short, I drove to Lagos one day with another CDC team member and a plan. We needed some jet injector parts. Requesting these was not likely to be a problem since they were maintenance items, not supplies. In the meantime, we could learn how the warehouse system worked and get to know the warehouse security people. As it turned out, during our visit, one of us kept the security person engaged in trying to find specific items while the other person was free to quietly and furtively acquire essential supplies. We loaded the white Dodge pickup with vaccine, diluent, cold boxes, cold packs, jet injector parts, and anything else we thought we would need to continue the campaign. We now had a truck full of the items that the Nigerian federal government had denied usâand we were scared.
A more direct approach might have been to bribe a security person. But including one additional person in the plan might have caused it to unravel, and there would be no second chance. Indeed, we decided not to even inform the CDC supervisor in Lagos, in case his work would be compromised if it ever came to light that he was aware of our activity. While I always suspected that he was aware of and understood the importance of our actions, the approach of simply taking what we needed is still sufficiently distasteful that in the forty years since then I have never discussed the event with him.
By midmorning my colleague and I were on our way back to Enugu, and we were more than nervous. We didnât even stop for food, as we imagined that shortages had been discovered by now and a posse had been formed to bring us to justice. Every vehicle approaching from behind was a source of fear.
In truth, no one even noticed. Months later, our supervisor mentioned some difficulty the federal smallpox program was having with its inventory. If this was an attempt to get us to open up, it did not work. I continued to believe that he supported our effort by keeping quiet.
We made it to the Onitsha Bridge, still several hours from Enugu, just as it was getting dark. The Onitsha was the only bridge across the Niger River for the entire western border of the Eastern Region. If we couldnâtcross there, we would have to drive more than one hundred miles north to take a ferry across the river.
We found the bridge blocked with bulldozers and trucks. The people of the Eastern Region were worried about a federal invasion from the west. We drove up to the bridgeâs entrance and asked the guards if we could speak with the commanding officer. They referred us to their superior, and up the chain of command we went, finally getting to a person with the authority required. We explained our situation and that we needed to get back to Enugu in time to refrigerate the vaccines. The commander asked his men to move the vehicles enough so we could pass, and we were able to wind our way through the roadblock and continue on to Enugu, arriving after midnight.
Hindsight brings clarity. In retrospect, obtaining those supplies from the warehouse in Lagos looms as one of the essential actions in a decade of events leading to smallpox eradication worldwide. In the extended chain of events from success in surveillance/containment in Ogoja province to the interruption of smallpox transmission with the help of this strategy in Africa, India, and elsewhere, perhaps no link in the chain was as precarious as proving that surveillance/containment could work as the primary strategy for an entire region. This happened in Eastern Nigeria, thanks to adequate supplies.
WAR LOOMS
Through the first half of 1967, the smallpox team in Eastern Nigeria identified every outbreak of smallpox in the region and contained each one in turn. We were now confirming, through what amounted to additional fieldtesting, that the theory of vaccinating only those who were at immediate risk of exposure was sound. However, the strategy was new, and we were still unsure about how large an area of vaccination
A more direct approach might have been to bribe a security person. But including one additional person in the plan might have caused it to unravel, and there would be no second chance. Indeed, we decided not to even inform the CDC supervisor in Lagos, in case his work would be compromised if it ever came to light that he was aware of our activity. While I always suspected that he was aware of and understood the importance of our actions, the approach of simply taking what we needed is still sufficiently distasteful that in the forty years since then I have never discussed the event with him.
By midmorning my colleague and I were on our way back to Enugu, and we were more than nervous. We didnât even stop for food, as we imagined that shortages had been discovered by now and a posse had been formed to bring us to justice. Every vehicle approaching from behind was a source of fear.
In truth, no one even noticed. Months later, our supervisor mentioned some difficulty the federal smallpox program was having with its inventory. If this was an attempt to get us to open up, it did not work. I continued to believe that he supported our effort by keeping quiet.
We made it to the Onitsha Bridge, still several hours from Enugu, just as it was getting dark. The Onitsha was the only bridge across the Niger River for the entire western border of the Eastern Region. If we couldnâtcross there, we would have to drive more than one hundred miles north to take a ferry across the river.
We found the bridge blocked with bulldozers and trucks. The people of the Eastern Region were worried about a federal invasion from the west. We drove up to the bridgeâs entrance and asked the guards if we could speak with the commanding officer. They referred us to their superior, and up the chain of command we went, finally getting to a person with the authority required. We explained our situation and that we needed to get back to Enugu in time to refrigerate the vaccines. The commander asked his men to move the vehicles enough so we could pass, and we were able to wind our way through the roadblock and continue on to Enugu, arriving after midnight.
Hindsight brings clarity. In retrospect, obtaining those supplies from the warehouse in Lagos looms as one of the essential actions in a decade of events leading to smallpox eradication worldwide. In the extended chain of events from success in surveillance/containment in Ogoja province to the interruption of smallpox transmission with the help of this strategy in Africa, India, and elsewhere, perhaps no link in the chain was as precarious as proving that surveillance/containment could work as the primary strategy for an entire region. This happened in Eastern Nigeria, thanks to adequate supplies.
WAR LOOMS
Through the first half of 1967, the smallpox team in Eastern Nigeria identified every outbreak of smallpox in the region and contained each one in turn. We were now confirming, through what amounted to additional fieldtesting, that the theory of vaccinating only those who were at immediate risk of exposure was sound. However, the strategy was new, and we were still unsure about how large an area of vaccination
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