In 1975, a female African American doctor journeys to rural India to help stamp out the last vestiges of smallpox on the planet. Cornelia E. Davis MD, was a pioneering African American woman doctor fresh out of pediatric residency. The World Health Organization hired Davis to work in its landmark smallpox eradication program. Davis traveled to India, where she scoured the countryside for the last remnants of the brutal, deadly disease. Connie didn’t allow entrenched sexism, or caste taboos to deter her from her fascinating mission. She tracked smallpox through the Thar desert on camelback and across volatile Indo-Bangladeshi borders. She negotiated with smugglers and fakirs. She met Mother Theresa. She climbed to the base camp of Mount Everest. Finally, her symbolic search for Sitala Mata, the Hindu smallpox goddess, came to a positive conclusion. An international certification team declared smallpox eradicated in India. To this day, smallpox is the only disease that’s been completely wiped out. Davis played a role in stopping a pestilence that’s dogged humanity for thousands of years. Searching for Sitala Mata is the story of how one brave woman’s simple desire to pay it forward had historic and positive ramifications worldwide.
What are the odds of traveling from California to a remote area of West Bengal and finding one of your clothing items your Mom had given to charity? Second hand clothes are sent all over the world. What is the likelihood of meeting up with something you used to own? All I can say is that I was overjoyed to find my old shirt and to have it to wear again in India.
The system of purdah really frustrated me in India. Seclusion in the end is isolation. And isolating anyone, not to mention potentially half the population, really is limiting. Yet, if you are looking for smallpox cases, who would be taking care of sick persons at home? Right, it's women! There is this idea that you are "protecting" women. Currently in the news in India now the headlines show how unsafe it is for women in both the urban and rural areas to move around. Yet women are being targeted, kidnapped, raped, threatened to not report the crime, and lack of support by the Police to do their job and bring the men to justice. Now my team was very protective of me, especially since in those days it was extremely rare for a solo woman to be working outside the home. I realize that I was "privileged" in being a foreigner, and in working for WHO. And the expat woman was treated as a third sex. I was given the status of a male and was listened to and obeyed. But I realized I moved confidently in my work and I was able to convince village elders and other leaders that they needed to do the right thing. But women everywhere need to be treated equally!
On the occasion of Mother's Day, I was reflecting on the above statement about the need to take risks sometimes. I'm not talking about taking stupid, dangerous risks with no thought to the possible outcome. But I took a number of risks going to India in 1975 to work on smallpox. I knew the culture was very different, and that I would have to work on my own to solve problems. I knew that as a women and as a black American in India I would face problems. But I wanted to take up the challenge. It's important to get out of your comfort zone. I knew I was going against orders to investigate fever and rash cases across an international border. But I didn't want smallpox to re-enter the district that had been free of smallpox for nine months. I needed to know what illness we were dealing with in order to provide the correct control methods. So my question is-- what would you do in the same situation?
We had instructions from WHO about what to do if we accidentally hit either a child or a cow. We were not to stop but to go immediately to the nearest Police Station. I never liked those directives. It seemed we could save a life if we just picked up the child and went to the nearest health center. Killing a cow takes away the livelihood of a family. And although the Police told me that the cow should have been tied up, it didn't take away my guilt. So although my driver was adamant that it was dangerous to stop, I ordered him to do it. Sometimes you have to follow what you know to be the right thing to do. And fortunately, the cow wasn't dead! I slept well that night.
Wherever you have collections of workers living closely together you have the right criteria for transmitting a infectious disease. Managers usually gave you permission to talk to their workers once the work was done. Once the tea leaves are picked there is a short time to dry and process the tea. Darjeeling tea is known the world over but I found it odd that I could not find any tea to buy in Darjeeling town. The manager explained that because of its quality and taste, Darjeeling tea is mostly exported to other countries and sold for a high price. Therefore, most of their tea was immediately shipped to Calcutta!
After coming down with diarrhea from drinking water in Calcutta, I went up to Darjeeling to regain my strength for a week. The first thing on my agenda was to see the sunrise on Tiger Hill! I arranged to take a taxis with some tourists from the hotel. It was pitch black when we left at 3:30am. and freezing! But luck was with us. No fog or clouds obscured the view. As the first rays of sun hit the mountain, it was truly magical as i captured the changing hues of light. I made a vow then and there, to climb to the base camp of Everest when I got some vacation. I mean, how could I come this far and not go to Everest!
