Episodes
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Dr. Ciro De Quadros tells us here about the lessons that the global smallpox eradication programme can provide to the present-day global polio eradication initiative. In this regard, De Quadros underlines the importance of using information coming in from the field in order to re-organize local projects; operational adaptability was crucial to success and this is a lesson that managers of all public health projects should keep in mind.
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Dr. Ciro De Quadros tells us here about the fears surrounding the use of smallpox – and polio – vaccines. Religiously informed resistance was localised in specific regions and communities, and was not over-arching in character; De Quadros highlights the importance of accessing interpreters fluent in local languages.
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Missing episodes?
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Dr. Ciro De Quadros tells us how an outbreak area would be identified, how members of local communities would be employed by the WHO to keep up effective isolation by guarding houses where smallpox cases were confined and how efforts were made to control travel from affected areas.
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Dr. Ciro De Quadros describes here the difficulties of working in the highlands of Ethiopia, as well as the form of civilian resistance to smallpox eradicators. He also tells us how WHO teams worked closely with all parties in localities, including Eritrean guerrillas who were fighting for the formation of an independent country.
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Dr. Ciro De Quadros tells us here of political difficulties in specific localities in Ethiopia, which made fieldwork very difficult – he underlines here the importance of developing a better understanding of local political and cultural factors. De Quadros also talks about the last Ethiopian case in the Ogaden desert region, which was largely populated by nomadic communities that did not respect national borders as they were drawn on official maps; this, he argues, caused difficulties in investigating – and reporting on – trans-national importations.
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Dr. Ciro De Quadros describes the ways in which cases were identified and reported in Ethiopia, and how the target of surveillance changed over time.
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Dr. Ciro De Quadros tells us about 1974, which brought on what he terms a ‘period of transition’, as well as the important and careful negotiations with the Ethiopian government. He describes how an expansion of WHO assistance to the Ethiopian smallpox eradication programme allowed for the employment of large numbers of local workers, who filled the gaps left by departing American ‘Peace Corps’ members.
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Dr. Ciro De Quadros describes here the challenges faced in mapping the incidence of smallpox in Ethiopia, the hostility of the managers of the malaria eradication programmes in the country, the role of the American ‘Peace Core’ corps in developing a better idea of the source of outbreaks and, not least, the WHO administrators’ role in developing a national chapter of a global smallpox eradication programme.
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Dr. Ciro De Quadros provides us with a description of Ethiopia in the 1970s. Apart from describing the political, social, administrative, geographical and economic conditions in the country, he also tells us about the national and local health infrastructure.
