. The other thing was that George had arranged-he was so proud of this-for a sophisticated method of simultaneous translation. Translators were sent in from Geneva, and they were set up in little booths. But, of course, it was dependent on the electricity working, and West Africa being West Africa at the time, electricity working was not something that you could count on. So George had requested that the translators be able to move into consecutive translation as well. Well, that's what happened. The electricity went out. And I have this fabulous memory of these translations, which were really improvisational performances. When the translator was translating from the French into English, the shoulders would go back and be squared, the neck would be buttoned up, elbows tucked in, and the correct accent. And then the same guy, when translating from English to French, would tousle his hair, undo his shirt, and he'd be scratching and all kinds of things. It was an absolutely wonderful performance. I sought them out afterwards at the cocktail party, and they said what a joy it was for them to go back to this old skill that they used to have but didn't get to use anymore. Sencer: Was one of them mustached? Lythcott: Definitely. The other was a young woman who was on one of those photographs. I remembered her name: Eleanor Trench I think one of them may have been in that photograph. Sencer: The mustached one was one of the WHO's [World Health Organization] translators, and he was just magnificent, just magnificent. Lythcott: It must have been him. Sencer: As you said, he would fall right into whichever language he was working in. He was great. Why do you think things worked so well in Africa, or worked as well as they did? Lythcott: You know, that's a complicated question. But I was thinking about Bill Foege's presentation, the final one at the seminar the other day. Bill's thought was that nobody really believed that they could pull it off. There may have been an exception because I know George believed it. He came back from meeting with D. A., and he didn't say, "We're going to try to eradicate smallpox." He said, "We're going to eradicate smallpox," you know-and control measles. The question for him was not whether it could be done. It was just, how in the world are we going to get it done? So he believed it. I don't know who did the interviewing, but given the issues of racism and lack of cultural sensitivity in our nation at that time, the selection of those young folks was amazing. But it also may have been their youth. Because they were very young, you know. When you're 23, 24, 28 years old and if you're smart, you do believe you can do anything. I thought I could run any school in the world better than anybody else who was doing it at that time. Sencer: You probably could. Lythcott: Yeah. So it's that chutzpah of youth. But I think the fact that there was a very small American presence in each country was a fabulous decision. I think if there'd been 10 CDCers per country, they would have coalesced into a tight little team, whereas being only 1 or 2, they trained their counterparts and worked with them; that was critical to this process. But because there was usually only 1 in every country and the medical officer covered several countries, there was a sense that you were not entirely isolated. And that's why George traveled 70% of the time. I calculated it. He was gone from Lagos 70% of the time. He needed to do that. He needed to have them know that somebody was on the ground caring about things. And, you know, he did a lot of caring for families. . So I think it was that. So there was the animus of can-do. I think the other thing was that there was probably a little of that rambunctious devilry in all of these young people- sort of an obstinacy that, if you hit a wall, it wasn't going to get you down. It was just something to get over. I think there was that. Clearly, for the team from the United States, that link, also incredibly tenuous-you know, how long it took to make an overnight call; you sent telegrams, and relied on a way of communicating that seems so old when we compare it to today's world-but that link, tenuous as it was, was also incredibly strong. I don't think for a minute that George ever thought that there was anyone back in the United States that would say no, would say we can't do it. It was that can-do spirit again. And you have to give credit truly to the country nationals also. It wouldn't have worked if they hadn't wanted it to work. There were more ways than we could ever invent in our culture for not getting it done in West Africa. Do you remember when Rafe and somebody went to the subcontinent to try to help WHO get that off the ground? I think they were there for about 3 weeks for an initial conversation with the Ministry of Health. So for 3 weeks, they'd met with the Minister of Health. He had been very courteous, very engaging. They'd had wonderful conversations. But there wasn't anything happening, nothing! And it was about time for them to come home. They had reached a level of maximum frustration, so they requested a meeting with him. And he said, "Welcome, and good journey home" and so on. And they said, "Before we go, we need to tell you how frustrating this is. We thought we might be able to go home and report that something had been done." And he said- and this is the line, the actual quote-"What would you do if a friend, as a gift, gave you an elephant? We can't cope with that big thing!" So the country nationals, they could have found ways to not get it done, to not enter into the problem-solving. And you have to believe that it was because they knew what a gift it was to keep children well. Sencer: I'm now giving editorial comment. So many of the people that went from the United States had worked in state health departments, where they saw their job not to be the leader, but to get behind the leader and gently push: Let's get this done; let's get this done. And I think a lot of that was part of the success in Africa, that they recognized the primacy of the native leaders. Lythcott: Yes. Sencer: And recognized that there were ways to get them to move. Lythcott: Mm-hmm, yeah. Sencer: I notice you're wearing a bracelet. Lythcott: Yes. Sencer: Tell me about it. Lythcott: I will. One of the extraordinary things about that time, which is evident for all of us who came this weekend, is that it was a short time in our lives. I'm 67 years old. The smallpox program was 3 years; Ghana, before that, lasted 4 years. Seven years is a very small part of a lifetime, but it was life-changing. We all learned things. We all learned a way of being there. We weren't there as art collectors; we weren't there out of curiosity. We were there as national, you know, the old National Geographic notion of, will there be curiosities? Jim Lewis [James O. Lewis] was telling a story on Saturday night about how the truck he was in had driven into this pond or this mud in the road, and the driver had assured them that they would get out. They were knee-deep in mud. People just turned up on bicycles and helped them get this truck out of the mud and refused payment and seemed offended to having even been offered it. And Jim said that since then, he always stops to help on the roadside. So, my point being that we all have remembrances of that. So, I've put on umpteen numbers of pounds, so I can't wear my African clothing anymore. I just have 1 dress that I can wear. But I wear it often. When I put it on, it puts me back in that part of the world. So the other day I was co-teaching a course with a professor friend of mine at Stanford. He was delayed considerably. When he got there, he said he'd had trouble with his car on the way. I said, "Now I'm going to use an Africanism at Stanford." He had trouble with his car. And my immediate response was, "Oh, sorry." And he said, "Don't be sorry. It's not your fault." And I said, "It's the West African sorry," sorry that the world did this to you. Another memory, when Georgia died. In Nigeria, if they came to your office and you weren't there, there was this phrase, "I came and I met your absence." It's the notion that there's a presence of your absence as well as the absence of your presence. And they're not the same. Sencer: You mentioned life-changing.. How did it change your life? Lythcott: It taught me that I needed to revise my sense of my own country. I needed to give up this notion of glorious British history and acknowledge that some of British history was an inglorious thing. Nobody had taught me in England about our role in the slave trade, or that there even was one. I specialized in the sciences. I gave up studying history at Henry VII to specialize in the sciences. But I don't think that they taught that in British schools anyway. How the raj came to be is an incredibly important issue. I had to reshape how I walked on planet Earth. So I think that that made me, as a human being, open to the difficulty of understanding cross-cultures and being with cross-cultures. One of the things that we talk about in academia is this notion of white privilege and how hard it is when you are in the position of privilege, which is almost always tacit. You just don't know yourself well enough to be think across cultures. So I think it did that for me. And the experience taught me the role of sharing, of not holding onto objects too hard, of the extended family, of what you have you have to share, and that kind of thing. And so, in lots of ways, George and I became who we were as a result of being in Africa. So I just wanted to say that now, Julie, our daughter, and her husband and her 2 children, and I pooled our resources and we bought a house together in Palo Alto. We never could have done it on our own resources. So we're living together under the same roof, a situation fraught with potential dangers, you know, the old mother-daughter thing, your mother-in-law. And we said at the outset that we knew it was going to be difficult and that we wouldn't hide it under the table. We'd make sure that we put it on top. It's been such an incredible journey for Julie and I. Julie is all set to write a book about it. One of the incredible things about George was that he never stopped living. He changed his mind on some really big things as an older person, as a 60-odd-year-old, as a 72-year- old. It's quite astonishing, you know. But I think once you've been in a situation where your whole world, the things that you're sure about, have to be totally examined, you can see yourself whole and confident and competent, having gone through that change. Sencer: Yes. What's Julie doing now? Lythcott: Julie is dean of freshmen at Stanford, and just newly promoted to associate vice-provost. She just completed her 4th year, and they absolutely adore her. Every year they've changed her role and brought her more into the centrality of what's happening at the university. This year, one of the things she initiated was that the incoming freshmen would read 3 books, or they could choose 1 of 3. Stanford will have the authors there, during orientation, so that there will be a conversation between the authors and the freshmen. They chose books on Afghanistan, Haiti, and a collection of short stories about mothers and daughters. Sencer: Carrying On the Tradition. Lythcott: Carrying On the Tradition. That's exactly right. She has George's oratorical skills, and she has George's charisma. You know, I saw George walk into a typical West African cocktail party (that's how people there spent their evenings), into a gathering of 80 people, and the room changed when he walked in. He had that power. Julie has that power too. Sencer: I'll tell you a story about George. We were in Mali and going out to the Dogon country. This was at the time of the 25th millionth vaccination. And we stopped at a little rest house way out in the middle of nowhere. At that time, Mali was very Chinese dominated. We walked in to the rest house. George was in a big orange jumpsuit. There were 3 Chinese in there, and they came over to him thinking him to be Malian, and George said, "Howdy, brothers!" And those Chinese turned tail and left, realizing he was an American. Lythcott: Oh, man! Yeah. George was with the first team that went into China after Nixon went. And then he went a second time. The second time, he was walking on the Great Wall of China, and he heard someone call out behind him, "George Lythcott?" Can't help Can I just tell you how D.A. looked after us in Atlanta? Sencer: Please. Lythcott: We were living in a motel, and D. A. was persuaded that trouble was brewing in the motel. We were breaking the segregation laws in several states at that time. I know that. And so he moved us for the duration to the apartment of at Unitarian minister. And then, while we were still here, George had to go to Washington for some reason, I'm not sure why. We were newly married that year, and I had hardly seen George. You know, he'd been roaming around West and Central Africa since we got married. Three days after we got married, he left. And then he was gone for 9 weeks in the summer. So George said, "I want you to come with me." The idea was that we would go on the overnight train from Atlanta to Washington, getting into the Washington on the sleeper train at 6:30 in the morning. But D. A. was very worried about us, as was George. So they got the plan together, which was that both George and D. A-and I don't know how tall D. A. is, about 6'; George was 6'2½"-with their raincoats on, unbuttoned, would get to the railroad station, with me, and then we would walk fast. I'm 5'½" tall. Their raincoats would flap open, and I would be hidden behind these raincoat flaps, and they would hustle me on the train. And that's what they did. And all was well. And then the last thing involved the chairman of the department in Oklahoma. He had come from Mississippi and had been told at his interview, "We have a black American on the faculty. How do you feel about it?"And the man had said, "Oh, just fine, just fine." And then a week or 2 after he became department chair, he called George in and said, "You need to know that I can't have anyone on my faculty whom I can't invite home to dinner." Later, that same guy applied for a position to Johns Hopkins. All we knew was George got a brown paper envelope. In it was a letter of application from this guy, and D. A.'s response on a little office memo. D. A. just wrote on it, "Turn of the screw." So D. A. looked after us in really important ways. Sencer: Yes. Well, thank you for talking. Lythcott: Oh, you're welcome. Sencer: And we'll sign off now at 10:25. Thank you very much. Lythcott: Thank you. # # # </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310129775%3Fsecret_token%3Ds-3IgEq&amp;color=ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false" frameborder="no" scrolling="no" width="100%" height="166"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource sound recording - nonmusical interviews Date A point or period of time associated with an event in the lifecycle of the resource 2006-07-16 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/158q3 emory:158q3 Subject The topic of the resource Smallpox Eradication USAID WHO CDC Format The file format, physical medium, or dimensions of the resource 585786768 bytes audio/x-aiff Creator An entity primarily responsible for making the resource Sencer, David (Interviewer); CDC; Former Director of CDC Lythcott, Jeannie (Interviewee); CDC; Wife of Regional Director Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of West and Central Africa Smallpox workers (2006 : Atlanta, Georgia) Title A name given to the resource LYTHCOTT, JEAN Description An account of the resource Jeannie Lythcott, widow of George Lythcott, who was the Director of the West African Regional Office of the Smallpox Eradication Program in Lagos Nigeria from 1966-69. Jeannie, originally from England, tells how she came to work in Ghana and met and married George. She narrates some of her husband's escapades working for the Smallpox Eradication Program and how it changed her life. