May 16, 2010
Smallpox Eradication – 30th Anniversary Celebration
On Monday, May 17, 2010, a statue will be unveiled at the World Health Organization headquarters in Geneva, in honor of the thirtieth anniversary of the certification of smallpox eradication. The last wild case of smallpox actually occurred in Somalia in 1977, though the last actual case (and death) occurred in 1978 because of a laboratory leak in the UK. WHO waited until 1980 to certify that the hideous disease was truly eradicated.
Smallpox, which had an enormous impact, afflicting people from Egyptian pharaohs to modern times, was a scourge that disfigured and killed millions – probably billions. The campaign to rid the world of this virus (except in freezers where it is kept for study) is a shining example of how coordinated global effort can have a lasting impact.
I documented the involvement of Epidemic Intelligence Service officers in the smallpox eradication effort, particularly in West Africa, India, and Bangladesh. EIS officers and other international epidemiologists were vital to the endgame in Asia in 1975. One chapter of Inside the Outbreaks, “Target Zero,” documents that incredible time. Here is the final section of that chapter:
The Legacy of Smallpox Eradication
Epidemic Intelligence Service officers always relied heavily on people around them. Nowhere was that truer than in the smallpox eradication effort. Epidemiologists from all over the world deserve credit for the success of the effort, but the greatest heroes were the Indians and Bengalis who devoted themselves to the cause.
It was not always easy for EIS officers to return to normal American life after the intensity of smallpox eradication. The urgency of their task and the immediacy of the results were addictive, and it gave them a perspective on what really mattered. “It was a very humbling experience,” Wilbert Jordan recalled. “It made me appreciate what I had. I made myself a vow that if I ever got back to America and heard myself complaining, I would kick myself in the ass.”
But it was also jarring to return and be treated like a regular person. “I was a superstar in India,” Jordan said. Wynn Hemmert had reverse culture shock when he came home to his wife and two small children. “I was sort of a sick stranger for a while. My wife looked at me, obviously thinking, What happened to you?”
Mostly, though, they came back with an overwhelming feeling of pride and accomplishment. “It was almost a religious experience,” Walt Orenstein said. “It was so dramatic to see the disfigurement, the dead children, and to know you were getting rid of it.” For Rick Greenberg, “Everything else in my life goes back to this moment in India, what we accomplished. It was a wonderful thing. You almost felt the earth should have stopped.”
Many veterans of the smallpox eradication crusade went on to become leaders in the world of public health. They brought a self-confident, can-do attitude, a refusal to accept that anything was impossible, a sublime impatience with stodgy bureaucracy or indifference to suffering. “We were cocky and arrogant, we smallpox warriors,” Stan Music said. “We became tough to deal with sometimes. We knew you could overcome any obstacle if you just pushed hard enough.”
Sometimes that pushiness in India and Bangladesh amounted to intimidation and coercion. “We overstepped,” Steve Jones admitted. But the crusaders were, after all, trying to save lives, trying to rid the world of an ancient scourge. A few years later, Bill Foege called smallpox eradication “an incarnation of Gandhian ideals” which led to “non-violent social change [and] a better world.”
D. A. Henderson summarized his approach to supervising field epidemiologists: “Give them running room, some support, and some back-up. Ask them questions, make them think about what they are doing, but by God give them the room to move, then you have great things happen.”
Don Francis, writing back to his colleagues about his 1973 smallpox eradication efforts in Sudan, wrote about qualifications an EIS officer should have. “I think what the EIS course teaches us all is how to fly by the seat of our pants and come out on top. Just give all graduates a bit of baling wire, a piece of bubble gum, and a slide rule, and send them off.”
In addition, officers should know how to repair Landrovers and learn foreign languages. “Tolerance must be part of the curriculum” – tolerance for eating raw camel’s liver, incredible heat, horrible roads, and cultural differences. Add to that “the ability to enjoy something in all this chaos,” including scenes of great beauty, wonderful people, and “finally seeing one of the most wicked diseases disappear from the faces of children.”