All the time I worked in India I always had a difficult time finding clean water to drink! There was no bottled water in 1975. When I had control of where I lived, I always boiled it for 15 minutes. You stayed in "good" hotels that boiled water and placed it in a thermos. So I was livid that the room boy was taking a short cut that would seriously affect my health! I had no time to complain because I had a cab outside and was heading to the airport. I barely got back to Jalpaiguri in the north before all Hell broke loose. I was seriously ill for the next three days with Shigella diarrhea and lost 15 pounds. But I survived and never had an episode of diarrhea again in India during the rest of my stay.
I was excited to get my first letters from home. Since no one knew where I was actually, the letters were sent to WHO/ New Delhi and they figured out how to send them to me. And the regional epidemiologist from Delhi hand carried the letters. Mom included the names of some friends of friends to look up in New Delhi. Well, I guess she didn't know that I wasn't in Delhi but closer to Calcutta. But even if I was in Delhi, she sends no address, no telephone number (of course then, no cell phone). How did she think I was to find these Americans? So you won't believe how I ran into the Gartenbergs in Calcutta.
I'm in my first regional meeting of smallpox and I'm ordered to write home. The irony was that I wrote weekly letters home ever since I studied or worked overseas. It always calmed the parents. However my letters were not getting home. I found out several months later that a pile of letters arrived at the same time in California. Each letter had been "censored" with names of localities blacked out by markers! I knew I worked in a sensitive part of India next to Tibet and Nepal but I couldn't believe that somehow the government waylaid my letters, read and censored them, and then sent them on their way? Incredible!
I was arriving from the airport in Calcutta heading for my hotel. Up ahead there was a problem with a yellow cab similar to my cab. In the space of a second there was a mob of about 100 people yelling and screaming. The mob gathered so quickly you didn't have time to react. I always thought Indians were so docile until you see mob violence. And it was then that I understood WHO telling us not to stop for an accident but to go straight to the police station and report it. You would not be able to reason with a mob!! #memoir, #womeninmedicine, #smallpox
I was really worried about smallpox being re-imported into India from Bangladesh which at the time had hundreds of cases. And with my three districts I had a 600 kms border with Bangladesh. It seemed hopeless to try and keep smallpox out. But if I could vaccinate anyone coming into India, then we might stay safe. But I was worried about the safety of my vaccinators. I needed to meet with the Chief Smuggler but how to do it? We put out the word in the tea stalls but I didn't think I would hear anything. Boy was I surprised to get contacted. I hadn't thought about how safe it was for me to talk to the smugglers!
I had passed these two men on walking through the veranda but they didn't give me a second glance. I thought to myself, I bet Delhi didn't tell them I was a woman! I only found out much later that I also didn't meet two other criteria that had been specified. Oh well, welcome to India!
Originally, I was supposed to report in to the Calcutta office before heading to my rural districts. But I needed to overlap with the outgoing epidemiologist. In those days, there were few banks in the rural area. So you had to carry large amounts of cash in small rupee notes. I hadn't thought about the fact that I didn't have money until Heymann arrived. Carrying a lot of money makes you feel like a thief even if you're not! What was I going to tell airport security if they asked me how I got all this cash?
All the male doctors in our training were going to Bangladesh where there were thousands of cases. I didn't want to stay in India and only investigate chickenpox cases! But clearly the Bangladeshi program was not going to accept a woman. But I also suspected that because I was a woman, in India they would post me to a capital city. Cities are very different from the rural areas. I didn't want to go to Calcutta! Be careful what you wish for- you just might get it! I didn't realize how difficult the rural areas would be!
Every junior epidemiologist led a team composed of themselves, a driver, and a paramedic. The paramedic spoke the local language and English. The jeep made us mobile and able to track down rumors of rash and fever cases. I had money to hire smallpox vaccinators if necessary. At the time I arrived, most health workers had not been paid for six months because the State had difficulties. And more importantly, I had money to pay villagers for just reporting a rash and fever case! Sitala Mata, the smallpox goddess was on notice. We were hunting her down.
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