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/35c8696b4dd6f0f097dcaf1c630112ff.jpg f8baece4f8f23a894202c3887c5a2a74 https://www.globalhealthchronicles.org/files/original/d04627830a2d6e8669f59fda68ccc468.pdf b992c68df44827472101ef704d64308f Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> INTERVIEW WITH RON WALDMAN Elisa: This is an interview with Ron Waldman on July 11th 2008 at the Centers for Disease Control and Prevention in Atlanta, Georgia about his role in the smallpox eradication project. The interviewer is Elisa Coskey. With this interview we're hoping to capture for future generations the memories of participants and their families involved in eradicating smallpox. This is an incredibly important and historic achievement and we want to hear about your experience. I have some questions to guide you but please feel free to recount any special stories or anecdotes that you remember about events or people. The legal agreement you just signed says that you're donating the oral history to the U.S. Federal government and it will be in the public domain. For the record could you please state your full name and that you know you are being recorded? Ron: Ron Waldman. Yes, I know I'm being recorded. Elisa: Okay, thank you very much and thanks again for being here today. I just want to start with a few chronological questions and if you can describe for me briefly your childhood, your college education and what influenced you to become interested in public health in general. Ron: Well, my childhood was spent in New York City and then in Long Beach, New York where I graduated from high school. I went to college at the University of Rochester in upstate New York and then to Law School at the University of Chicago in nineteen sixty seven where I studied for one year until I left the U.S. during a period when many people my age then were leaving out of objections for the Vietnam war and I ended up in medical school at the University of Geneva in Switzerland. I can't honestly say that while there I had any exposure to public health at all and I really didn't know what I wanted to do in medicine with my medical degree when it was awarded to me somewhat surprisingly in nineteen seventy - in May of nineteen seventy five. Being a foreigner in Switzerland that time meant that without having the benefit any more of a student permit to live there I had to leave the country and I really didn't have much knowledge of what I was going to do. While there I had been coaching a high school baseball team and I was talking one day to my star pitcher from the team who was graduating from the international school in Geneva at the time. And we were talking about what we were going to do. I asked him what he was going to do and he said he was going to go out to Colorado to ski. And he asked me what I was going to do and I said I didn't have any idea, that I had just finished medical school at the university and I would probably end up doing something related to medicine. And he said, "Oh that's pretty interesting. You ought to meet my girlfriend." And I said, "Why?" "Well her dad works with the World Health Organization," and I said, "Okay well bring her to the next game." So, he came to the next game accompanied by his girlfriend and she said, "Well you ought to go up and see my dad," and her dad turned out to be D.A. Henderson. So I went up to meet with him and was long hair and all at the time ushered up to the smallpox offices where I don't remember exactly what happened but the upside of it was that they asked me if could leave for Bangladesh within the next few days and I said sure. And that's how I got my introduction to public health and to smallpox, which has been basically the beginning of career that's still going on. Elisa: So, quite an unanticipated chain of events. Ron: Very serendipitous event as had other previous events been so yeah, not the usual pathway into the program. I don't think so. I left as a basically - no basically I left for Bangladesh a few days after that meeting as a WHO volunteer so smallpox eradication was really my first job of a serious nature but I didn't get paid really any more than just the subsistence that WHO volunteers had at the time. I didn't know anyone who was working in public health. I didn't know what public health was. I'm sorry to say and maybe it doesn't reflect well on the very strong academic program at the University of Geneva medical school, but I hadn't really heard of smallpox and I am not entirely sure that I had heard of Bangladesh either but there I went. Elisa: Quite the adventure you were beginning. Can you tell me a little bit about your arrival there in Bangladesh and? Ron: Yeah. We went - I remember leaving Geneva and we were heading off for training in Delhi. I remember distinctly flying into Delhi and when they opened the door of the plane there was this rush of heat that I had never experienced before in my life and I knew I was somewhere different. We had a small orientation group there in India. I remember some of the people who were in that group with whom I'm still good friends. I think that orientation took about five days. Some people stayed in India, others were sent on to Bangladesh that's where the action was and I remember that first plane trip t o Bangladesh. I never thought I was going to land at all. It was May, the beginning of the monsoon season and the plane flew over Dhaka, tried to land, storms came in, the plane was rocking, it was just awful. For about an hour they kept circling around and trying to land. They couldn't and eventually the plane went back to Calcutta where we spent the night. This is all like in the fog of all of this newness happening to me. We were forced to spend the night in Calcutta, got out the next day. They took us to the airport, put us on a plane again and flew us off to Dhaka where this time we landed and we were greeted by Daniel Tarantola who was - I don't know exactly what but high up in the smallpox bureaucracy in Bangladesh - and taken into another orientation session that lasted about a week. And that's where I met all these acquaintances and many of which were with people that I'm still in regular contact with as I am with Danielle just now. At the end of that orientation where they were talking about things like imprest accounts and administrative matters and stuff that I really didn't understand and which I had frankly little interest, they shipped me off. I was young and there were few of us, a number of volunteers like myself. They shipped me off to the northeastern corner of the country, Syhlet district and there I went. I went from Syhlet - the smallpox base in Syhlet they shipped me off even further towards the Indian border to a upazila I think they're called now, a thana called Chhatak - a town called Chhatak where there were no roads. They had given me an outboard motor. I had no experience with motorboats but they gave an outdoor motor. I carried it up there on my back, found a boat, found a driver and started doing what they had instructed me to do which was to conduct surveillance activity. Elisa: You mentioned that you traveled further outside of your central village and had an outboard motor. Can you tell a little bit about what travel was like, did you have a team with you? Ron: I had one person with me basically, a driver who I had hired. I located up there. This was a place it was really far out in many ways but it was a place that had a big paper pulp factory that was run by an Eastern European country and when I got up there I didn't speak the language or anything. But I went over there and with a translator -- I had a translator -- just to find somebody who could drive me around in this motorboat. And we located a guy who just turned out to be fantastic and who literally saved my life a number of times. He'd been a freedom fighter during the Bangladeshi war of independence and those guys, Rakkhi Bahini they were called, were very highly respected by everyone. This was a guy of indeterminate age I would say. He had long flowing white beard but I don't think he was very old. He was probably in his forties or early fifties. And he attached himself to me and when we explained what I was there to do and what the program was about and became a very, very loyal, faithful, dedicated and incredibly competent colleague. We went around with fliers and posters and obviously had supplies of vaccine, bifurcated needles, everything else that we needed to control outbreaks of smallpox should we find them. We went around to - there were no roads literally. We only had the rivers to follow and then when enough rain had fallen and as I mentioned we were on the Indian border and when they created Bangladesh they just - the surveyors establishing the boundaries would walk and walk and walk and as soon as they took a step up, that's where they drew the border. So, Bangladesh was completely flat and there was no rock to build with. So, all of the stones for construction came from the Indian side of the border and they would carry them along the rivers in these long - I don't know - canoe like boats that they would load with rock until there was no free board whatsoever on the side of the boat. They were going with the top of their boats flushed with the waterline. Why not? There wasn't really any motorized traffic in these areas until I came along with my motorboat. So, I basically held their lives in - my driver did cause if we had created wake going past them with their boats filled with rock they were going down. So, the upshot of it was that basically I was king of the river or my driver was. So, it was really kind of we went everywhere. Like we went to market places, mosques, other gathering places, every little village we could find. After it had rained enough we could go straight as the crow flies. We didn't have to stay to the course of the rivers. Little rice paddies filled with water and the whole place was under water. I remember that we would just go straight from one point to another. Sometimes they had these little dykes between the rice paddies and sometimes we would hit our motor up against those dykes and we would break off what's called a shearing pin that keeps the propeller in place. So, we always had to have a hefty stock of shearing pins whenever we traveled. I remember that and I remember having to change them quite a number of times. As time went by I learned how to deal with the boat and I learnt enough of the language to get by so that on the weekends when we would go down to Syhlet to get a little R&amp;R; for a day or so with the other smallpox workers from the region, I used to take the boat down myself. I'd leave the driver up at home with his family and I used to go down probably about a three-hour ride with this little maybe thirty horsepower Yamaha engine that we had. So, I got to be pretty good with the motorboat in addition to smallpox. And you know by now many people must have explained what the deal was. We would ask if people - we had these recognition cards that the WHO had given us and we'd show them around and we would invite people to tell us if they had seen anybody with a rash that led them to suspect that this person might have smallpox. And then we would go out to that place, to the person's house. We'd try to get enough information to know where it was. And if indeed we identified the patient as a person who had smallpox we would institute containment activities which meant that we would isolate the patient in the home, hire guards from the village to make sure that no one could come in or out of the person's hut and we began vaccination routine. That's when we started hiring people and we would round up as many people as we could. They were usually younger kids who were interested; at least interested in earning the pittance that we were paying them. Six taka a day I remember really. It wasn't very much money and they would begin to - we would instruct them on how to vaccinate and they would begin vaccinating everybody. I don't remember exactly what the protocol was but it was maybe within the first day to vaccinate everybody within a one hundred meter radius of the index case and then within five days maybe three hundred meter radius or five hundred meter radius and eventually up to a kilometer around the case. For us it wasn't difficult at all because this was a pretty sparsely populated rural area and as I mentioned everything was water. So, the little villages if you could call them that, the clusters of homes were all on little islands basically that just were slightly elevated above the water. Maybe there'd be ten or twenty homes or something like that so we do 00:15:25 and vaccinate everybody and then just get back in the boat and go to the next line and get out and explain what we were doing there and vaccinate everybody. So it really wasn't for me all that many people. On the other hand we had a lot of smallpox. So, out of all the people that you will be talking to, I've seen as many cases of smallpox as anyone. This happened I think it was in March or April or maybe early May in Bangladesh the government knocked down the slums in the capital city of Dhaka and when they did that people fled back to their home villages and they transported diseases all over the country. During that - I know it's a big event that the WHO people really tried and CDC people really tried to get the government not to do this but the government was intent on knocking down these slums and they did and because then when smallpox was carried throughout the country that's when they had this huge resurgence. They had been doing quite well in bringing it under control but in that spring of nineteen seventy five there was a huge resurgence in the number of cases which is why coming full circle, they were so interested in taking anybody who would go basically and sending them out there. So, when I turned up on the basis of D A's daughter's recommendation at the offices in WHO they were really happy to see a warm body who was willing to go out there. They were throwing everything into trying to bring the epidemiological situation back under control. Elisa: Very interesting. Can you tell a little bit about your reception in some of these villages or as you called them like clusters of homes in combination with the social circumstances at the time? Were there ever any challenges that arose for you? Ron: Yeah, that's a terrific question and one that my answer will maybe be a little bit controversial and has been at other meetings of smallpox people. One of the reasons why the smallpox eradication effort in countries like Bangladesh was so successful was that those of us working in the program were fanatically committed to its success. I think that the tone was set by those people who were leaders and Bangladesh for us it was Stan Foster, Daniel Tarantola, a number of others, people from the CDC but we were going to get this job done. And I can't even tell you with tremendous accuracy what the reception was. Sometimes it was quite warm, we were always invited. I remember before we did anything when we arrived there and remember I was traveling with a guy who was incredibly respected in society there and who everyone knew. But we were always asked to take a seat; we were always offered green coconuts and the coconut water. We were offered tea always with - whatever little bit they had to offer guests we were always offered right off the bat. The hospitality was incredible. When it came to doing the job of if it meant isolating somebody