Living Longer

Interview with Zafar Husain
Smallpox Campaigner, India

Zafar Husain Q: How did you begin your work against smallpox?

Husain: When the smallpox eradication program started in 1961, I was working in Moshangabad as a paramedical assistant. I then went to work in other districts of Madhya Pradesh. I found areas badly affected with smallpox.

Q: Were there many?

Husain: I saw the beginning of the disease when I came into this job, and I saw the end as well. Because earlier there was no importance. I mean, when I joined this service, there was no reporting of smallpox. It was common that the cases were not reported.

Q: Then how did you find cases of the disease?

Husain: I will give you an example. In January of 1974 it was decided to try to find the whereabouts of smallpox cases during Shankaradri Fair -- organized on the banks of the Narmada River. So Dr. L. B. Bland and I, along with a team of 10 or 15 doctors, went to the Fair. There was a gathering of between 10,000 to 15,000 people. Initially there was no incentive for people to tell us about the cases. Dr. Bland and I pondered over an action plan.

It was decided to fix a reward of ten rupees to anyone who would tell us about a smallpox affected village.

Because of this reward system, many villages were detected. Martala and Hua were two villages which were badly affected. Palibilag was another -- in fact, the entire Shehdol district was badly affected. Therefore, I was assigned one - Palibilag - and was asked to initiate search and containment.

Q: Why would you need to offer a reward for information about such a deadly disease?

Husain: People used to hide the cases. They thought the goddess would get angry. This was the main difficulty.

We used to ask them, "Why do you think this does this not happen in other countries? Why is it here, only? Actually, this is a disease. It can be eradicated. This is a disease, not a goddess." From the beginning we were faced with this problem.

Q: Is this difficult work?

Husain: Whatever work was done in the smallpox eradication program was mainly done by vaccinators and supervisors. These people played the main role, and they worked day and night.

Indian workers did commendable work under the guidance of national and international officers. I can say that not even once did anyone refuse. Whenever they were asked -- even if at night -- they went.

Indian workers made the program a success, and that is why smallpox could be eradicated. Everybody worked together. The state cooperated; the Indian government extended its cooperation. Our international guests also guided us and worked with us. It was a time when -- from the lowest to the highest position -- everyone was busy with the eradication program.

And they never considered themselves... they said we were all equal. The whole team worked together. I have worked with people from 30 countries. I believe that everyone made it into a miracle.

Q: What was your basic approach to eradication?

Husain: I told you that when the pilot project was started, mass vaccination was carried out. But mass vaccination was not as useful as the search program. WHO took up the policy of search and containment. Vaccination was being carried out in schools and other places, but the enemy, the real target, could not have been detected without a search.

Wherever cases were detected, containment followed. At that time, all the nearby places around the radius were vaccinated. The whole village was vaccinated, so that the infection would not spread. Whenever a case was located, infection was contained. When the last scab shed, the infection was eradicated.

Q: How did smallpox end in India?

Husain: When the last village in Bihar was reported, Dr. Sharma (who was in charge of India's smallpox eradication program) said to me, "Mr. Zafar, because you are a trainer of doctors, you should go and confirm that it remains the last village, and the last case." This was said in a challenging tone.

I went to Pachera village in Bihar. Our team from Madhya Pradesh came along with me and we did search and containment in the entire village. A girl named Manju became India's last indigenous case on the 15th of May 1975. I felt that no one should come in contact with her so that the infection did not spread. According to smallpox eradication theory, the patient should be kept under surveillance by a watchguard so that no one goes in and no one comes out and no one comes in contact with the patient.

So, I spent 15 days in her house. I used to sleep in the verandah on the floor and whatever was given to me was my only meal. It was a very small village, and a difficult one.

The last scab, which was on her right leg, shed in front of me. That is the reason I stayed there for 15 days. And when the scab shed, I destroyed it. I was now assured that the infection would not spread.

Q: Your job evolved from fieldwork to training others...

Husain: Yes, although during my training in Randu, I said that I would not take up briefing. Dr. Bland came to me in the morning and said, "Mr. Zafar, how many villages can you visit? If you will brief everyone, there will be a Zafar everywhere. Therefore, you should train everyone. Whosoever comes to Bihar to work will be trained by you."

I really liked what he said -- that I alone will do the briefing everywhere. I was the only trainer. I gave practical briefings to medical staff and visiting epidemiologists also, because they had never seen smallpox. They had only read about it in the books. I used to take them to the affected villages and show them the cases.

No junior medical officer or paramedical officer could pass without coming in contact with me.

Q: What was the situation in Pawapuri?

Husain: We saw a terrible epidemic there. Pawapuri is a very important place where people come from all over India. It is a Jain pilgrimage. There again I was a trainer, and I took my team along with me. Dignitaries from all over the world had come to see it. Among them were Dr. Sensor from Atlanta, and Dr. Freggie, as well as the Commissioner. All of them came to see how Pawapuri was being contained. Within 15 days we were able to contain Pawapuri.

Q: What other sorts of difficulties did you encounter?

Husain: Along with Pawapuri, we approached other nearby villages where people avoided vaccination. Vaccination was very difficult in a village of Chaibasa district. Dr. Bland said, "Mr. Zafar, you have got to vaccinate that village."

I started to vaccinate a woman, she was so angry she spat in my face. I didn't say a word. But the other people in the village got very upset by her behavior.... [but] later on everyone in the village was vaccinated.

Such were the difficulties we had to face. There was also a community where the people did not like anything to touch their bodies. It was a very difficult area.

Q: Do you feel this disease has been permanently eliminated?

Husain: I hope this disease will never return. I would like to say that if there is a scab of smallpox preserved either in America or Russia, it should be destroyed.

All the children up to the age of 14 to 15 are unvaccinated in this world; that is, for the past 14 to 15 years, no vaccinations have been carried out -- which means those children are unprotected. If somehow the infection comes up, it can spread like fire.

So nothing should remain. The virus should not remain anywhere in the world. In the end, I wish that till the end of this world this disease does not come back-that it never returns.

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