Sometimes Brilliant by Larry Brilliant

Author:Larry Brilliant
Language: eng
Format: epub, pdf
Publisher: HarperCollins
Published: 2016-09-11T16:00:00+00:00

CHAPTER 13

Tales of the Jungle

We are all faced with a series of opportunities brilliantly disguised as impossible situations.

—Charles Swindoll

We returned to the capital of India, alive with parades and pageantry, the celebration of the twenty-fifth anniversary of modern nationhood for this ancient land. It was the 26th of January, 1974, and for Republic Day posters and banners honoring the accomplishment were tacked to nearly every tree along the road in New Delhi from the Palam airport to our little barsatti in Jor Bagh.

There were no celebrations at WHO, however, when I arrived to work the next morning for a very somber status review. D. A. Henderson and Isao Arita had flown in from Geneva to meet with the Central Team. Everyone had been working themselves ragged; they were all gaunt and sick. The office looked like a hospital ward: shingles, pneumonia, various tropical infections, and now I added my damaged neck. Nicole had been suffering through kidney stones, an occupational hazard for many of the foreign epidemiologists who faced a Hobbesian choice between drinking contaminated water or dehydration, which could precipitate kidney stone attacks.

D.A. reported on the global smallpox situation, and said pretty much only the Indian subcontinent stood in the way of eradication, at least for Variola major, the form of the disease that was called killer smallpox. Bill brought everyone up to date on India. Three of the four hyperendemic states had undergone three rounds of searches. Madhya Pradesh had started late due to a prolonged monsoon. With each successive search, fewer and fewer new cases were found. Those that we did find were discovered much sooner, preventing spread and limiting the size of outbreaks to a handful of cases. However, each month several previously hidden enclaves of the disease were reported. These new foci of disease were just where we might have expected them: in the poorest and most remote communities, the most vulnerable, the places farthest from the reach of government and the public health staff.

The main topic of concern at the meeting was whether these foci were the last dying embers of the great epidemic or something new to worry about, an unending stream of new disease in a country with more than one thousand dialects and niche cultures and tribes. Our fear was that the cynics would be proved right and the problem of India indeed would be unsolvable, being a perfect storm of complexity, poverty, and bad governance that would wear out the world’s patience. One hundred and fifty countries were smallpox-free. Three of every four human beings sick with smallpox now resided in India. Our Indian colleagues bore the weight of these statistics, especially M.I.D. and Mahendra Dutta, who seemed to feel most of the awesome weight of responsibility for their country while it contained the last dangerous foci of smallpox on earth.

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