in a home, if it meant vaccinating people who might not want to be vaccinated for one reason or another, the reception could become at times a little cooler. But it never really dissuaded us from getting the job done. So there were times when things were done even forcibly. If people tried to flee when it was their turn to be vaccinated because they were afraid of what it might be and it was never I don't think all together adequately explained to people or maybe it was and they didn't understand. They could be at times physically restrained and forcibly vaccinated. I have a very deep and abiding interest in human rights and in the relationship between communicable disease control and human rights. But I have to say that at least in my - from my personal experiences in Bangladesh there were times when one could be questioned about one's respect for other people's rights to have a particular intervention explained to them. And I know that this was the case in India as well and there was some papers and the literature to talk about this. There were times - I was very friendly because I had this big motorboat, not big but I had a motorboat, which was unusual for the area so the military forces would come by at times and you know just to see what I was up to because I had something that could be of value to them under certain circumstances. So, I was kind of friends with the military and people knew that and it was interesting. But we always got the job done and I really, really hope that we did it with the maximum amount of explaining to people what we were after and to the largest degree possible with their assent and their accord. Elisa: Okay. I'm really interested in hearing a little bit more about your relationship with your guide. It sounds like he was an incredible asset to your whole experience there and you mentioned really early in our conversation that there were a couple of times when he may have even saved your life. Could you discuss that a little bit more? Ron: Well sure. So, you know he was a Rakkhi Bahini. He was with the Bangladeshi Liberation Fighters during the war of separation from - of independence, Bangladesh independence from Pakistan, which was in 1971 and 1972. These are the guys who - they're the - that war was terrible as wars are in that part of the world, in any part of the world and the Pakistani forces would pillage villages, rape women and so on and so forth. And the major resistance was in the peripheral areas where these, I guess you could call them to a certain extent guerilla fighters who would do what they could to resist. Hit and run activities. Just you know, sabotage and whatever. These are guys who would when they were being chased they would stay underwater. The apocryphal stories were that they would stay underwater for 12 or 24 hours at a time breathing through a reed they would have plucked from the brush on the side of a river. So they were legendary and he happened to be a part of that and in the post independence days they could pretty much do what they wanted. And he was just a really upstanding guy who wanted to continue to provide service to the people and the country that he loved. And he was very, very happy to hook up with the smallpox eradication program. I don't remember if he had had relatives who had died of smallpox but everybody knew people who had smallpox. It was a fairly common disease in that part of the world. So yeah, I was really lucky that I had him because I'm sure I could have made some serious diplomatic faux pas and probably did and I'm sure I don't know of all the many times that he protected me actually. But I did say that there were times when he did save my life and that's true because as I said I didn't really know what I was doing with the motorboat at all and I would go and get in trouble with it a lot of the time. And I remember one time leaving - I lived in a guesthouse on one part of this town of Chhatak and he lived on the other side of the town along the river still. I remember I took the boat out one evening just to go for a little spin and it stalled. There was a big river we were on, the Surma River and I took the boat out and I didn't know what I was doing. And the motor stalled out and I got caught in a current and I was going down, down the river to places I didn't know. I didn't speak the language; I didn't know where I was going to end up or how I was going to get out of it. I just remember that as I was going down past where he lived I was waving my arms and everything and somehow he was there and he saw me. I don't know how. And he hopped into a canoe like thing and paddled out to the motorboat and got it started and took me home. It was dark by then I remember. I was a little scared but I remember him coming to the rescue. Elisa: Great story. Can you tell me anything about your relationships with other country counterparts and your relationship with other WHO team members, CDC team members? Ron: Yeah. In terms of the country counterparts I didn't have - in that iteration I later was transferred - actually maybe I was transferred because of this incident that I might recount now. So I did - I was up there for about five or six months in that part and then I was transferred down. We took - smallpox was over and I was assigned to an area that was on the Bay of Bengal so in the southern part of the country, Noakhali it was called. My relations with the Bangladeshi Ministry of Health officials who were up there in Chhatak my first posting were not so great. I remember - you know we worked a lot - a lot of people who have been working in the malaria program came over and were assigned to smallpox. And for the most part the ones I had to deal with were not - maybe they were malaria people but I remember there were some district medical officers. Remember this is my first job ever and I was - you know we were focused is what we wanted to do and that my impression is that as I remember it now is that I wasn't impressed with their dedication to their job. I thought that they were not working hard enough to get the job done. I thought that they could have been doing a lot more and basically I didn't have so much respect for their competence. Now I've been working in global health ever since then so for the past thirty or some odd years or more and I know a lot of things now that I should have known then about how much they were being paid, how they had to do other things to earn a living to support their families. I didn't have any of these things. I had never had a paying job and still didn't have a paying job. I didn't have a family. I had nothing but smallpox eradication. And I went in and I suspect I was probably an imperious, self-centered, uncaring foreigner who didn't know anything about the place where I was working. I didn't even have an appreciation for learning the culture or having an understanding of the history of the place. I was a young kid, brash, brazen and interested in only one thing which was getting the job done that I was there to do as quickly and as effectively as possible and I was probably pretty obnoxious. On the other hand there were things that in the way that I was treated there also they were pretty annoying and people will tell you Bangladeshis have this strange habit that I've really never seen any place else of staring and gathering around foreigners and staring at them and sometimes just poking. And just you know they don't have the same at least then or at least my perception then was that they didn't have same respect for individual space that we have. On top that I'm left handed and they eat with their hands and I ate with my left hand which wasn't a really cool thing to do in a society like that. I remember I had to go out to a restaurant in town. I always went to the same place every night to eat the small amount that there was to eat but people commented. I'd be trying to eat and people would be - you'd have a crowd around you cause they didn't see 00:29:04 standing there looking, staring at you or what you were doing. And I'd be eating and I'd be eating with the wrong hand and eventually the restaurant owner took pity on me and built a small little - put a curtain up in a corner of the restaurant and that would by my area where I could go and eat in peace. So it was tough. It was a lot of pressure on me. It was a strange environment, it was my first job and so on and so forth and it got at times a little lonely up there. I was on my own in terms of WHO team and it was tremendous. It was just a phenomenal learning experience that I tried to handle as well as possible. I'm very happy that we got the job done. I'm very happy to have had that experience and to have grown so much from it, to have learned from it and to have launched my career there and I've had a great career since then. So, that was good. In terms of other people from WHO there was another guy like me a young - I think he's going to be here this weekend, in the thana next door, much bigger thana. I had - most of us had a - I forget what the words that the administrative areas were called; you know the equivalent of a province or region or something. And most of the people were assigned to a region of a country that contained a number of districts. I had one district under my - in my area of supervision. It was a large district and it was so difficult to get around. But there was a guy in the one next-door called Sunamganj who had the same job as I did and we would get together occasionally. Not all that often cause it was probably an hour down the big river between us. An hour one way and an hour back the other way against the current. It's a lot. We did get together as I mentioned on weekends probably about eight or ten people. Steve Jones was the sort of overall supervisor of all of us working in that area and we would go down to his place in the center of Syhlet and meet up for a weekend. Elisa: Did you find it helpful to have a group of people that you could sort of commune with to share your experiences with who were also foreigners doing the same type of job and what sort of things did you do when you got together? Ron: Yeah. Yeah, I found it great. It was a good break from the field. I think we went every two weeks. It was a good break from the field. It was only a couple of days which was fine because after a day you wanted to get back to the field and back to work anyway. But it was a nice house and it had a roof. I remember we used to sit up on the roof and you know if somebody got their hands on a couple of cans of beer or a bottle of whisky or some marijuana or whatever it was we would have a nice little time and it was a good break. And then we'd go back and back to work. But we really only went down for the Dhaka very, very rarely maybe. Maybe I went in the whole time I was up there twice at the most except that in the middle of all this I had mentioned my relationship with the military. In the middle of all this the President of the country Sheikh Mujibur Rahman was assassinated by a military coup and it was basically a lock down every place. And they came because they knew where I was and took my boat because they needed it to get around. So that was a little scary too cause you know we communicated with the center by radio, walkie-talkie and communications were down, they took my boat. It was a little scary for a little while but I don't remember how eventually I got down to Dhaka but I know that during that period we were called back in and I know that I got there somehow so that was okay. Elisa: I'd like to talk a little bit about how your experiences in Bangladesh impacted the rest of your life and as you said it started you on a long career in public health. Ron: Yeah, it sure did. I mean I - while I was there obviously I met a lot of the people from here from the CDC who had gone out there. Some people were there for a long time like Stan and Steve Jones. They were doing - they stayed in smallpox for a while. Other people, a lot of people came through on a regular basis from the CDC. We used to call them 90-day wonders. Those of us who were the hippie volunteers in the field after a month or so you were a veteran and you knew what you were doing and you were totally experienced. And here came these new coming guys from the EIS or whatever and they were going to come out for three months where we had all made two year commitments or more. And we just, 'big hot shot docs from the U.S.' and we used to look down on them a lot. Try to make fun of them whenever we could so we called them ninety day wonders but I met a lot of them and asked them questions like you're asking me, "Why did you get into public health, what are you doing, do you like it?" and I liked a lot of them and they liked me. And before I left they asked if I would consider joining the EIS program and I said, "Yeah let me in. It sounds good." I'd finally found my calling. This is really wanted to do was the kind of stuff I was doing, the field work that I was doing in Bangladesh. Elisa: Sure. I was just asking about how your experiences in Bangladesh influenced your subsequent career in public health? Ron: So, I met a lot of people from the CDC and I liked them, they liked me and before I left they asked if I would consider joining the EIS. I said sure but I had remembered I didn't have any internship. I had just graduated from medical school and had my degree. So, it was a requirement that you had to do an internship so eventually when I left smallpox, I guess it was in seventy seven, I went back to the States where I hadn't been in some time, almost ten years and I did an internship. And then I liked that so I stayed another year and I started doing a residency in internal medicine. But then I started not liking it so much but what I did was I had called D.A. Henderson. I went Johns Hopkins after having contacted D.A. again and I got my Masters in Public Health degree. They had then a preventive medicine program and the second year of their preventive medicine program that I was in they would place the students with state and county health departments and things like that. So, I remember that the chief resident, the head of that residency program asked me, "Well Ron for your practicum how would you like to go work with the EIS officer in Maryland?" And that sort of triggered my memories of EIS. I was a student. I was paying them for the privilege and here they wanted me to go and work alongside of whoever the EIS officer was who was making what was a not bad salary. So, I basically said, "Listen that reminds me. I don't want to work with EIS officer I can be the EIS officer." And I applied to the EIS that year and got in and there you have it. I was assigned to the state of Michigan to do my EIS and that time I was one of the few people in the EIS class that had substantial overseas - international experience, my Bangladesh experience but I don't know if they counted my Switzerland experience or not I don't know. But early on they asked me if I wanted to go and work in the Cambodian crisis. The genocide from Cambodia had resulted in large numbers of people fleeing to Thailand and they asked if I would head a team from CDC to - no they asked if I would work as a epidemiologist on a team of people going out there and for a number of reasons I didn't want to do that so I didn't go. I was involved in other stuff in Michigan actually but a few months there was a crisis, a refugee crisis in Somalia and they asked me again. The CDC had very good ties with Somalia because it was the last country that had smallpox and there was a guy there in particular named Abullahi Deria who had been instrumental in the Somalia effort to control smallpox and he had friends -- Bill Fagee notably -- at the CDC. And they asked me if I would head a team going out to Somalia. And by that time I had things in Michigan under better control and I was happy to do that. So, I went out to Somalia for about three months we organized things with the ministry of health. Now I really had the benefit of much more experience than I did the first time I had done this and we did a pretty darn good job. Some people came over who I met who were excellent. We had a number of EIS officers and we did a really good job there organizing what was called the refugee health unit at the ministry of health in Somalia. And was actually the first time that we were able to undertake a series of fairly decent epidemiological studies that enabled us to define and describe the kinds of problems that refugees face when they are settled in refugee camps as at that time was so often the case. With other colleagues here and people that we brought in here afterwards we really kind of developed the epidemiology of refugee health and that's - did that for a long time. After EIS I'd gone to Somalia two or three times 00:40:14 EIS. Then there was - I applied for a position here in what was called the international health program office and I was accepted into that and I came down to Atlanta to work. But there was a reduction in force in the public health service so they shipped me out to Somalia again and I was there for another six months and we developed primary health care programs and so on and so forth. But the point is that I basically stayed connected to the CDC here for about five years in the international health program office. Eventually I became a division director in that office. Stan Foster was - there were three divisions. Stan Foster was the other division director on the country support side and I was the head of the technical support division. We were implementing a program called Combating Childhood Communicable Diseases in fourteen African countries, a programs funded by USAID so I was traveling all over the place doing a variety of stuff. Before taking the division director job I had been posted as an epidemiologist in Africa so I was in Abidjan, Ivory Coast for three years for the CDC as a regional epidemiologist in the context of this combating childhood communicable diseases or Triple C D Program as it was called. Interestingly there were three of us in Africa, three regional epidemiologists. Myself, there were two people during that time in then Zaire and then in Malawi David Hamen was posted who had also been in smallpox in India in west Bengal at the same time that I had been in Bangladesh. So we were pretty close friends and we still are to this day. After that I stayed here until about - I don't know - eighty eight, eighty nine, something like that and then I moved to Geneva to WHO and became eventually the head of cholera program there but continued doing refugee work. So, I served in a - I was asked to coordinate humanitarian assistance for CDC. I was still at CDC. During the Gulf War I was in northern Iraq and Turkey and then continued to work in these humanitarian crises. I was seconded by CDC to the UN to coordinate infectious disease control policy in Zaire after the Rwanda genocide in Goma and just continued on. And I had - eventually I built up a reputation here of getting very creative assignments and in nineteen ninety four still on a CDC billet, I was actually assigned to the private sector to a company called John Snow Incorporated that is a contractor to USAID. And they had a very large child health program, a hundred and twenty five million dollar program called BASICS and I was the technical director of that for a while. And then still on a CDC billet I did that for about five years and then I was asked to start this program at the Mailman School of Public Health of Columbia. It was called the - it is called still the program on forced migration and health. And then I eventually retired from CDC although I'm still - well now I'm working for USAID on pandemic preparedness. So yeah that initial experience not only exposed me to public health but also exposed me to the CDC where I've spent the better part of my career doing different things all directly involved in global health. And so I'm really grateful to have had that experience because while I was in medical school what I was entertaining most was becoming a thoracic surgeon which sort of would have taken me in a different direction all together. Elisa: A very different direction. Ron: Yeah. Elisa: Well, thank you so much for sharing your experience. It sounds like experience with smallpox in Bangladesh certainly started off a very long and rewarding career in public health. And in closing I just want to ask if there is anything else you would like to share, anything I didn't touch on that you would like to add to our discussion? Ron: I guess the only thing that I would say in regards to smallpox eradication, it's really taught me a lot about programming and I think that different people have different thoughts about not so much smallpox eradication which everyone accepts has having been an inordinately successful program. But you know it spawned a number of other programs I think we need to learn from the smallpox experience both the things that were good about it but also the potential pitfalls that a program like this created because it really was a big employment industry if you will, smallpox. It went in and it really took control of a lot of ministries of health in a lot of poor and developing countries. And all of the other programs that were going on in a country like Bangladesh or like India, I won't say all I don't want to exaggerate, but this really cut the legs out from a lot of other programs because we took the personnel, we had the resources, we had the action and we really set the agenda in a lot of these countries. And I think we have to learn from that because from smallpox you've had a lot of other things happening. One thing led to obviously the guinea worm eradication program, the polio eradication programs, soon there will be a measles eradication program. And I think we have to learn that the most important thing that's come out of my experiences and my career for me is that people have a right to access health care for whatever their needs might be. And we have to make sure when we're undertaking these very singularly focused programs that we're doing it in a way that strengthens rather than weakens health systems in poorer countries where people can still go to a public health facility near where they live and make claims on that facility to meet their current health needs. Not everybody is going to require smallpox services. We should make sure that when these other programs are being implemented and they're all good programs, that they're not cutting the legs out from under malaria control programs or diarrhea control programs or pneumonia programs or whatever else it might be. Those things that are so important to people's health and their ability to survive and towards meeting the overarching millennium development goals that have been set for all of us working in public health. Elisa: Okay. Thank you again for sharing with us and we appreciate it. Ron: Thanks. </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/bi_KyDH9Qks" frameborder="0" allowfullscreen></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource interviews motion pictures moving image Date A point or period of time associated with an event in the lifecycle of the resource 2008-07-11 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16rv5 emory:16rv5 Format The file format, physical medium, or dimensions of the resource 10340160000 bytes video/x-dv Creator An entity primarily responsible for making the resource McNatt, Kellie (Interviewer); Emory; Student Waldman, Ronald (Interviewee); WHO; Epidemiologist Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of Southeast Asia and East Africa Smallpox Workers (2008 : Atlanta, Georgia) Title A name given to the resource WALDMAN, RONALD J. Description An account of the resource Dr. Ron Waldman describes experiences in the Peace Corps working with the Smallpox Eradication Program in Bangladesh during 1974-1975 Subject The topic of the resource Language A language of the resource English https://www.globalhealthchronicles.org/files/original/6d5a1e1404f5438ea282aaaef5ee22f3.jpg bc48be88f6f273f40238ff6efd93d765 https://www.globalhealthchronicles.org/files/original/bea45593d2b48447984e83ae33645ab2.pdf 3f622a9eb6649dd4597eb78826583ba3 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> McNutt: This is an interview with Carolyn Olsen. It's July 14, 2006, and we're at the Center for Disease Control and Prevention in Atlanta, Georgia, and this is about her involvement with the West African Smallpox Eradication Program. This interview is being conducted as part of the reunion marking the 40th anniversary of the launch of this program. The interviewer is Kathryn McNutt. McNutt: I'm glad you're here. The purpose is to do an oral history. We hope to capture for future generations the memories that you have about all of the participants and their families in eradicating smallpox in West Africa. So, essentially we'll just kind of walk through your story and what your and your family's experiences were. You were involved in the Smallpox Eradication Program in Liberia. Could you tell me what years you were there? Olsen: We lived in Liberia from September '67 to May '70. McNutt: And what was your family situation. Olsen: My husband and I had just gotten married in March of '67. We came to CDC for training in July, August, and September, and then we went off to Liberia. McNutt: That's a bit of a transition. Olsen: Yes. We were in California before we came to Atlanta. So the weather in Atlanta was hot and humid, and when we arrived in Liberia, it was actually cooler and less humid. McNutt: Really? Olsen: Even though we were on the equator. McNutt: So, what was your experience? Kind of paint a picture for me. When you first got to Liberia, what were your living arrangements? Olsen: When we arrived in Liberia, the living arrangements were interesting. The house was outfitted so that you had your basic needs until your freight came. We were met at the airport, which was about 25 miles from town, and taken into town. Dr. Shalimar and his wife took us out to dinner. Then they took us to our little house and said that they would come back the next day. It was a Saturday. We were living in a kind of a compound, and right at the gate there was somebody else's packing crate that someone was living in. When your packing crates came, oftentimes the local people would take the box, which was very large, and make it into a house. It was probably 9:00 PM, but when you're on the equator, it gets dark at 6:00 PM and gets light at 6:00 AM. So we were going to go to bed. We had sheets on the windows because, again, we were just moving into this house. All of a sudden there was this bright light. So we opened windows, and a transformer on this pole was burning. We were going to call the fire department, but we realized we didn't have a telephone. So we just watched it and thought, "Well, if it comes to the house, the house is made of cinderblock." But the fire just kind of went out. And after it went out, we realized that we did have a telephone. However, the black rotary telephone that was under the bed had no cord or connection. Since we really didn't know where we were-and our neighbors were gone for the weekend, so-it was probably just as well that the telephone was inoperable. So that was an interesting start. McNutt: Is that when it hit you that you were in West Africa and not the States? Olsen: I think that when we stopped in Senegal before arriving in Liberia, that was when it hit that us that we were in a very different place. And living overseas then was very different than it is now. There was no email or operable telephone. And so basically for 3 years, we did not talk to our family. We sent letters and, if necessary, there was teletype and occasionally a telegram Also, occasionally at work, my husband would talk to CDC. But most of the time we were on our own.[ And, again, we didn't have a telephone-even though we were in the biggest city in the country. McNutt: Monrovia? Olsen: Yes. And on that first Monday, 2 days after we arrived, the USAID van came to get my husband to go to work. There were about 20 men on the porch, and the driver said to my husband, "Oh, they all want to work for your wife. They want to be the houseboy." I looked at them, and I thought, "How am I ever going to choose?" I'd never had house help. So I thought, "Well, I'll just take the first person, and I'll just have a different person every day until I pick somebody." McNutt: You're trying them out. Olsen: Trying them out. And so I told Timha I was only hiring him for one day. And in Liberia, they speak pidgeon English. It's a little different than English. So Timha came to work for me that day. He was an older man. I was only 25, so he probably was 35, but he seemed like an older man. And we didn't have anything in the house, and so I thought, "What can he do? Well, he could wash some clothes." So I had him wash my husband's shirts and a couple of things because we'd been traveling. After he finished that, he hung all our clothes on the bushes outside so that they could get dry. I thought that I could bring them in, so I said, he could go. And then I looked a little later, and I thought the shirts were mildewing because they all had blue and green on them. So I brought the clothes in and I used all the different cleaners to get the spots out, and I was thinking, "Boy, things really mildew fast here." So when Dennis came home for lunch, I told him we had to buy a dryer. Well, the next day came and everybody was on my porch again. Timha was there again, and I noticed that he was wearing a country shirt, made out of indigo. I realized then that when he was wringing the wet clothes, he had put them up against his shirt, and the dye in his shirt had bled on all of our clothing. Well, luckily, the driver had a friend or a brother or something, and he introduced me to David Parker, who then became our houseboy for the next 3 years. He was a very nice man, and it worked out very well. McNutt: You didn't have to try all of them. Olsen: Didn't have to try. And Timha became our gardener. That was the job he wanted. He didn't want to be the houseboy. Another episode with Timha was funny. The farmers do slash-and-burn in the fields. So I asked him to clean up the yard, and all of a sudden I look out and there's fire. Everything he cut down is burning. But other than that, keeping the house was easy. McNutt: You had electricity, you had a stove, refrigerator, a dryer. Olsen: We bought a dryer, and we had a stove that was furnished. The stove used gas, and so we always had to make sure, if we were going to have company, that we had enough gas so that all of a sudden we didn't run out in the middle of entertaining. Somehow, USAID [US Agency for International Development] would only give us one gas canister at a time. But the people were very, very nice. We felt very comfortable. And the American community was nice. But the smallpox program didn't quite fit with the embassy and it didn't quite fit with USAID, so we were kind of our own program. I am an environmental engineer, and so I wanted to find a job. I found one, working for a firm that was doing an extension of the airport. But then someone who I didn't know took a job that supposedly took a job away from a local person. The upshot was that no dependents could work except as schoolteachers or nurses, so I couldn't work. And then they approached me and asked if I would substitute at the American school. So I taught 7th through 12th-grade math. I had never taught before, but somebody told me the first day of school that you need to be really tough. So I was really tough. Any time the kids were not good, I would immediately give them a test. So after about a week, they just knew they were going to be good when they came in. And, having never had any education classes, I just taught them like I was taught. Years later, it was rewarding when I met some of my students who had actually done well. It was a relief that I didn't do permanent damage. McNutt: They can't blame you for anything. Olsen: Right, right. And then, I guess it was the second year, the principal or the superintendent of the American school crossed the Liberian government and was asked to leave Liberia, so I became superintendent. One day I was sitting in my office and the phone- I told you the phones didn't work, but all of a sudden the phone on my desk rang. I was so excited. I picked it up and said, "American Cooperative School," and they said, "Oh, wrong number," and it never rang again. But the thing that was so nice about our African experience, it gave us a feeling not only for Africa but also for what French countries were like, since we took trips, as part of the smallpox program, to Ivory Coast, which is a francophone country. And we were given vacations every 2 years or so. On our first vacation, in l968, we went with a Peace Corps charter to East Africa for 6 weeks. That was when Jomo Kenyatta was Prime Minister of Kenya, and Uganda, Tanzania, and Kenya were on such good terms with each other that they had common currency. McNutt: Really? Olsen: The drought had not occurred yet in Ethiopia. It was a very kind and gentle country under Emperor Haile Selassie. So we saw part of Africa that no longer exists, and it was a very enjoyable, interesting experience. It was also interesting to see how that part of Africa was different than West Africa. Now, we weren't always just going on vacations, but we were able to go to Europe also. Neither of us had been there, and to spend 6 weeks in Europe just wandering around was really interesting. It was winter, so we ended up in a lot of art museums and other museums. It gave us a whole different perspective on the world. McNutt: Sure. Olsen: Those breaks were nice because, when we went back to Liberia, we could kind of look at life a little differently. In Liberia, there were only a couple paved roads, and we just looked at the same thing every day. And as far as the smallpox program goes, I did not go up- country with Dennis because there was really no place to stay. Later on, when we lived in India, I used to travel with him because they had guest houses and different places where we could stay. But oftentimes he would stay with Peace Corps volunteers, and so a lot of the Peace Corps volunteers would then come to stay with us when they came to Monrovia. Toward the end of our stay, we got very excited because cholera was all of a sudden detected in Sierra Leone. They anticipated it coming into Liberia, so Dennis had an opportunity to meet with President Tubman, who was one of what they called an honorable. His parents had come back to Africa after Abraham Lincoln was president, when many of the descendants of slaves in the United States went back to Liberia. So Liberia was never colonized. But Liberia had an American influence. Their Pledge of Allegiance is just like ours, with a few words changed, and their flag is just like ours except it has only one star. And during the Second World War, Roberts Field was used as a base where the planes would fly to Africa from Brazil and then up to Europe. In fact, sometimes you would see houses made of military runway materials. But in theory President Tubman was a benevolent dictator. And when we came back, we were in Washington for a short time. I would tell people that Liberia was the kind of place that, if you went out at night, you always took a flashlight because there were no lights except the Moon and the stars, and you wanted to make sure you didn't step on a snake or step in a hole. You had no fear of any of the people. And at that time in Washington, DC, if you heard someone walking up behind you, you immediately turned to see who was there. I remember seeing the soldiers. They didn't carry real guns; they carried wooden guns. And oftentimes, after a parade, they would carry their shoes on their guns because they weren't used to wearing shoes, but they had to wear them for the parade. McNutt: How interesting. Olsen: But socially, we had to make your own entertainment. McNutt: Sure. Olsen: The last year we were there, they brought in television. But before that, it was the BBC news. And, actually, Liberia was 45 minutes off of Greenwich Mean Time. During World War II, there was supposedly a German ship off the shore that sent word they wanted to meet with the president of Liberia at 10 o'clock, and so Liberia changed its time so that the Germans would be late, as 10 o'clock became 10:45 Liberian standard time. McNutt: No way! Olsen: Yes. But sometimes people would say that Liberia was like a poorly done United States. But we were in our 20s, and it was our first assignment. We had a very enjoyable time and we met lots of people. At the American school, about 50% of the children who I taught were Americans, about 25% were from other embassies, and the other 25% were Liberian students. Of this last group, some had parents, who were doctors and honorables, and some students were on scholarship. So it was a nice blending. We got to know people from all kinds of different embassies, like the Asian embassies. And if you were their child's schoolteacher, you were a very special person. The students seemed to get together very well. They took care of each other. McNutt: So tell me a bit more about the social life. You were probably one of the younger couples there, I'm assuming. What were the social activities that you did? Olsen: There were a lot of cocktail parties, and you found excuses to have parties, like for St. Patrick's Day. The social life on weekends was really out at the Voice of America transmitter site, which was about 20 miles out of town. They had to maintain short grass around the transmitter, so they made it into a 9- hole golf course. The golf holes were sand with a little bit of oil mixed in. People kept the sand raked. So if you got out on the green, it was like putting on the bottom of a sink: the ball went down toward the hole, like water toward a drain. So you really had an unfair advantage. But it was very interesting. And we all had young Liberians as our caddies. They lived near Harrisburg, which was where Voice of America was. My regular caddy was Michael. He would make sure there were no snakes where I was going. But I never had a bad lie because Michael could pick up a golf ball with his toes, and by the time I got up to my ball, it was sitting on top of a nice little tuft of grass waiting to be hit. One year before Christmas, Michael said, "Missy"-they called a man Boss Man, and the ladies were called Missy-"Missy, are you going to get me a Christmas present?" "Well, Michael, what would you like?" And he said, "I was looking in the book, and I think I would like roller skates." Now, there was no pavement. I mean, there was a dirt road to get there, there was a dirt parking area, and there was grass on the golf course. And so I said, "I think that you really don't want roller skates." But in ways it was kind of sweet, the simplicity of life and not realizing some things. Another sweet moment was when we all made curtains. You could always tell when people came to Liberia by their curtains. People who came in the rainy season had bright curtains; people who came in the sunny season had dark curtains. I used to sew things, and I always had material left over. And David, who worked for us, said, "Are you going to use that material?" So I gave it to him. And one day, Dennis was up-country vaccinating in a certain area. David's wife and children were in that area, so he went along so that his children would definitely get vaccinated. And they took a picture. And there were my bedroom curtains-everybody was wearing them. McNutt: Oh, my gosh. Olsen: But I'm trying to think of some of the other social things we did. I remember our going-away party. Usually when you invited people for these cocktail parties, there were always so many things to do that maybe only 50% would come. And just about the time we were leaving the country, there was an outbreak of what they thought was smallpox. It was way out in the hinterland, where you had to hike in. It turned out to be monkeypox. But Dennis and his replacement, Randy Moser and the team hiked in. And so for our farewell party-and the Moser's welcome-to- Liberia party-they were all still up-country. But Barbara Moser and I were putting on this party, and everybody showed up. And our house was just like they used to stuff Volkswagens: it was just full of people. And about halfway into the party, Dennis and Randy arrived in their Dodge truck. One lady, as she was leaving, said to me, "That was a really good cheese ball." "Oh. Did you like it?" She said, "Yes. My friend and I ate the whole thing. We got stuck in the corner and we couldn't get out, so we would get drinks from out the window, and we just ate the whole cheese ball." I think the thing that was nice about Africa is it gave you a totally different perspective of the world and gave you a wonderment for travel, for things you can do-or the things you try to do anyway. McNutt: So it's great to have that perspective in your early or middle 20s. Olsen: Right, yes. McNutt: Changes your whole outlook. Olsen: Some of the people who are here at the reunion I have never met before. They were in the first group in '66. We were kind of the fill-in group, so we had a much smaller group. There were maybe 10 or 12 of us. So, except for meetings that were held about once a year in someplace like Abidjan, we didn't meet the other people because Africa was so remote that to get from one country to the other you often would have to fly to France first. McNutt: I've heard that. That's crazy. Olsen: And, as opposed to India, where we traveled all over, Africa was hard to travel in. But we had a lot of people from CDC come through -and it was always fun people, like Jim Hicks [James W. Hicks]. Then we would catch up on the news, because we were never quite sure what was happening in the world. Bad news travels fast though, so when Martin Luther King was killed, we knew within hours of its happening; the same thing with Bobby Kennedy. Like I said, bad news traveled very, very quickly. And it was hard to convince Liberians that there was actually a man on the Moon. That was happening while we were there. The local people would say, "Oh, yes, Missy, oh, yes, there's somebody on the Moon." But they had never flown; they had never really been aware of so many things out there. McNutt: It was 2 different worlds coming together. Olsen: Right. But, then again, you don't have to be educated to be smart, or to be wise. I think that all of us learned a lot from the different people we encountered. And at that time, since Liberia had a heavy American influence, we would have a lot of American foods. We had 2 supermarkets, run by Lebanese. The Lebanese also were the jewelers. When I went into the supermarket, I would check the cottage cheese to see if it was green or not. Or I would buy one box of cereal and take it home, and if it didn't have weevils, I'd go back and buy a whole bunch of boxes. But weevils and ants were just everywhere, so we kept everything that wasn't canned in the refrigerator. Even when I baked a cake, I took it out of the oven and put it in the refrigerator. If you left it sitting out for a little while, you'd come back and it would have ants all over it. And if I made spaghetti, I had a strainer so that, after it started boiling, I could scoop all the weevils off the top. Otherwise, it would look like you had pepper in your spaghetti. Flour was the hardest thing. You had to sift your flour because the weevils didn't go through the holes, and then you'd throw them away and you'd make whatever you were going to with the flour. McNutt: What did you do for water? Olsen: Originally, we were on a well. We had to boil the water and put it through a filter. We had these big tall filters with clay candles on them. Once a week, the filters would be boiled and cleaned so that we always had water. Now I was teaching school. One day I was taking a shower. I was totally lathered, and the power went off. So the water went off. So I called David, who brought me the water from the dehumidifier and I poured that on. I still needed more water. So then it was ice water from the refrigerator. So even to this day, I wash my hair, rinse it off, wash one arm, rinse it off, just in case. McNutt: Tools of the trade. Olsen: And after that day, we had a large plastic garbage can that we always stored water in, and every couple of weeks we would replace the water. [Toward the end of our tour, we were actually on a water system, but we still boiled our water just as a precaution. We had excellent restaurants. Salvatore's had probably the best Italian food I've ever eaten in my whole life because they had to make everything from scratch. So they had their own pasta, their own cannelloni. When I went to Italy, it was almost anticlimactic because I had better food in Liberia. And eating out was a very social thing. We ate out quite a bit. There was also a Lebanese restaurant. And this is kind of funny. They had an expansion, and the back area-again, you're talking 100% humidity, 90°-100°F-was decorated like an ice cave, with blown white plaster. You'd go back in there, and they'd have air-conditioning blowing down. They made wonderful hamburgers and shawarma sandwiches. And since I worked at the school, some of the teachers were from different neighborhoods. We had a Haitian French teacher, and we had some Liberian teachers. It was a nice way to get to know different nationalities and different people and work with them. McNutt: What did your family think about your taking off at age 25 for Africa? Olsen: Oh, I had already been to Brazil with the Peace Corps,. I grew up in Wyoming and my first job was in Los Angeles, and I had never been to California. Being the youngest of 7, I was a bit of an adventurer. McNutt: So what special training did you have? You mentioned training at the CDC. What prepared you or your husband for West Africa? Olsen: The participants all went through the EIS [Epidemic Intelligence Service] course, so even though my husband is not a doctor, he went through the course that's usually reserved for the EIS Officers. McNutt: Is that a 2-year course? Olsen: No. It was a 3-month summer course. The EIS Officers who were staying then worked with CDC for 2 years. But we went off to Africa. So there was a lot of statistics and epidemiology, even mechanics. The spouses were invited to attend any of the sessions that we wanted to, which was quite interesting. Plus they had another course, one taught by Dr. Waddy [B. B. Waddy], who was very English and had spent many, many years in Africa. He talked about tropical diseases and the African culture. Other people talked about things like the weather. So we had demographics, history, and geography. But when we first arrived in Liberia, we had very, very little because you were only allowed to carry 40 pounds of materials with you. So we had a couple books and a few other things. But then CDC sent some program materials, so, with nothing else to read, I read the book on tropical medicine. And one by one, you followed the pictures and would see the diagnosis. And not being a doctor, I would think, "Oh, I've got this rash." I think I needed something else to do. I had a couple bouts of food poisoning. One was caused by strawberries. They looked just like the kind of strawberries you bought at the grocery store, but they had probably been frozen and thawed a couple of times on their way to Africa. They used to actually send California lettuce and California celery to Liberia. It did not come by airplane; it came by ship. McNutt: And it made it? Olsen: Yes. We would save the lettuce for special occasions. We had these green Tupperware containers. If you took the core out of the lettuce and put the lettuce in a paper towel, it would last. I'm sure it had no food value, but it was like, "Oh, lettuce, lettuce from the States!" And the tsetse fly is in that part of Africa, so they couldn't raise cattle because they would be killed by the tsetse fly. So all the meat was imported. About the only thing you would get locally was chicken. McNutt: That answers a huge question for me because I did not see many cattle when I was in Liberia in June, and I was wondering why not. Olsen: There is some other bug that gets into clothing that is washed. The bug is in the water, and so you have to iron everything. McNutt: Interesting. Olsen: Yes. And at that time, there were parts of Liberia that were not mapped, because the heat would cause steam to rise in the rainforest. We had some friends who were with the USGS [US Geological Survey]. They kept waiting for a clear day. But if you look at the 1967 USGS map, there was a section of the Liberia map , they probably have mapped the area by now because of the satellites. But I'll tell you about one of our regular activities. Everybody wanted to have some African art. It was very "in" in the States to have African art, and so people would buy different things. There was a group of vendors or sellers, who were called Charleys. So there would be Charley number 1, Charley number 2, Charley number 3. And if you purchased something from them, you could actually write check to "Charley Number 3". Liberia used the US dollar. So I have cancelled checks to Charley number so-and-so. The Charley's must have had a great network. You would hear a noise on your front porch, and then you'd hear the doorbell ring. You would open the door, and there would be like a little store. The Charley would have laid down all his artifacts, and then you would look to see if there was anything you wanted. They would often come on weekends when most people were at home, and we would bargain and bargain. The Muslim Charley's, would sometimes take a break and go say their prayers and come back, and you would bargain some more. My husband didn't like to bargain, so I would be out on the porch to bargain, and then I would bring an artifact in the house and he'd, "Oh, that is so ugly, I don't like it in our house!" and I would go bring it back out and the price would be lowered. One day, I started bargaining because I was bored and there was nothing else to do. I was probably at maybe $10 and the Charley was at $15, and after an hour we were going nowhere. And then I decided I would use a different technique, and I said, "Well, $7." And he looked at me and said, "Missy, $7, two aspirin, you give me a headache." And I still have the artifact. It looks like somebody made it out of mud. It's an interesting, kind of strange piece. One time, my husband was up-country. We had night watchmen, so I felt perfectly safe. One of the Charleys that I hadn't dealt with before came to the door. He had a fine Senefo artifact. It was the only piece he had, and so I knew there wasn't going to be a lot of bargaining. I think I probably ended up spending $100 or maybe $125. It's a beautiful piece, and I must get it into a museum someday. But the next night the doorbell rings, and there he is again, and he wants to buy it back from me for $250. So evidently, somebody had heard about it and had offered him much more. But I said, "No, no, no. It is sold." McNutt: Someone within your group heard? Olsen: One of his customers, because we would describe art pieces we were interested in obtaining. The Charley would then try to find them. . If you had company, especially when anybody from the States was visiting, the Charleys knew it. If you were having a cocktail party, all of a sudden you would hear a ring, and there would be tie-dye on the porch banisters and different Africa items at their little store on the porch. And then, sometimes rogues-they didn't call them burglars in Liberia-came in at night. They never hurt anybody. McNutt: While somebody was there? Olsen: Yes. So at night, when you went to bed, you locked the front door, the kitchen door, and every door in the house. You had these big skeleton keys. Then you locked yourself in the bedroom. And if you were lucky, you had a bathroom attached to the bedroom, but if not, you locked the bathroom too. And off to bed you went. The first incident occurred the first time my husband was out of the country. It was my first night alone in Africa and I had locked myself in. I hear this tap-tap on the window, and I think, "My goodness, somebody's coming in." Finally, I looked out, and there was my husband throwing rocks at the window. He had come back early, and when he rang the doorbell, it rang in the kitchen, and I was 2 locked doors away. McNutt: Your husband was trying to break in. Olsen: Yeah. But then one time I got up in the morning, went into the kitchen, to turn the coffee on, and noticed that we had been broken in. I ran out of the kitchen and locked the door, and I said, "We've been robbed." And Dennis said, "What did they take?" I said, "The water filter." And he said, "What?" And I said, "They were in the kitchen. The only thing I could see is that the water filter was gone and the window was gone." (We had these sliding windows). It was just before Thanksgiving, and the embassy had brought in turkeys for us. So we had 3 turkeys in our kitchen freezer, one for Dr. Thompson and his family and 2 for us. Well, the rogues had taken 2 turkeys and a kitchen curtain to wrap them in because they were frozen solid. That's all they took. We all had tin roofs, and when it would rain, it was like somebody playing the drums. We had the most exciting electrical storms. There were big booms, and the power would go out. The storms would come in off the ocean. The robberies were timed. Just as the thunder boom resounded, the rogues would take the window out. In our bedroom, we slept with our heads against the wall. On the other side of the wall was where the burglars had actually come in the house. We didn't hear them at all. We were in embassy housing. So Dennis went to the embassy to report that we had been rogued. The burglars had gone through the whole area; they had taken money; they had taken stereo equipment. Dennis said he felt kind of strange saying they took 2 turkeys and the kitchen curtain. The robbers had tried to get out of the kitchen, but they couldn't get the door open, so they were confined to that little area. McNutt: That's funny. So, security-wise, you weren't worried while you were there. Olsen: No. We were never in fear. I mean, there was just no concern. McNutt: It was relatively stable out there? Olsen: Very, very stable. Again, you had a night guard. But you paid him, and I'm sure he paid whoever it was that was stealing so they wouldn't come and rogue you. I have a letter that a night guard wrote me. He was a very old man. The letter said, "Dear Mother, please buy me a bed so I can sleep on your couch while I guard. I might have considered his request if he had called me Missy, but "Dear Mother." McNutt: What kind of problems did you have in establishing working relationships with the African counterparts there? Olsen: Well, I wasn't working, except at the school. I really didn't have problems. By that time, I could understand pidgeon English, and usually they were a very kind and quiet people. Many times, the little boys who played soccer with a grapefruit in the vacant lot next door would come over to get a drink of water or just to say hello. Or they would pick the papaya off my tree and then want to sell it to me. But we never felt threatened at all. I'm sure things have changed-the world has changed-but then it was very nice. They made beautiful tie-dye. I used to buy tie-dyed material from the lady who lived under the bridge. Her name was Mama Sony. I would take other American women to her. I think sometimes people were reluctant to interact with local people but I was very comfortable with them because I was teaching Liberian children at school and working with Liberians. So it was very natural. At that time, there was a large international population, too. There was the German store, and there was a large Irish population, so we made many international friends. We would get invited to their houses for dinner, and so we'd have all kinds of different foods. McNutt: So, what about your husband? Within the smallpox program, how did he or the team work to get people to sign on to the program and agree to being vaccinated? Did they have to go to tribal leaders? Olsen: They didn't have the kind of health systems then that they had in some of the colonial countries. Oftentimes they would go to the different villages. And all of his staff were Liberian. He oversaw program operations, and Dr. Thompson was in charge of the medical aspect. I don't know; he'll probably describe it. But his office was incredible. It looked like it washed out to sea and came back. His office was in an interior room, and somebody had painted it a few years before, but when they painted it, if there was a bookcase, they just painted around the bookcase, so you could see where the furniture had been in the past. I remember one time he was really upset because, again, it was really humid and really hot, and he had gone to the USAID mission and asked if he could have an air-conditioner. And they said, "No, that's a Liberian building, you can't have an air conditioner, or everybody will want one." The statement that was made was, "You have the benefit of working with local people. Therefore, you should be able to cope with the local conditions." But he enjoyed working with the Liberian staff. Years later, he went to Liberia on short-term consultancies. His staff were still there and were very pleased to see him. He went up country, where he found out that his driver was now a paramount chief in one of the villages. On his way back, there was a pole thrown across the highway, which meant stop. It was placed there because John Masaquoi wanted to give him a present. He had this country shirt. He stepped aside and said to Dennis, "Tell Carolyn to wash it in Clorox; it's been under the bed." We have only fond memories. We have things that probably no longer exist. They made country money. Nimba Mountain had such rich iron ore that they just pounded the iron ore into 6- inch sticks with kind of a forked end and a round circle at the top and twisted, unrefined iron; one piece of country money was worth a penny. Years later, I met somebody whose cousin had lived in Liberia back in the Firestone days. She used to go into the bush. In the afternoon, they would tell stories, so she made a whole book of notes. After Liberia had all its problems, she went back to her notes that she had taken in the '40s, and even though she was in her 70s, she made a book on Liberian folk tales. It is entitled, You Can't Unsneeze a Sneeze. And reading those tales just brought back so many memories. Food, for instance. They have one thing that's made out of casava called dumb boy, and it is to make you feel full. And you're a dumb boy if you don't swallow it quick because if you chew on it, it swells in your mouth and you can't swallow it. McNutt: That's interesting. Olsen: And then you would eat it with just a little bit of what they called soup, which is kind of like our chili. McNutt: Wow. I love to hear these stories. You said that you did a lot of work, and you spent a lot of time with the locals as well as the expatriates. What was it like coming back to the States? How did you fit in again? Olsen: We came to Atlanta for about a month, and then Dennis was assigned to San Francisco Bay area. One of the hardest things was going back into the grocery stores, places where you had so many options. You had a whole row of dog food. We had gotten so used to having a limited amount. In Liberia, if the ship came in, everybody knew that there was fresh or at least new products. I think the part that amazes me is when you return to the states and you start to tell people about your experiences, and suddenly their eyes glaze over. Then you realize that you are now a part of a different group. If you really want to communicate about travel or about experiences, you have to find a new group of people who also have done similar things or who are well-read. I find that people who are well-read oftentimes enjoy the same interests. The thing about reading or seeing movies of these areas, be it Darfur or whatever, you don't get the heat and the smell. And the heat and the smell are just as much a part of everything as everything else. I think it gives you an appreciation in the United States of many things, but at the same time, it makes you realize that you're fortunate and you need to give something back. McNutt: What was the toughest problem you faced, and how did you handle it? Olsen: It must have been so tough, I put it out of my mind. I feel like I had no problems. Oh, I know. This is a funny problem, but it seemed traumatic at the time. They didn't have parallel parking. You pulled in. And a parking spot in front of the grocery store was always prized. We had a little green Volkswagen, and I'd just been to the grocery store. I was backing out. I looked and no cars were coming; it was clear. And I backed up and I ran into a car, a big black Mercedes. McNutt: Oh no! Olsen: And a lady came out. I could tell she was an honorable's wife. I was in the middle of the main street, but all of a sudden, I was totally surrounded by Liberians. Everybody was talking about this great wreck. The woman was distressed. The policeman was there. And I am the only white face in the crowd. All of a sudden this very tall black man comes and puts his arm around me and stands next to me. He was the husband of one of the schoolteachers at the American School. Dennis was up-country, and so I gave the woman my name and I told her we would have her car fixed. What had happened was, she had passed my parking spot, but her friend said, "Oh, there's somebody coming out," so she backed up, and so she ran into me. McNutt: She should have been looking for you. Olsen: She should have been looking for me. So I was looking for oncoming traffic, and she is backing up down the street. Bang! I was so distressed. I went home and knitted. Whenever I'm distressed, I knit, so I knitted. And when Dennis came back, I said, "You've got to talk to Honorable so-and-so because I ran into his wife's car." Well, the honorable said, "Forget it. She was distressed because she had just gotten it out of the shop from her last wreck." But, I mean, when you're suddenly surrounded, I mean, it's scary. McNutt: So you were glad that man was able to help you. Olsen: Oh, yes, yes. He said he was driving down the street and he saw this big crowd of people. When somebody sees a crowd, something must be happening. He said, "And there you are in the middle of it." McNutt: So, back to smallpox, at what point did you think that smallpox would actually be eradicated in Liberia and West Africa? Olsen: Well, I have to tell you, I've never seen a case of smallpox. As close as we came was toward the end, when they found a case of monkeypox. It was the first time they had found monkeypox transmitted to man, and the lesions looked like smallpox, but it didn't manifest in the rest of the family. And so a lot of people went up into that area. They would take a scab and send it to CDC to be verified. So it was kind of like the show-and- tell. But it was kind of an exciting time. But, like I said, I never saw a single case of smallpox. Evidently, somebody had come through and vaccinated the people years before. Or perhaps, because of their isolation, smallpox just never happened there. But there was so much migration. People from other countries moving in and moving out. McNutt: The tribes aren't divided along country lines. Olsen: No. McNutt: So, had your husband seen smallpox there? He was more up- country. Olsen: Not in Liberia. He saw it in Sierra Leone. He went there short- term. One day we were driving. Our car hadn't arrived, so we always took the taxis. And I said, "Dennis, look! I think I see smallpox!" And here was this little kid sitting there by the road. They have what they call the sandy society, and they have mud stuck all over them, and it looked like some kind of disease. But taxis were interesting. The taxi drivers spoke in pidgeon English. You could take a bus for 5 cents, or you could take a taxi for 25 cents. But you would have to flag the taxis down. Even the policemen didn't have police cars; they used taxis. You would take a taxi up-country. Our Peace Corps friends would go down to the taxi area to catch a taxi up-country. One time the taxi driver was very aggressive. His fare was inexpensive to take them all the way back up to their village. They went with him, and the person in front was not talking. About 5 miles out of Monrovia they realized the passenger in the front was dead. The taxi driver was taking him back to his village. McNutt: Oh, my God. Olsen: One night we had a group of Peace Corps people come to visit. It was late, so we were going to take them back to where they were living in Monrovia. We were going down the main street; 4 of us were in the back of a Volkswagen, and 2 big guys were up front. And all of a sudden this taxi pulls around and tries to stop us. And pretty soon this taxi goes around us again, yelling, "Stop in the name of the law!" So we pulled over, and this policeman, who was drunk, comes to our car and says, "You're under arrest! You have 2 people in the front, you have 4 in the back. That's 7; that's too many." And he said, "Follow me. I'm taking you to the police station." And we're thinking, well, should we go or should we not because we had always been instructed to go to the embassy. The one fellow in the front with Dennis was Peace Corps, and he was teaching law. He said, "I'd like to see this part of the law." So we proceeded to the police station. It was midnight. So Dennis and the arresting officer walk into the police station. They have to wake up the policeman on duty. So now the policeman and the arresting officer come out to the car, and you can tell that this policeman is really tired. He looks in the car and says, "Professor!" The policeman was one of the lawyer's students. So policeman said to the arresting officer, "Now, I know these people and they are okay, so we will let them go." It's now like 12:30 AM. Just as we're leaving, the officer who had tried to arrest us said, "Okay, I'll let you go this time, but if I see you out after midnight, there'll be no mercy." Policemen also directed traffic. If they arrested you, they would get in the car so that they could take them to the police station. But we had these little driver's licenses, little red books. The people who work there for business had told us that if we ever got stopped to just put a dollar in the license and give it back, and they'd let us go. Well, I had one friend. She was downtown, and this policeman started to give her a ticket, and she had done nothing wrong. So she proceeded to give him the riot act. He took her license and put a dollar in it and gave it to her! McNutt: How funny! Olsen: But, again, you would go to the movie and you would always have some young fellow watch your car. When you got out, you would give him a quarter or 50 cents, and your car was safe. Your car probably would have been safe anyway, but it's just the way that they made some extra money. But the movies were interesting because it was back when they had reels. Sometimes you would see the middle reel, the first reel, and then you had to try to figure out the movie. Or they would have broken it and spliced it in backwards or something. When we saw "Wait Until Dark," the opening scene showed the plane backing into the airport port from the sky. McNutt: Whoa! Is there anything from your experience or from the program that you were involved with that you would change? Olsen: Nothing I would change. It was such a wonderful opportunity. I think that it is a shame that young people don't have that opportunity now. You know, Peace Corps sometimes gives them an opportunity. But, actually, they usually work at a grassroots level, and this was more on the professional level. The thing that was kind of amazing was that most of the people in the smallpox program were probably 10-20 years younger than their counterparts. They were all in their mid-20s or early 30s, and most of the doctors and people in Liberia that Dennis worked with were probably in their 40s or 50s. On the social level, it probably took us 2 years before we started getting invited to Liberian houses. When we were in India, it was much easier. In India, we lived in what was basically an Indian house, and we would have different people come to a party at our house, which was probably not as good as what they lived in. So then when we would be in their city or New Delhi, they did not feel uncomfortable inviting us to their house. So that made it much easier to interact. But I think in Liberia, there was a status level that was involved. Even though the salaries weren't that good and the housing wasn't that good compared to stateside, they were still better than what many people had. When the power went out, we had a game we would play. Whoever had the flashlight would have the almanac and ask questions. The other entertainment, if it was light, was watching the geckos. But I think that we benefited because of the people who went before us, in 1966. So I would say the training for the group that went in '67 was good. The other thing is, Bill Foege [William H. Foege] and the Thompsons had had to leave Nigeria, because of the civil war, so they were at CDC during our training and gave us first-hand experiences of what it was like. And different people would tell you things to take to your post. We were very spoiled as far as having American foods. People who came to visit from Mauritania or Guinea would think they'd died and gone to heaven because they could have dill pickles and ice cream and all these things that you couldn't get in other countries. McNutt: So, how did participating with this project change your life? Olsen: I would say that, being an environmental engineer, it gave me more of a global view of the world, and also a real appreciation for water , especially the needs of people for clean drinking water. Unless you have lived in a situation where you really have to plan what you're going to drink, you don't have that same appreciation for water. And remember we lived in Africa before bottled water. Nobody carried bottled water around, and you didn't go to the store and buy a case of bottled water. So you had to make sure that your water and your food were clean and good. That was a challenge. McNutt: And did this first experience contribute to later work experience? You talked about India. Olsen: Yes, India, and in my profession. I was a utility manager, and I was on the board of American Water Works and Water for People. Then I was the president of the nonprofit Water for People. For the last group, I would talk to people, trying to raise money for water projects. And being a woman in a professional field, Africa was, to some degree, a matriarchal type society, but in India you realize how downtrodden women are. But in any society, it's the women who end up carrying the water. McNutt: And the little ones. Olsen: The little ones, yes. And so it just gave me a real appreciation, for different cultures. And to know that almost everywhere you go, there are people who are wiser than you. McNutt: So is there anything else that you want to add? Any words of wisdom for the next generation of public health workers? I mean, you've had so many nuggets already. Any last statements? Olsen: I think that it is very good that we were able to see the world and see the problems of the world. I think also that people need to realize that there are problems here that are also very trying, and we need to be aware of that. People really need to know about health issues. Maybe we don't have the tropical diseases, but we have the overweight and the diabetes and the other things that affect that same socioeconomic group here. Water and wastewater are my areas of special interest. Global warming and cultural changes are going to see the development public health problems that we don't even envision yet. McNutt: Thank you for your time. Olsen: Thank you. McNutt: What a wonderful discussion. # # # </pre> Player html for embedded player to stream video content <iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/310135748%3Fsecret_token%3Ds-Hx2bg&amp;color=ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false" frameborder="no" scrolling="no" width="100%" height="166"></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource sound recording - nonmusical interviews Date A point or period of time associated with an event in the lifecycle of the resource 2006-07-14 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/158ws emory:158ws Subject The topic of the resource CDC Smallpox Eradication Life as expatriate wife USAID WHO Format The file format, physical medium, or dimensions of the resource 753573744 bytes audio/x-aiff Creator An entity primarily responsible for making the resource McNutt, Kathryn (Interviewer); Rollins School of Public Health; Graduate Student Olsen, Carolyn (Interviewee); CDC; Wife of Operations Officer Contributor An entity responsible for making contributions to the resource Centers for Disease Control Reunion of West and Central Africa Smallpox workers (2006 : Atlanta, Georgia) Title A name given to the resource OLSEN, CAROLYN Description An account of the resource Carolyn Olsen recalls life as an expatriate in Monrovia, Liberia in the period of 1966-1970 while her husband, Dennis Olsen, served as Operations Officer. Carolyn talks of taking a job as a teacher in Monrovia, expatriate social activities, and daily life living in Monrovia. Carolyn also briefly compares life with the smallpox program in Liberia to their later posting in India. Language A language of the resource English https://www.globalhealthchronicles.org/files/original/d9d3344841f7ee1e31cbf1119e18815e.jpg b119c483da7ce5e9c4aff054054e1608 https://www.globalhealthchronicles.org/files/original/b9b13dc7be656fa4160662dd5f22a075.pdf 9d00fbcda7d3d95f10ace91b05468fde Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Smallpox Description An account of the resource <div class="landing"> <p>Smallpox disease was declared eradicated in 1980, the result of a collaborative global campaign. To date, it is the only disease affecting humans to be eradicated from the world. Global eradication of smallpox ranks among the great achievements of humankind. Gone, through determined human effort, is a disease which has brought death to millions, frequently altering the course of history, and traveling through the centuries to every part of the world.  </p> <p>The vital contributions made by the Centers for Disease Control and Prevention are highlighted. Official government correspondence, meeting transcripts, policy statements, surveillance reports and mortality statistics tell a part of that story. Adding depth to these traditional archives are the personal stories of the public health pioneers who worked tirelessly on the frontlines of the smallpox eradication campaign.</p> <p>The links above connect you to a database of oral histories, photographs, documents, and other media.</p> <p>Use of this information is free, but please see <strong>“About this Site”</strong> for guidance on how to acknowledge the sources of the information used</p> </div> Moving Image A series of visual representations imparting an impression of motion when shown in succession. Examples include animations, movies, television programs, videos, zoetropes, or visual output from a simulation. Transcription Any written text transcribed from a sound. <pre><strong> Interview Transcript </strong> INTERVIEW Audio File: Dennis Olsen Audio File Transcribed: January 24, 2009 Melissa McSwegan: This is an interview with Dennis Olsen on July 11th, two thousand eight at the Centers for Disease Control and Prevention in Atlanta, Georgia about his role in the smallpox eradication campaign. The Melissa McSwegan is Melissa McSwegan. With this interview we're hoping to capture for future generations the memories of participants and their families involved in eradicating small pox. This is an incredibly important and historic achievement and we want to hear about your experience. I have some questions to guide you but please feel free to recount any special stories or anecdotes that you remember about events or people. The legal agreement you signed says that you are donating the oral history to the U.S. Federal government and it will be in the public domain. Now, for the record could you please state your name and that you know you are being recorded. Dennis Olsen: My name is Dennis G. Olsen and I know that I'm being recorded. Melissa McSwegan: Okay, great. Thank you. So to start out with could briefly describe your childhood, your college education and how that led into you working in public health? Dennis Olsen: Well, I grew up in Bend Oregon and all of my pre-college schooling there. Went off to the University of Oregon then for my college work and I can honestly say that none of that prepared me for a role in public health. My first inclination to be involved in public health was through the University of Oregon placement service where I met a CDC colleague E. J. Spike and I was recruited at the CDC and spent thirty two years with the organization. Melissa McSwegan: Okay. Well great. Well how did you then become involved with the smallpox eradication [inaudible 01.53]? Dennis Olsen: I was first recruited to come back to Atlanta out of my assignment in Los Angeles California to actually be involved with the early malaria eradication effort and as the politics of that were working their way through Washington and it was determined that what the plans had been were not going to come fruition, I was contacted to ask if I wanted to go to West Africa for smallpox eradication. Agreed to do that, got married to my lovely wife and off we went to the country of Liberia and spent three years there. After returning from that we knew then eventually that the Indian program was going on and made overtures to be one of the people who went to India for a three month assignment. At the conclusion of that and the enjoyment of that work and the colleagues from around the world and the imminent success of the program I asked if I could go back for a longer term and was - we were accepted and returned for a two year stint and that time I was named the WHO World Health Organization coordinator of the smallpox eradication effort in the state of Uttar Pradesh, a population of about one hundred and ten to one hundred and twenty million people. My role was to assure that the program policies were being carried out, searches were being conducted, that the international staff and the Indian domestic staff that were working on the effort had the resources that they needed to carry out the function, to do spot assessments of the work at the primary health care centers and/or hospitals. Handle largely also to be the banker and make sure all the funds were flowing in the right direction. A very enjoyable experience and I met a lot of interesting people. Besides Uttar Pradesh my wife and I went to Bangladesh for a three to four week period of time to assist in one of the major searches and quite possibly look at an assignment in Bangladesh that they were - they need an administrator and I'm a public health advisor and not a physician. We decided that we're - we appreciated more the Indian aspects of that project and returned to Lucknow and carried out those functions for another, I'm guessing now - six to seven months and then we were reassigned into Delhi in the regional office in order to be the senior administrator for the program for its duration in India and participated with the international commission to declare India smallpox free. So, quite an interesting period of time for us and we really enjoyed the work. Melissa McSwegan: Describe a little bit your relationship with your - with the host country counterparts in India and Bangladesh? Dennis Olsen: On the first assignment, the three month assignment, we were working directly with the - I was assigned to a city in Bihar state or a town called Bhagalpur along the Ganges and our immediate relationship was with the health officer of that town. And the people who had gone before of which there were at least two others possibly three, had developed a strong working relationship so my fitting into that was just a simple as it possibly could be. There was absolutely not difficulty at all. We could work and do what it was that was required, got support to the extent that it was available from the locals and of course a lot of support from Cyro in Delhi. So it was a very easy experience that way. And all of the people, staff for the most part at the primary health care centers had been heavily involved with the effort to eradicate smallpox and participated to the extent that their abilities allowed. There were those times when we had to do a little extra encouragement in some areas and so forth but we still had very strong support of the local health officer and the Indian government from Delhi. Those people made periodic visits to assure that these relationships were maintained and overcame any of the infrequent difficulties that approached. When I became the WHO coordinator in Uttar Pradesh then I worked directly with the Minister of Health for that state and the staff at the other levels in order to carry out the functions. Again these things went very smoothly because of the overall direction of the Indian government from Delhi and the support that they provided to the program and those relationships never got in the way of carrying out the function. That is why I think the program was successful to a large degree. Melissa McSwegan: What would you say would have been the biggest challenge while you were there? Dennis Olsen: That's a hard question. There were - the challenges of first of all motivating the population to report rash like illness. So many other things were impacting on the population. Of course we instituted a reward system, a financial reward system to help with that. The difficulties of just getting around in the country. Not all areas had a road network been established. Quite often those that were established were interrupted for flow of water to farm. Quite often where we had to go roads had never been established so just getting to investigate an outbreak, getting to it was difficult. Getting supplies sometime the area were difficult. Heat, surviving in certain areas was difficult but all of those things could be overcome. It just took a little bit longer to do things than one might have hoped for. Melissa McSwegan: And what do you think - you've talked a little bit about the relationships that you've had and other things that helped it to be very successful but what do you think were the greatest successes that you had during that time? Dennis Olsen: Well the great success was that smallpox eradicated and I think that also a success to show that through a combined effort and the cooperation you could - excuse me - tackle a difficult situation and have some success from it and therefore the encouragement to continue with whatever effort you were in. Quite often we were approached out in the hinterland if you will about doing something for other sets of problems that existed in the country. Something to do with water, something to do with sanitation, to go beyond our scope of work in smallpox eradication to add some assistance or input into these levels. And of course we would report these sorts of requests back through the system but I think our experience and our being on site and the success of the program probably led, I think there is evidence that it did lead to attention being paid to these sorts of circumstances and problems as well and having them attacked when resources and political support were provided. Melissa McSwegan: How did your family adapt to living abroad both in Africa or in India? Dennis Olsen: Well, my wife were together. We don't have children. We're still married so. My wife Carolyn actually was quite involved in the Indian program. Some of the things that I would make recommendations to the central offices in Delhi with technical graphs and so forth that had to do with demonstrating how you could show your project was moving in a certain direction or had these successes or these failures, Carolyn being an engineer and having these kinds of talents put these together. So - and she went with me on the searches out into the field and through her own oral history she'll tell you some very interesting stories from her side but I probably would not have made the full two years if she hadn't have been there. Melissa McSwegan: So, what was it like living in India beyond the working environment, just living in India and participating in the culture? Dennis Olsen: Well, I can tell you from my - I had already been to Africa with that program and so when I thought, not thought but had been accepted to go to India the African situation would prepare me and it was largely true. But I do remember getting off the plane in New Delhi and the heat and the just large numbers of people and the immediate difference with - just an overwhelming humanity kind of thing, I thought what in the world have I gotten myself into. And we had a few days of training in Delhi then we were set out into the field to be with colleagues that had already been in the country two to three months to gain some experience. And I met a good friend Ras Charter in Bareilly who showed me how to get the jeep stuck as soon as you could but did demonstrate how work was done in the field. And then I went off to my assignment and met another CDC person waiting for me in Bhagalpur, Dr. David Hayman who had been there for a couple of months and he was kind of a light yellow. He had hepatitis so I thought well if he can put up with that I can put up with whatever is here. But I - Bhagalpur was a small place in comparison to the capital of Bihar, Patna. Patna was a small place compared to Delhi and I guess the point of this story is when I got back to Delhi after three months it looked like a large European city that I can definitely survive in. That's when - with that successful three months I asked Dr. Henderson - D. A. Henderson - and Dr. Bill Fergie if it would be possible to come back to India for a longer period. And after that longer period both my wife and I asked again if there was some way to stay with an active program be it immunization, diarrheal disease control, malaria, whatever it is that we might do to remain in India because we enjoyed the experience so much. We met a lot of interesting people. The Das family Lucknow. We lived above their residence. The people that we rented from in New Delhi, people in the field, it was just a pleasurable two years. Melissa McSwegan: Have you maintained any of your relationships with people you met in India probably? Dennis Olsen: You know thirty years have passed and I'm not sure how many people are - but the answer to that, short answer to that is not from the Indian side although I understand I will be seeing - we will be seeing a Dr. Dada who was a senior person in the Ministry of Health. He's in town and I look forward to renewing that relationship. We have shared with our CDC colleagues and others over the years when reliving these experiences, honing our lives and things like that. Melissa McSwegan: What would you say are your most memorable moments from working with the smallpox campaign? Dennis Olsen: Oh my goodness. One was going out to the very first smallpox investigation in Bhagalpur with Dr. Hayman. We had to walk through the rice paddies and wade through a river and my shoes were not appropriate. I lost the nails off both big toes, had full foot blisters underneath the - on my bottoms of my feet. Had to have tea and sugar and salts to get the electrolytes up and rode out on a donkey. It was - thanks to Dr. Hayman. Other experiences, I have to take some time to reflect. The international commission we happened to be there at the end of our assignment when they actually the commission came and announced that smallpox was eradicated from India. That was so satisfying to have spent the time and then to actually be there at a moment when history had been made. That will certainly be hard to - I will never forget it. And the others I think were just the individual relationships we made with people. The staff in Lucknow from the secretary to the very important and very good friend paramedical assistant Rujinder Singh. It's just things like that that stick with you and if it ever could happen again would not hesitate at all to do it again. Melissa McSwegan: And how would you say working with this campaign has affected your life and career since then? Dennis Olsen: Well I don't have a career anymore. I retired in nineteen ninety four. Affected our lives is that we're extremely proud that we had the opportunity to do it. I like to think that we did it well and enjoy the relationships that we still have with people that went over and did these sorts of things and days like today when we're back to remember what we all went through. It wasn't always easy. I don't ever want to let people think that it was just all good times and success. We lived in very harsh conditions a lot of the time and we put ourselves in jeopardy many times but just the pride of having done it, the pride of success and listening just this morning to what's happening with global programs. We like to think that maybe we were in a small way part of what allowed these things that now happening to move forward and hopefully enjoy some of the success that we had. We did the pioneer work they live to say. Melissa McSwegan: At what point during the program while you were working on it, at what point did you know that smallpox would be eradicated? Dennis Olsen: The day they announced it. Melissa McSwegan: So you weren't convinced until then? Dennis Olsen: Well you know you always wait for the next person to come forward and say we have a report of rash like illness. And you might have gone for six or seven months or a year and think you know this is pretty much it, we're sort of wrapping so it can happen. When I left Liberia in the African program we were sure for a whole year that we had not smallpox, quite successful and then someone came down from upcountry and said we have a woman and child in the hospital with rash like illness that looks like smallpox. So, when I - my wife and I were just ready to leave the country. Our assignment was over and my replacement had arrived so the same thing could have happened in India. As it turned out the African issue was monkey pox not smallpox but once they made the announcement in India we had assurances after many, many searches that there was no illness, no smallpox. Of course the search went on for anther couple of years to continue to assure that. It really didn't end at that point. It was the point where we said that we had reached that particular part of the goal but we had to confirm it again. Melissa McSwegan: What were the important lessons that you learned from smallpox eradication that you then applied to other parts of your career afterwards? Dennis Olsen: Well, the career after that was some domestic program work in childhood immunizations, then international work in HIV Aids and some work with international immunizations, diarrhea disease control and malaria control. For the international things what was learned was how to deal in an international setting. What things had to be attended to, to allow the program to have some success in the relationships that you needed to develop with the host country. How important it was to assure that you had the proper logistics before you tried, got the plan established and the logistics to carry it out and the resources to carry it out. And the important, very important tools of assessment. Continuing to look to see where you were along the road to trying to achieve your objective. Not just assuming you were doing okay but actively making sure from tools to asses your program activities and a personal relationship skills were honed I think. How to make sure that you were for example whatever credit might be accruing that you made sure it was the local that got the recognition. We knew we were doing okay, we didn't need to be told. So those kinds of things. I think those are always helpful. They are the more mundane things about improving your writing skills and these sorts of things but I think I touched on the more important. Melissa McSwegan: Now you have spoken a lot about the successes of the program. If you had been the one running the entire program worldwide is there anything that you would have done differently, that you would have changed about it? Dennis Olsen: No, I don't think so. How can you fight with success? You know I never ever thought of myself having those kind of capabilities. When you work for someone like D.A. Henderson, Bill Fergie, those are the people that have those visions and skills and at that level it's just a happy occasion that we got to be able to be a part of it. I can't think of anything I would change. Melissa McSwegan: Well do you have anything else that you would like to add about your experience? Dennis Olsen: No, I think we've pretty much covered the territory. Melissa McSwegan: All right. Well, thank you very you much for your time and I appreciate you sharing with us your experience in India. Dennis Olsen: Thank you very much for doing this. </pre> Player html for embedded player to stream video content <iframe width="560" height="315" src="https://www.youtube.com/embed/vMgriQjaR74" frameborder="0" allowfullscreen></iframe> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Type The nature or genre of the resource interviews moving image Date A point or period of time associated with an event in the lifecycle of the resource 2008-07-11 Identifier An unambiguous reference to the resource within a given context http://pid.emory.edu/ark:/25593/16rjx emory:16rjx Format The file format, physical medium, or dimensions of the resource 4643160000 bytes video/x-dv Creator An entity primarily responsible for making the resource McSwegin, Melissa (Interviewer) Olsen, Dennis (Interviewee) Contributor An entity responsible for making contributions to the resource Centers for Disease Control Title A name given to the resource OLSEN, DENNIS Description An account of the resource Dennis Olsen describes his experiences as a CDC Operations Officer and Manager in the Smallpox Eradication Program in India 1972-1974. <br />Interviewed by Melissa McSwegin. Subject The topic of the resource Smallpox Eradication WHO Language A language of the resource English